Analysis of Repeated Bone Graft after Secondary Bone Graft in Children with Alveolar Cleft.

Koh, Kyung Suck; Lee, Sung Wook; Choi, Jong Woo; Lee, Young Kyoo; Kwoun, Soon Man

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(3):273-278.
Published online May 1, 2008.

Analysis of Repeated Bone Graft after Secondary Bone Graft in Children with Alveolar Cleft.

Kyung Suck Koh, Sung Wook Lee, Jong Woo Choi, Young Kyoo Lee, Soon Man Kwoun

¹Department of Plastic Surgery, University of Ulsan, College of Medicine, Seoul, Korea. kskoh@amc.seoul.kr
²Department of Periodontology, University of Ulsan, College of Medicine, Seoul, Korea.
³Eastman Orthodontic Clinic, Seoul, Korea.

Abstract

PURPOSE
The most widely accepted protocol for alveolar cleft reconstruction is to repair it during the mixed dentition stage. There were lower resorption rate (about 88%) at this stage. However we found some cases that need repeated bone grafting. Therefore we sought to analyze the cause of repeated alveolar bone grafting in connection with other factors. METHODS: From January 2000 to January 2006, thirty-nine secondary alveolar bone grafts with iliac crest spongiosa were carried out. In 39 patients, 5 patients who had significant bone graft resorption received repeated alveolar bone graft. In all the cases, the causes of repeated bone grafts were dental root exposure(angulation), and the deficiency of the bony support for lateral incisor or canine eruption. In 3 cases, there was deficiency of the alveolar bone at the cleft side. There was the need of repeated bone grafts for orthodontic treatment in 2 cases and for application of dental implants in 1 case.
RESULTS
During the follow-up period, the clinical and radiologic examinations showed that repeated alveolar bone grafts were maintained successfully without any complications. The volume of the repeated bone graft was sufficient for orthodontic treatment and implantation.
CONCLUSION
The essential conditions for successful alveolar bone grafting includes the status of cleft sided teeth, further treatment and planed schedule, as well as canine eruption. Alveolar bone grafting has to be performed with difference of each case in mind.

Keywords: Alveolar cleft; Cancellus bone graft; Bone resorption

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