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A New Technique in Alveolar Cleft Bone Grafting for Dental Implant Placement in Patients With Cleft Lip and Palate
Ist Teil von
The Cleft palate-craniofacial journal, 2018-02, Vol.55 (2), p.180-188
Ort / Verlag
Los Angeles, CA: SAGE Publications
Erscheinungsjahr
2018
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Objective:
To evaluate 2 iliac corticocancellous-block grafting techniques for dental implant placement in residual alveolar clefts.
Design:
Nonrandomized prospective clinical trial between March 2010 and December 2014.
Setting:
National Hospital of Odonto-Stomatology, Hanoi, Vietnam.
Participants:
Thirty-two patients (23 female, 9 male; mean age, 21.28 years; range, 16-31 years) with unilateral complete alveolar cleft after reconstructive surgery for cleft lip and palate (CLP).
Interventions:
Harvested iliac crest bone was cut into 2 corticocancellous blocks. The smaller block was adapted against the sutured nasal mucoperiosteum and overlaid with cancellous bone; the larger one overlapped the labial cleft margin and was fixed with screws. Endosteal dental implants were placed after 4 to 6 months, and final restorations were delivered 6 months later.
Main Outcome Measures:
Flap statuses were assessed clinically. Bone formation was assessed using the Enemark scale. Cone-beam computed tomography was used for graft height and width measurements. Implant health was assessed by the Misch criteria.
Results:
The mean postgrafting follow-up period was 36.7 ± 10.4 (range, 18-53) months. Three patients (9.4%) showed flap dehiscence but no infection 7 days after bone grafting. Twenty-nine patients (90.6%) had 75% to 100% bone fill (Enemark score of 1). The mean graft height and width were 11.4 ± 2.4 and 6.1 ± 1.0 mm, respectively. Sufficient bone for implant placement was noted in 29 patients (90.6%); the others required partially fixed prostheses. All implants functioned for at least 18 months.
Conclusion:
The proposed technique is reliable to reconstruct the alveolar cleft for implant placement in CLP patients.