Monocortical mandibular bone grafting for reconstruction of alveolar cleft.
OBJECTIVE
To assess and develop a monocortical mandibular bone grafting procedure for reconstruction of alveolar cleft.


METHODS
Prospective study.


METHODS
Hokkaido University Hospital.


METHODS
Forty-two consecutive Japanese patients who had been treated for a total of 48 clefts according to a strict clinical protocol. Mean age at bone grafting was 6 years 11 months.


METHODS
Bone grafting was performed by harvesting lateral cortical bone plates from the symphysis and/or body and then placing them on the labial and palatal openings of the alveolar process defect. No particulate bone grafts were packed into the bony cavity. Mean follow-up after bone grafting was 37 months.


METHODS
Status of the grafted area and eruption of cleft-adjacent teeth were assessed prospectively using computed tomography and periapical radiography.


RESULTS
At 6 months postoperatively, computed tomography showed sufficient bone bridge formation at the cleft site in 85.4% of clefts. Periapical radiography showed ≥75% of the root surfaces of cleft-adjacent teeth were covered with spanning bone in 83.3% of clefts. In 92.6% of clefts in which the cleft-adjacent canine was uncovered with bone during follow-up, the canines erupted spontaneously.


CONCLUSIONS
Monocortical mandibular bone grafting appears extremely effective for sufficient bone bridge formation and facilitation of cleft-adjacent teeth eruption. The procedure is advantageous in that the quantity of bone required per unit volume of cleft defect is relatively reduced, and larger clefts can thus be treated.
Mikoya
Tadashi
T
Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan. mikoya@den.hokudai.ac.jp
Inoue
Nobuo
N
Matsuzawa
Yusuke
Y
Totsuka
Yasunori
Y
Kajii
Takashi S
TS
Hirosawa
Tomoyuki
T
D064728:Alveolar Bone Grafting / Q000379:methods*; D064592:Autografts / Q000637:transplantation; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery*; D003481:Cuspid / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D010012:Osteogenesis / Q000502:physiology; D011446:Prospective Studies; D016300:Radiography, Bitewing / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014078:Tooth Eruption / Q000502:physiology; D014095:Tooth, Impacted / Q000209:etiology; D060053:Transplant Donor Site / Q000601:surgery; D016896:Treatment Outcome