title: Secondary and Delayed Bone Grafting in Alveolar and Anterior Palatal Clefts.
abstract: BACKGROUND
  Surgical repair with suitable bone graft / substitutes plays an important role in rehabilitation of individuals with residual anterior palatal or alveolar defects associated with an oronasal fistula.
  
  
  METHODS
  52 cases were treated by secondary or delayed bone grafting of the alveolar defects in isolation or associated with defects of the anterior palate from July 2002 - Nov 2004. Dimension and the extent of the defects were assessed with the help of radiographs & maxillofacial CT. Cephalometric analysis, presurgical orthodontics and dentofacial orthopedics preceded surgical repair with cancellous graft from the iliac crest, followed by post surgical orthodontics and prosthetic rehabilitation.
  
  
  RESULTS
  Satisfactory results were achieved in 49 cases with three cases showing failure of graft acceptance. Postoperative clinical and radiological evaluation for all the patients was done at an interval of one, three and six months. Bone density and trabeculation was comparable to the adjacent bone within six months.
  
  
  CONCLUSIONS
  Recreating the bony continuity of the maxillary arch followed by orthodontic correction of dental discrepancies achieves a comprehensive orthosurgical correction.
authors.affiliation: Classified Specialist (Oral & Maxillofacial Surgery), Delhi Cantt.
authors.forename: S K
authors.initials: SK
authors.lastname: Roy Chowdhury
authors.affiliation: Associate Professor (Oral & Maxillofacial Surgery), AFMC, Pune-40.
authors.forename: P S
authors.initials: PS
authors.lastname: Menon
authors.affiliation: Classified Specialist (Orthodontics), MDC (BEG), Kirkee, Pune.
authors.forename: M R
authors.initials: MR
authors.lastname: Vasant
authors.affiliation: Classified Specialist (Orthodontics), Delhi Cantt.
authors.forename: B
authors.initials: B
authors.lastname: Jayan
authors.affiliation: Classified Specialist (Prosthodontics), Delhi Cantt.
authors.forename: R K
authors.initials: RK
authors.lastname: Dhiman
authors.affiliation: Classified Specialist (Oral & Maxillofacial Surgery), Army Dental Centre (R & R), Delhi Cantt - 110010.
authors.forename: S
authors.initials: S
authors.lastname: Karkun
keywords: Alveolar cleft; Cleft orthodontics; bone grafting