Correction of Secondary Alveolar Clefts with Iliac Bone Grafts.

INTRODUCTION: Cleft lip and palate deformities are one of the most common birth defects. The alveolar cleft requires bony repair to allow proper eruption of dentition. The purpose of this study is to evaluate success in the repair of alveolar clefts with iliac bone grafts. AIM: The aim of this study is to restore the function and form of both arches with a proper occlusal relationship and eruption of tooth in the cleft area. SUBJECTS AND METHODS: Five patients were selected irrespective of sex and socioeconomic status and whose age was within the mixed dentition period. The iliac crest is grafted in the cleft area and subsequently evaluated for graft success using study models, periapical, and occlusal radiographs. RESULTS: At the time of evaluation, teeth were erupted in the area and good alveolar bone levels were present. Premaxilla becomes immobile with a good arch form and arch continuity. There are no major complications regarding pain, infection, paresthesia, and hematoma formation at donor site without difficulty in walking. There is no complication regarding pain, infection, exposure of graft, rejection of graft, and wound dehiscence at the recipient site except in one case. CONCLUSIONS: Long-term follow-up is required to achieve maximum advantage of secondary alveolar grafting; the age of the patient should be within the mixed dentition period, irrespective of sex and socioeconomic status. It may be unilateral or bilateral.

Bilateral Cleft Lip Repair - Advantages of Pfeifer's Technique.

CONTEXT: Primary repair of bilateral cleft lip depends on the sound knowledge of anatomy, identification of landmarks, clinical variation of presentation, surgical expertise of the operator, etc., Herewith, we present the results of 129 cases performed during our study. AIM: To evaluate the advantages of Pfeifer's technique in bilateral cleft lip repair. DESIGN: This was a retrospective analysis of the results of repair. PATIENTS AND METHODS: The study was carried out on 129 patients using Pfeifer's technique. Pfeifer described a technique which involves changing the lip skin incision to a wavy line, thus making it less conspicuous, using the concept of "morphological order." The basis of this technique is, a skin incision between two points can be lengthened if both points are joined in a curved or wavelike manner rather than in a straight line. RESULTS: Lip parameters improved by 70% as viewed in frontal profile in terms of white roll match, vermilion match, and Cupid's bow. Nasal parameters improved by 80% as viewed in basal view in terms of alar symmetry, nasal dome and alar base. CONCLUSIONS: We found four advantages by strict adherence to the steps in the technique as given in the available literature. This technique is easy to learn and teach with satisfactory results.