Primary alveolar bone grafting using rib bone in cleft patients

ABSTRACT

Alveolar bone grafting is an essential component of successful surgical rehabilitation in many common cleft deformities. Primary alveolar bone grafting is defined as alveolar bone grafting which takes place before eruption of the primary dentition or before 1 year of age. The major objective in primary alveolar bone grafting is to prevent significant maxillary segmental collapse and arch disturbances. If severe, this can make secondary rehabilitation difficult, costly, and protracted. Such early stabilization may eliminate or, at least, decrease the amount of orthodontic arch expansion required during the transitional dentition period. Furthermore, early obliteration of alveolus fistulae improves speech and dental hygiene. It is critical that abutting maxillary segmental alignment be achieved(generally when the patient is 8 to 10 months of age) before grafting. Otherwise, the amount of dissection necessary to develop mucosal flaps for bone graft coverage will be more extensive, thus risking increased scar formation with potential adverse effects on growth. We report a preliminary result of 4 cases of primary alveolar bone graft using rib bone, performed by limited dissection and onlay graft technique at 8 to 10 months of age. They showed satisfactory clinical results especially in terms of growth up to now.