Clinical Study on Secondary Bone Grafting to Alveolar Cleft

Secondary bone grafting was performed on 229 patients with cleft lip and/or cleft palate including 289 alveolar cleft sites from August 1986 to December 1998. Among them,188patients including 233 alveolar clefts which were grafted with autogenous iliac cancellous bone and with sufficient records were studied based on the primary data of the patients and the prognosis of bone grafts. We divided the patients into three groups according to age and eruption situation of the tooth adjacent to the alveolar cleft:<BR>Group 1: Before eruption of canine or lateral incisor on th e cleft site<BR>Group 2: After eruption of canine or lateral incisor of those under 18 years old<BR>Group 3: Over 18 years old (including 18)The results were as follows.<BR>1. Soft tissue coverage consisted of local mucoperiosteal flap in 137 patients, buccal rotation flap in 10 patients, and tongue flap in 41 patients.<BR>2. The overall success rate of bone bridg e formation was 93.6% (218/233). By group, the success rate was 98% (49/50) in group 1,97.1% (67/69) in group 2, and 89.5% (102/114) in group 3. These results showed no statistical significance between the success rate of bone bridge formation and the group division (p=0.025).<BR>3. On assessment of marginal bone leve l, the overall rate of score 1 (over 75% of full root length of teeth adjacent to the cleft) was 32.1% (74/233). By group, the rate of score 1 was 62.0% (31/50) in group 1,31.9% (22/69) in group 2, and 18.4% (21/114) in group 3. These results showed statistical significance between the rate of score 1 and the group division (p<0.001). The rate of score 1 and 2 (over 50%) was 60.1% (140/233) in total. By group, the rate of score 1 and 2 was 84.0% (42/50) in group 1,58.0% (40/69) in group 2, and 52.6%(60/114) in group 3. These results showed statistical significance between the rate of score 1and 2 and the group division (p<0.001).