The development of an expert consensus based on specific domestic situations will provide practical guidance to the efforts aiming at improving cleft care in China. The team approach of twenty-one cleft centers were pooled together, covering pre-surgical orthopedics, primary surgical repair, orthodontic treatment, alveolar bone graft, secondary deformity correction, palatal fistulae repair, the diagnosis and treatment of velopharyngeal incompetence, speech therapy, otitis media management, and skeletal deformity correction. Agreement was achieved among the authors concerning the application of critical surgical and non-surgical techniques. The ambition of this consensus is to introduce more clinicians to the revolution of sequential treatment of clefts, and form the basis for a more comprehensive cleft care manual in the future.
Alveolar Bone Grafting ; Cleft Lip ; Humans ; Velopharyngeal Insufficiency

OBJECTIVETo evaluate the clinical effectiveness of tooth-alveolar bone grafts in repairing dentition defects.

METHODSForty-five patients with dentition defect were divided into two groups according to different operation methods. In group A (n=24), the tooth-alveolar bone grafts of the transplanted tooth and its surrounding alveolar bone were cut using modified surgical orthodontics and then embedded into the designated planting hole. In group B (n=21), the teeth were extracted through conventional tooth transplantation and then embedded into the prepared planting holes. The transplanted teeth were fixed for about 4-6 weeks using the orthodontic method. During the postoperation, which lasted for 2-12 weeks, root canal treatments were administered selectively. The medical effect was regularly followed up and evaluated.

RESULTSNo significant difference was found in the change of color and the periodontal ligament image between the two groups (P>0.05) whereas significant differences were observed in the degree of tooth mobility, the absorption of root and alveolar bone, and the rate of root canal treatment (P<0.05). The curative effect in group A was superior to group B.

CONCLUSIONSTooth-alveolar bone graft transplantation has overcome some of the limitations of traditional tooth transplantation. Therefore, it is an effective means of repairing dentition defect.

OBJECTIVETo observe and improve the short-term outcome of alveolar bone graft (ABG) by palate side approach.

METHODSABG by palate side approach was performed in twenty patients with non-syndromic unilateral complete cleft lip and palate. Eight patients were incomplete cleft alveolar, and twelve patients were complete cleft alveolar. Each patient took cone beam computer tomography (CBCT) before and after surgery. The related data was measured by Image-Pro Plus 5.1 and analyz statistically.

RESULTSThe overall implanted bone mass ratio was 88%, the labially implanted bone mass ratio was 93%, and the palately implanted bone mass ratio was 84%.

CONCLUSIONABG solve the shortcoming of bone insufficient at palatal side. Triangle nasal flap in cranny can assume the closure of nasal floor and palatal mucosa, avoid a large range of relaxation incision and applying of buccal mucosal advancement flap.

alveolar bone grafting using autogenous iliac particulate cancellous bone marrow in cleft maxilla. MATERIALS AND METHODS: We evaluated 107 cleft patients who had been admitted to the Dept. of Oral and Maxillofacial Surgery of Pusan National University Hospital from January 1, 1991 to January 31, 1999 and had been performed secondary alveolar bone grafting with autogenous particulated cancellous bone marrow from iliac crest. RESULTS: 1. Men were 70 and women were 37, which shows 65.4% and 34.6% and the proportion of males to females was 1.9:1. Unilateral cases were 89(83.2%) and bilateral cases were 18(16.8%). 2. Age of bone grafting is widely distributed from 7 to 29, and the average was 13.2. 3. Success rate was 97.8% in unilateral cases, 94.4% in bilateral cases. Overall success rate was 96.7%. 4. We evaluated the bone graft contour by the percentage of bone attachment level adjacent to the alveolar cleft and the mesial side showed 82.4% and the distal 87.7%. 5. The amount of notching the alveolar ridge at the grafted site through the ratio of notching length up to the most apical base to the length of proximal segment anatomic root was 0.19.]]>
Alveolar Bone Grafting ; Alveolar Process ; Bone Marrow ; Bone Transplantation ; Busan ; Female ; Humans ; Male ; Maxilla ; Surgery, Oral ; Transplants

The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.
Alveolar Bone Grafting ; Cleft Lip ; Cleft Palate ; Malocclusion ; Periosteum ; Retrognathia ; Transplants

The atrophy of edentulous ridge and pneumatization of the maxillary sinus often limit the volume of bone available for implant placement on maxillary posterior teeth. Most clinicians suffer difficulties from poor bone quality and quantity on maxillary posterior site. Thus, the success of maxillary posterior implant surgery depends on the increase of the available bone and obtaining a good initial stability of the implant after maxillary sinus reconstruction. The maxillary sinus augmentation methods include a crestal approach and a lateral approach. Less morbidity and complications after operation is major advantage to sinus augmentation using crestal approach than lateral approach. However, when the residual ridge height is ≥ 6 mm, it is known that crestal approach is appropriate. Also delayed implantation after sinus augmentation is recommended in severely atrophic ridge. We present the three cases of implant placement simultaneously sinus augmentation using crestal approach in posterior maxilla site with ≤ 3 mm of residual alveolar bone.
Alveolar Bone Grafting ; Atrophy ; Dental Implants ; Maxilla* ; Maxillary Sinus ; Molar ; Tooth

OBJECTIVETo evaluate the clinical effect of semi-attached quad-helix appliance in expanding the narrow maxillary arches in patients with cleft lip and palate.

METHODS15 cases with cleft lip and palate were selected and treated by semi-attached quad-helix appliance. Before, during, and after treatment, the dental arch width between cuspid, the first premolar and first molar were measured.

RESULTSThe upper dental arches of all patients were expanded effectively in about five months. After orthodontic treatment, the upper dental arches were expanded, and the teeth were alined regularly, which provided good conditions for alveolar bone grafting.

CONCLUSIONThe semi-attached quad-helix appliance with the fixed orthodontic treatment can expand the narrow maxillary arches in patients with cleft lip and palate effectively and conveniently.

PURPOSE: The aims of the present study were to quantitatively assess graft height changes after sinus lift procedures and to analyze the factors that influenced graft height changes, including the residual bone height before surgery, surgical approach, and tooth type. METHODS: A total of 39 maxillary posterior implants placed during a simultaneous sinus lift procedure were evaluated. Panoramic radiographs of all patients were taken immediately after implant installation and at 3 months, 6 months, 1 year, 2 years, and 3 years. To analyze graft height changes over time, we measured the distance between the implant platform and the base of the grafted sinus floor at 3 locations. The radiographs were analyzed by a single examiner. RESULTS: Graft height tended to decrease over time, and a statistically significant difference was observed at 2 years compared to baseline (P < 0.05). There was no statistically significant difference in graft height change according to the surgical approach or tooth type. For residual bone height, a statistically significant difference in graft height change was found between those with 4–7 mm of residual bone height and those with ≥7 mm (P < 0.05). CONCLUSIONS: Graft height after sinus lift procedures significantly decreased at 2 years compared to baseline after sinus augmentation. Further studies should be done with controlled variables, and prospective studies with 3-dimensional images are needed to clarify the factors that influence graft height changes.
Alveolar Bone Grafting ; Dental Implants ; Humans ; Maxillary Sinus ; Prospective Studies ; Sinus Floor Augmentation ; Tooth ; Transplants

BACKGROUND: We evaluated and compared the outcomes of different ossification processes in patients with alveolar cleft in whom correction was performed using endochondral bone graft or intramembranous bone graft. METHODS: The patients were divided into two groups: the endochondral bone (iliac bone or rib bone) graft group and the intramembranous bone (mandibular bone) graft group. Medical records and radiologic images of patients who underwent alveolar bone grafting due to alveolar cleft were analyzed retrospectively. Through postoperative and follow-up radiologic images, the height of the interdental bone septum was classified into four types based on the highest point of alveolar ridge. Then, the height of the interdental bone septum and the area of the bone graft were evaluated according to the type of bone graft. In addition, the occurrence of complications and the need for an additional bone graft, the result of postoperative orthodontic treatment, and the eruption of impacted teeth were investigated. RESULTS: Thirty patients were included in this study. There was no significant difference in the change of the interdental bone height and the area of the bone graft according to the type of bone. There was no significant difference in the success rate of the surgery according to the type of bone. One patient underwent an additional bone graft surgery during the follow-up period. CONCLUSIONS: The outcomes of alveolar bone grafting were not significantly different according to the type of bone graft. If appropriate to the size of the recipient site, the chin bone is a useful graft material in alveolar cleft, as is the iliac bone.
Alveolar Bone Grafting* ; Alveolar Process ; Chin* ; Follow-Up Studies ; Humans ; Medical Records ; Retrospective Studies ; Ribs ; Tooth, Impacted ; Transplants

OBJECTIVES: The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. MATERIALS AND METHODS: Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. RESULTS: No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%+/-8.4%. CONCLUSION: Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.
Alveolar Bone Grafting ; Bone Transplantation ; Cone-Beam Computed Tomography* ; Dental Implants ; Humans ; Inlays ; Jaw ; Male ; Tissue Donors ; Transplants*