Correction Of Alveolar Cleft By Autogenous Cancellous Bone Graft

Objective To analyse methods which correct alveolar cleft by autogenous cancellous bone graft and the factors which are able to influence the result of alveolar bone grafting with mini incision(ABGM). To put forward clinical classificatory standard of the postoperative effect.Methods 22 patients with alveolar cleft (19 males and 3 females,total 24 sides) received ABGM by one operator. The age range of the patients was 8-19 years. The cleft area was restored with autogenous cancellous bone which is from iliac crest with mini incision by Cylinder Osteotomes for Extraction of Bone Transplants(COEBT). All the patients have been follow up for at least six months postoperatively. The effects of the bone grafting was evaluated on the radiographs. We also discuss the connection between clinical classification and age, operative style, cleft style, anaesthesia style, etc.Results 20 patients were healing perfectly, one patient bone tissue was out, one wound was split partly, after removing the out grafting, wound was healing. 21 patients produced fresh bone except one by radiogram. The continuous osseous bridge was come forth in cleft area.-3-The density of alveolar process was similar with normal bone. The author put forward more reasonable clinical classificatory standard. The overall bone survival rate of ABGM was 95.8%,and clinical successful rate of ABGM was 91.7%. The success rate of patients below 18-year-old was 100%, those above 18 was 66.7%; those who had pure cleft lip and alveolar cleft was 100%,those who was complete cleft lip and palate was 88.9%; unilateral cleft lip and palate was 95%, bilateral cleft lip and palate was 75%. Extracting autogenous cancellous bone from iliac crest by COEBT with mini incision, the average length of these incisions was 1.2cm.The wound was little than osteotomy. All wounds of ilium was healing perfectly. No complication occurred.Conclusion ㊣t is a good way for ABGM that Extracting autogenous cancellous bone from iliac crest by COEBT. 〧orming of excellent bone grafting bed and closely suturing is the key to the success of ABGM; The critical variable affecting the quality of alveolar bone grafting is the timing of the surgery.㏕he successful rate of ABGM in group of patients above 18-year-old was significantly lower than other groups; The successful rate of ABGM in patients with cleft lip or incomplete cleft palate was superior to patients with complete cleft palate. There was no relation between the successful rate and anaesthesia style.There is significent difference between unilateral cleft lip and palate and bilateral cleft lip and palate of ABGM.