Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants.
Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation.
Private practice, Sisak, Croatia.
Marko
M
Vuletić
School of Dental Medicine, University of Zagreb, Croatia; Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
Predrag
P
Knežević
Division of Orthodontics, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
Dražen
D
Jokić
Private practice, Samobor, Croatia.
Jerko
J
Rebić
School of Dental Medicine, University of Zagreb, Croatia; Deprtment of Prosthodontics, University Hospital Dubrava, Zagreb, Croatia.
Domagoj
D
Žabarović
School of Dental Medicine, University of Zagreb, Croatia; Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
Darko
D
Macan
Alveolar bone grafting; Bone Morphogenic Proteins; Cleft Lip; Cleft Palate; Dental implants; Dental prosthesis; Orthodontic Space Closure
Eur J Orthod. 2010 Apr;32(2):207-13
20335565
J Oral Surg. 1972 Feb;30(2):87-92
4550446
Int J Paediatr Dent. 2010 Nov;20(6):442-50
20642471
J Oral Maxillofac Surg. 1996 Jan;54(1):74-82
8531003
J Oral Maxillofac Surg. 2009 Oct;67(10):2045-53
19761898
Angle Orthod. 1999 Dec;69(6):523-8
10593442
Cleft Palate Craniofac J. 2012 Sep;49(5):601-8
21740181
Cleft Palate Craniofac J. 2010 Nov;47(6):591-6
21039278
Plast Reconstr Surg. 1965 Jan;35:34-44
14231378
Plast Reconstr Surg. 1965 Apr;35:371-6
14265360
Scand J Plast Reconstr Surg. 1981;15(2):127-40
7041248
Br J Oral Maxillofac Surg. 2008 Dec;46(8):665-70
18760515
Cleft Palate Craniofac J. 1999 Jan;36(1):67-72
10067765
J Oral Maxillofac Surg. 1987 Nov;45(11):913-9
3312537
Adv Clin Exp Med. 2012 Mar-Apr;21(2):255-62
23214291
Int J Periodontics Restorative Dent. 2009 Dec;29(6):583-91
20072735
Scand J Plast Reconstr Surg Hand Surg. 1987;21(1):95-102
3589586
Clin Oral Investig. 2011 Jun;15(3):297-303
21465220
J Craniomaxillofac Surg. 2006 Sep;34 Suppl 2:1-2
17071381
Int J Oral Surg. 1985 Oct;14(5):389-98
3932232
Clin Plast Surg. 1993 Oct;20(4):691-705
8275634
Cleft Palate Craniofac J. 2000 Jan;37(1):98-105
10670897
Br J Oral Maxillofac Surg. 2006 Aug;44(4):308-12
16107298
Oral Maxillofac Surg Clin North Am. 2002 Nov;14(4):477-90
18088649
Cleft Palate Craniofac J. 2007 Jul;44(4):444-7
17608551
J Oral Maxillofac Surg. 2003 Sep;61(9):1082-90
12966485
Ann Plast Surg. 1986 Dec;17(6):460-74
3548551
J Oral Maxillofac Surg. 1987 May;45(5):386-92
3553501
In Vivo. 2008 Mar-Apr;22(2):231-6
18468408
Cleft Palate Craniofac J. 2010 Sep;47(5):499-506
20170387
Cleft Palate Craniofac J. 2000 May;37(3):229-33
10830800
Cleft Palate Craniofac J. 2002 Mar;39(2):193-6
11879078
Plast Reconstr Surg Transplant Bull. 1962 Jun;29:625-41
13872578
J Oral Maxillofac Surg. 2003 Sep;61(9):1078-81
12966484
J Oral Maxillofac Surg. 1996 Jan;54(1):83-8
8531004
J Craniofac Surg. 2009 Sep;20 Suppl 2:1759-64
19816345
J Med Invest. 2012;59(1-2):152-65
22450004
Cleft Palate J. 1986 Jul;23(3):175-205
3524905
J Craniofac Surg. 2003 Nov;14(6):840-6
14600625
Cleft Palate Craniofac J. 2010 Nov;47(6):586-90
20500069
Plast Reconstr Surg. 1999 May;103(6):1630-44
10323695
Cleft Palate Craniofac J. 1998 Mar;35(2):154-60
9527312
J Oral Maxillofac Surg. 2007 Dec;65(12):2503-11
18022477