[Secondary Alveolar Bone Grafting in Orofacial Cleft: A Survey of a Portuguese Tertiary Hospital].
BACKGROUND
Orofacial clefts are the most frequent craniofacial birth defects. In the presence of bone defect, the secondary alveolar bone grafting is the correction method most commonly accepted by clinicians. This study evaluates the result of this technique in a tertiary hospital.


METHODS
Analysis of the secondary alveolar bone grafting performed between 2007 and 2014, with inclusion of cases in which the iliac crest was the donor site for the graft and the clinical and imaging information was complete. The success of the intervention was assessed radiographically using the Bergland scale (type I-IV) and correlated to variables associated with pathology and/or surgical correction.


RESULTS
Of the 32 secondary alveolar bone grafting performed, 29 met the inclusion criteria: 13 cases (44.8%) corresponded to complete unilateral pre-foramen clefts; four (13.8%) to complete bilateral pre-foramen clefts; eight (27.6%) to transforamen unilateral clefts and four (13.8%) to bilateral transforamen clefts. According to the scale of Bergland (applied with a mean follow-up of 8 ± 5 months) six were classified as type I, 15 as type II, five as type III and three as type IV. No association was found between the effectiveness of the surgery and the type of orofacial clefts, the presence of the incisor and the canine eruption phase. Five patients were re-operated (three of type II and two of type III at baseline).


CONCLUSIONS
In this series, the secondary alveolar bone grafting was effective in most patients (72% type I and II) regardless of the type of orofacial clefts. The relatively high proportion of failures (10.3%) and subsequent need for re-intervention (17%) justify long-term follow up and the continuation of this study.


CONCLUSIONS
It is important to highlight the multidisciplinary involvement in order to identify previously the ideal timing for each intervention and to optimize results.
Faculdade de Medicina. Universidade do Porto. Porto.
Ana Isabel
AI
Costa
Serviço de Cirurgia Pediátrica. Centro Hospitalar São João. Porto.
Hélder
H
Morgado
Serviço de Cirurgia Pediátrica. Centro Hospitalar São João. Porto.
Carlos
C
Mariz
Faculdade de Medicina. Universidade do Porto. Porto. Serviço de Cirurgia Pediátrica. Centro Hospitalar São João. Porto.
José Manuel
JM
Estevão-Costa
D000293:Adolescent; D064728:Alveolar Bone Grafting; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011174:Portugal; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult