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http://dx.doi.org/10.5999/aps.2017.44.3.188

Current Methods for the Treatment of Alveolar Cleft  

Kang, Nak Heon (Department of Plastic and Reconstructive Surgery, Chungnam National University School of Medicine)
Publication Information
Archives of Plastic Surgery / v.44, no.3, 2017 , pp. 188-193 More about this Journal
Abstract
Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.
Keywords
Alveolar bone grafting; Bone substitutes; Bone morphogenetic proteins;
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1 Semb G. Effect of alveolar bone grafting on maxillary growth in unilateral cleft lip and palate patients. Cleft Palate J 1988;25:288-95.
2 Chang HP, Chuang MC, Yang YH, et al. Maxillofacial growth in children with unilateral cleft lip and palate following secondary alveolar bone grafting: an interim evaluation. Plast Reconstr Surg 2005;115:687-95.   DOI
3 Troxell JB, Fonseca RJ, Osbon DB. A retrospective study of alveolar cleft grafting. J Oral Maxillofac Surg 1982;40:721-5.   DOI
4 El Deeb M, Messer LB, Lehnert MW, et al. Canine eruption into grafted bone in maxillary alveolar cleft defects. Cleft Palate J 1982;19:9-16.
5 Rawashdeh MA, Telfah H. Secondary alveolar bone grafting: the dilemma of donor site selection and morbidity. Br J Oral Maxillofac Surg 2008;46:665-70.   DOI
6 Sharma S, Schneider LF, Barr J, et al. Comparison of minimally invasive versus conventional open harvesting techniques for iliac bone graft in secondary alveolar cleft patients. Plast Reconstr Surg 2011;128:485-91.   DOI
7 Hudak KA, Hettinger P, Denny AD. Cranial bone grafting for alveolar clefts: a 25-year review of outcomes. Plast Reconstr Surg 2014;133:662e-668e.
8 Oberoi S, Chigurupati R, Gill P, et al. Volumetric assessment of secondary alveolar bone grafting using cone beam computed tomography. Cleft Palate Craniofac J 2009;46:503-11.   DOI
9 Cohen M, Figueroa AA, Haviv Y, et al. Iliac versus cranial bone for secondary grafting of residual alveolar clefts. Plast Reconstr Surg 1991;87:423-7.   DOI
10 Rahpeyma A, Khajehahmadi S. Chin bone graft for maxillary alveolar cleft: indications and limitations. J Craniofac Surg 2014;25:1650-2.   DOI
11 Steven MR, Emam HA. Dental implant prosthetic rehabilitation: allogeneic grafting/bone graft substitutes in implant dentistry. In: Bagheri SC, Bell RB, Khan HA, editors. Current therapy in oral and maxillofacial surgery. St. Louis, Mo: Elsevier Saunders; 2011. p.157-62.
12 Misch CE, Dietch FM. Keys to bone grafting and bone grafting materials. In: Misch CE, editor. Contemporary implant dentistry. St. Louis: Mosby Elsevier; 2008. p.839-68.
13 Bajaj AK, Wongworawat AA, Punjabi A. Management of alveolar clefts. J Craniofac Surg 2003;14:840-6.   DOI
14 Rodella LF, Favero G, Labanca M. Biomaterials in maxillofacial surgery: membranes and grafts. Int J Biomed Sci 2011;7:81-8.
15 Ilankovan V, Stronczek M, Telfer M, et al. A prospective study of trephined bone grafts of the tibial shaft and iliac crest. Br J Oral Maxillofac Surg 1998;36:434-9.   DOI
16 Enemark H, Sindet-Pedersen S, Bundgaard M. Long-term results after secondary bone grafting of alveolar clefts. J Oral Maxillofac Surg 1987;45:913-9.   DOI
17 Kinsella CR Jr, Cray JJ, Durham EL, et al. Recombinant human bone morphogenetic protein-2-induced craniosynostosis and growth restriction in the immature skeleton. Plast Reconstr Surg 2011;127:1173-81.   DOI
18 Francis CS, Mobin SS, Lypka MA, et al. rhBMP-2 with a demineralized bone matrix scaffold versus autologous iliac crest bone graft for alveolar cleft reconstruction. Plast Reconstr Surg 2013;131:1107-15.   DOI
19 Sivak WN, Macisaac ZM, Rottgers SA, et al. Management of failed alveolar bone grafts: improved outcomes and decreased morbidity with allograft alone. Plast Reconstr Surg 2014;133:345-54.   DOI
20 Bergland O, Semb G, Abyholm FE. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J 1986;23:175-205.
21 Long RE Jr, Spangler BE, Yow M. Cleft width and secondary alveolar bone graft success. Cleft Palate Craniofac J 1995;32:420-7.   DOI
22 Kindelan JD, Nashed RR, Bromige MR. Radiographic assessment of secondary autogenous alveolar bone grafting in cleft lip and palate patients. Cleft Palate Craniofac J 1997;34:195-8.   DOI
23 Witherow H, Cox S, Jones E, et al. A new scale to assess radiographic success of secondary alveolar bone grafts. Cleft Palate Craniofac J 2002;39:255-60.   DOI
24 Feichtinger M, Mossbock R, Karcher H. Assessment of bone resorption after secondary alveolar bone grafting using three-dimensional computed tomography: a three-year study. Cleft Palate Craniofac J 2007;44:142-8.   DOI
25 Kyung H, Kang N. Management of alveolar cleft. Arch Craniofac Surg 2015;16:49-52.   DOI
26 von Eiselsberg F. Zur technik der uranoplastik. Arch Klin Chir 1901;64:509-29.
27 Lexer E. Die Verwendung der freien knochenplastik nebst versucher uber gelenkversteinfung und gelenktransplantation. Arch Klin Chir 1908;86:939-43.
28 Drachter R. Die Gaumenspalte und deren operative Behandlung. Dtsch Z Chir 1914;131:1-89.   DOI
29 Schmid E. Die aufbauende kieferkamm plastik. Ost J Stomat 1954;51:582-3.
30 Skoog T. The use of periosteum and Surgicel for bone restoration in congenital clefts of the maxilla: a clinical report and experimental investigation. Scand J Plast Reconstr Surg 1967;1:113-30.   DOI
31 Cohen M, Polley JW, Figueroa AA. Secondary (intermediate) alveolar bone grafting. Clin Plast Surg 1993;20:691-705.
32 Daw JL Jr, Patel PK. Management of alveolar clefts. Clin Plast Surg 2004;31:303-13.   DOI
33 Choi HS, Choi HG, Kim SH, et al. Influence of the alveolar cleft type on preoperative estimation using 3D CT assessment for alveolar cleft. Arch Plast Surg 2012;39:477-82.   DOI
34 Amirlak B, Tang CJ, Becker D, et al. Volumetric analysis of simulated alveolar cleft defects and bone grafts using cone beam computed tomography. Plast Reconstr Surg 2013;131:854-9.   DOI
35 Santiago PE, Schuster LA, Levy-Bercowski D. Management of the alveolar cleft. Clin Plast Surg 2014;41:219-32.   DOI
36 Abyholm FE, Bergland O, Semb G. Secondary bone grafting of alveolar clefts. A surgical/orthodontic treatment enabling a non-prosthodontic rehabilitation in cleft lip and palate patients. Scand J Plast Reconstr Surg 1981;15:127-40.   DOI
37 Tan AE, Brogan WF, McComb HK, et al. Secondary alveolar bone grafting: five-year periodontal and radiographic evaluation in 100 consecutive cases. Cleft Palate Craniofac J 1996;33:513-8.   DOI
38 Honma K, Kobayashi T, Nakajima T, et al. Computed tomographic evaluation of bone formation after secondary bone grafting of alveolar clefts. J Oral Maxillofac Surg 1999;57:1209-13.   DOI
39 Trindade IK, Mazzottini R, Silva Filho OG, et al. Long-term radiographic assessment of secondary alveolar bone grafting outcomes in patients with alveolar clefts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:271-7.   DOI