Development of surgical techniques of secondary osteoplasty in cleft patients following 12 years experience.
OBJECTIVE
To evaluate the results of secondary osteoplasty in cleft patients, over a 12 years period, and to propose certain modifications and improvements of the cleft repair technique.


METHODS
Data were retrieved for all young patients treated from 2000 to 2011. Patients were divided in 3 groups, of 4 years duration each; parameters registered among others included peri-operative orthodontics, type of graft used, techniques applied and revisions required until final repair.


RESULTS
65 patients (mean age 11.6 years) were included in the study. 80 cleft sites were treated. All clefts were finally repaired and bone continuity was achieved. Peri-operative orthodontics was applied in 84.6% of the cases. Bone grafts were harvested 60 times (84.5%) from the left anterior iliac crest and 11 times (15.5%) from the genial region of the mandible. During the 12 years period ameliorations and changes were made at the recipient site, regarding the technique applied and the type of the graft. Revision operations for additional bone grafting were required in 6 cases in all (6/80 or 7.5% of the cleft sites). A gradual reduction of the number of revision osteoplasties was recorded in the 3 time periods, attributed to the improvements afore mentioned.


CONCLUSIONS
Cleft bone repair, even in difficult bilateral cases, may be achieved with standardised preparation of the recipient site, adequate graft from the iliac crest, used in the form of both particulate bone and cortical plate on top, as well as full coverage of the graft.
University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis) at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece. Electronic address: lygidakis-nadia@ath.forthnet.gr.
Nadia
N
Theologie-Lygidakis
University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis) at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece.
Konstantina
K
Chatzidimitriou
University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis) at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece.
Fotios
F
Tzerbos
University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis) at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece.
Nikolaos
N
Kolomvos
University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis) at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece.
Ioannis
I
Iatrou
D000293:Adolescent; D064728:Alveolar Bone Grafting / Q000379:methods; D001862:Bone Resorption / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007085:Ilium / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery; D009971:Orthodontics, Corrective; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D016896:Treatment Outcome
Iliac crest graft; Secondary osteoplasty; Technique modifications