A Study of Postoperative Occlusal Construction with Secondary Bone Grafting in Cleft Lip and Palate

Abstract

The purpose of bone graft is to close alveolar cleft and fistula and to build good occlusion by guidance with natural tooth eruption of the lateral incisor (cuspid) or orthodontic treatment by continuity of the alveolar bone. However, the aspect of the absorption of the transplant bone after the art varied and examined the case not to achieve an original purpose for the purpose of checking progress after the bone graft that I appeared and enforced in our course at this time.
【Material and methods】 In 202cases that enforced bone graft, the last treatment (orthodontic or prosthetic treatment) for occlusion construction was finished, and data intended for enough 132 cases on the occasion of examination in that.
I evaluated 6-month bone bridging after treatment of bone graft using a classification of Enemark and examined a state of alveolar cleft and the last cure.
【Results】
1) I classified states of alveolar bone by Enemark classification. Level-1 was 55 alveolar cleft. Level-2 was 50 alveolar cleft. Level-3 was 23 alveolar cleft. Level-4 was 4 alveolar cleft. The classification that the guidance of the tooth is possible is Level-1 and Level-2. The total of level-1 and Level-2 was 105 cases (79.6%).
2) The case that the last cure after the bone graft treated follow-up until eruption of nature of the tooth or the guidance of the eruption of the tooth was 56 alveolar cleft. Lateral incisor was a birth defect, and the case that gave orthodontic treatment was 41 alveolar cleft. The case that did not need prosthetic treatment was 97 alveolar cleft (73.5%). The case that prosthetic treatment needed was 35 alveolar cleft (26.5%).
【Conclusion】The case that enforced bone graft before cuspid tooth eruption of 91.7% was Level-1 or Level-2, which was a good result.
In addition, 86.7% of alveolar cleft that performed bone graft before cuspid tooth eruption in that were good occlusion, and there is no need of prosthetic. It was thought that a good result appeared by ascertaining appropriate bone graft time.