Study of bone grafting in alveolar cleft and occlusal guidance for cleft palate patients

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The autogenous particulate cancellous bone and marrow from Iliac bone were transplanted in the alveolar clefts of 289 patients. The average age at the time of transplant was 11 years 11 months, with a range of 7 years 4 maths to 33 years. A clinical and radiographic evaluation of this bone grafting was made to the patients who had underwent transplant more than l. 5 years before. The results were as follows.1. We see better bone bridging of cleft, alveolar bony height, and normal gingival fors on the grafted region among the younger age group. Moreover we had wore cases needed only orthodontic treatment to make a dental occlusim, and less teeth of root resorption adjacents to the cleft in the younger age group.2. Most of the cases, in which alveolar'contour@was iumved on the grafted region, had orthodontic tooth, movement in the new osseous tissue after bone grafting without prosthetic treatment.3. Although we could not denied the possibility of maxillaly growth inhibition, we could simplify the management of a total dental rehabilitation for cleft patients after the bone grafting.4. The frequency of the cleft with unfavorable bone bridging or the root resorption of the tooth was highest in bilateral cleft lip and palate cases. This results were thought to be caused by the insufficient volume of grafts to fill up the bony defects.It is concluded that the autogenous particulate cancellous bone grafting in alveolar cleft should be carried out at younger age as long as it dose not disturbs the growth of Iliac bone with some exceptions. In the cases with wide alveolar cleft or bilateral cleft lip and palate'. the proper age of transplant may be a little later because it is necessary to take mueb swe cancellous bone chips from Iliac bone.