ABSTRACT
Dental reconstruction in the cleft space is difficult in some patients with cleft lip and palate because of oronasal fistulas. Most of these patients receive a particle cancellous bone marrow (PCBM) graft to close the alveolar cleft, and secondary bone grafting is also required. Treatment options for the alveolar cleft including fixed or removable prostheses require the preparation of healthy teeth and are associated with functional or social difficulties. Recently, the effectiveness of dental implant treatment for cleft lip and palate patients has been reported. However, there have been few reports on the use of this treatment in bilateral cleft lip and palate patients. We report the case of a patient who had bilateral cleft lip and palate and was missing both lateral incisors. She received dental implant treatment after a PCBM graft and ramus bone onlay grafting (RBOG). A 34-month postoperative course was uneventful.
Subject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Dental Implants , Adult , Bone Transplantation , Cleft Lip/pathology , Cleft Palate/pathology , Female , Humans , Incisor , Plastic Surgery ProceduresABSTRACT
Both periosteum and bone marrow have the potential to induce heterotopic bone when grafted. Whether the process of bone formation is controlled by the recipient environment where the donor graft is placed or by factors from the donor site is not well documented. The purpose of this study was to examine the histology of new bone induced by either autogenously grafted periosteum or autogenously grafted bone marrow using the rat calvarial defect model in Sprague-Dawley rats. Grafts of either bone marrow or periosteum obtained from tibias were placed in calvarial defects with beta-tricalcium phosphate. Ten days after grafting, active cell proliferation was observed in the defects of both types of grafts. After 20 days, cancellous bone formation was observed in the defects with bone marrow grafts, and intramembranous bone formation was observed in the defects with periosteal grafts. After 30 days, bone marrow grafts had developed bone with a bone marrow-like structure, and the periosteal grafts had produced cortical bone structure in the defects. The findings suggest that the type of bone formation is determined by characteristics of the donor site.
Subject(s)
Bone Marrow Transplantation/methods , Osteogenesis/physiology , Periosteum/transplantation , Animals , Biocompatible Materials/pharmacology , Bone Transplantation/methods , Calcium Phosphates/pharmacology , Histological Techniques , Models, Biological , Osteogenesis/drug effects , Periosteum/cytology , Rats , Rats, Sprague-Dawley , Skull/surgery , Tibia/surgery , Transplantation, AutologousABSTRACT
We investigated the osteogenic potential of a combination graft of beta-tricalcium phosphate (TCP) and periosteum in the rat calvarial defect model. The combination beta-TCP and periosteum graft was grafted into rat calvarial defects; the newly formed bone in the defect was studied histologically and radiographically and compared with periosteum grafts and TCP grafts. Ten days after combination grafting, the grafted periosteum showed cell proliferation and Runx2 immunoreaction; 20 days after grafting, new bone formation was seen around the beta-TCP; and 30 days after grafting, new bone developed and actively replaced beta-TCP, while radiography showed calcified areas. Total bone formation of the combination periosteum and beta-TCP graft was significantly increased compared with single grafts of beta-TCP or periosteum (P < 0.01). The combination graft of periosteum and beta-TCP showed marked bone formation in rat calvarial defects. This result suggests that combination grafts may be effective for repairing bone defects.
