Arch Plast Surg.  2017 May;44(3):188-193. 10.5999/aps.2017.44.3.188.

Current Methods for the Treatment of Alveolar Cleft

• Kang NH

• KMID: 2403911
• DOI: http://doi.org/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.

Keyword

Alveolar bone grafting; Bone substitutes; Bone morphogenetic proteins

MeSH Terms

Alveolar Bone Grafting
Bone Morphogenetic Proteins
Bone Substitutes
Bone Transplantation
Clinical Protocols
Dentition, Mixed
Fistula
Follow-Up Studies
Humans
Intercellular Signaling Peptides and Proteins
Methods*
Operative Time
Tooth
Tooth Eruption
Transplants
Bone Morphogenetic Proteins
Bone Substitutes
Intercellular Signaling Peptides and Proteins