Evaluation of secondary bone grafting of the alveolar cleft in adult cleft lip and palate patients

Objective: The aim of this study was to evaluate 13 adult cleft lip and palate patients who underwent secondary bone grafting using short-term follow-up examinations. Materials and methods: The subjects were 13 cleft lip and palate patients. The mean age of the subjects were 28.6 years old (range: 20-47 years). Seven of the patients had BCLP, seven had UCLP, and one had UCLA. None of them had BCLA. Autogenous particulate cancellous bone and marrow (PCBM) was grafted onto the alveolar clefts. The marginal bone levels of the grafted bone were assessed by means of periapical films, which were taken after an observation period of six months, according to the Enemark's classification. Results: Eight bone grafted alveoli had scores of 1 (53.3%), six had scores of 2 (40%), and one had score of 4 (6.3%). None had score of 3. The formation of bone bridges was satisfactory in 93% of the bone-grafted alveoli. The postoperative prostheses used in this study (15 bone grafted alveoli) included seven dental implants; one straightening of the teeth alone; one straightening of the teeth and dentures; and two cases in which the prostheses used were unknown. Patients who underwent dental implant surgery had obviously higher score of Enemark's score (1.8) than those without dental implant (3.1). Conclusion: This study confirmed that PCBM grafting of alveolar clefts works as well for adult patients as it does for pediatric patients and the effectiveness of use of implants in the grafted alveoli to the maintenance of the grafted bone. (C) 2011 Asian Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.