Subject(s)
Alveolar Process/surgery , Bone Transplantation , Cleft Lip/rehabilitation , Cleft Palate/rehabilitation , Orthodontics, Interceptive/methods , Orthodontics, Preventive/methods , Age Factors , Child , Child, Preschool , Cooperative Behavior , France , Humans , Infant , Infant, Newborn , Interdisciplinary Communication , Patient Care TeamABSTRACT
INTRODUCTION: Two problems need to be faced during cleft lip and palate surgical treatment to gain a functional and esthetic result: restoration of the maxillary bone defect and the missing lateral incisor tooth, which may be replaced by an implant. The aim of our study was to demonstrate that it is possible to successfully place a dental implant after obtaining adequate bone graft volume. PATIENTS AND METHOD: 12 consecutively treated patients were studied, 7 with unilateral and 5 with bilateral clefts, mean age 21.5 years, with an average follow-up of 5.5 years (range: 1-10 years). Various types of autogenous or alogenous bone grafts were performed to provide adequate bone volume for immediate or secondary implant placement. We studied the number of bone grafts needed to reach this target, and the number of implants placed, focusing on lateral incisor tooth replacement. RESULTS: Enough cleft bone volume for the implant was obtained in 9 out of 12 cases (75%). All endosseous implants placed in bone graft were successfully restored, 8 out of them for lateral incisor. Some surgical cases are described. DISCUSSION: Global improving of cleft lip and palate surgical treatment by implantology is now feasible. Maxillary defect bone grafting, often in several stages, is strictly necessary to place an implant but also to obtain a good cosmetic result in cleft repair. Length, direction, and cervical implant position have to be considered too. Reconstruction of mucosal anatomy also contributes to the end result.
Subject(s)
Bone Transplantation , Cleft Palate/rehabilitation , Dental Implantation, Endosseous , Dental Implants, Single-Tooth , Incisor , Adolescent , Adult , Cleft Lip/rehabilitation , Dental Occlusion , Female , Gingiva/anatomy & histology , Humans , Male , Maxilla , Motivation , Retrospective StudiesABSTRACT
The treatment of cleft lip and palate at Saint-Vincent-de-Paul hospital is realized by a multidisciplinary team. The calendar of the primary treatment is adapted according to the eventual antenatal diagnosis: it may be early and in two sessions, or late at 4 months but in one session. The calendar of the secondary treatment is more classical.
