Arch Plast Surg. 2017 May;44(3):188-193. doi: 10.5999/aps.2017.44.3.188. Epub 2017 May 22.
Current Methods for the Treatment of Alveolar Cleft.
Archives of plastic surgery
Nak Heon Kang
Affiliations
Affiliations
- Department of Plastic and Reconstructive Surgery, Chungnam National University School of Medicine, Daejeon, Korea.
PMID: 28573092
PMCID: PMC5447527 DOI: 10.5999/aps.2017.44.3.188
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 morphogenetic proteins; Bone substitutes
Conflict of interest statement
No potential conflict of interest relevant to this article was reported.
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