Abstract
Secondary bone grafting to the alveolar cleft of patients with cleft lip and palate is now a widely accepted surgical procedure. This paper describes the placement of an osseointegrated implant at the site of a bone graft in an adult with unilateral cleft lip and palate.
The patient was a 19-year-old female with right unilateral cleft lip and palate. At the time of referral for surgery, the patient was found to have several residual clefting problems, including an oronasal fistula, an alveolar bony defect, and open space of the dental arch in the left central and lateral incisor areas. To close the oronasal fistula and reconstruct the alveolar ridge, iliac cancellous bone was grafted to the alveolar cleft. The postoperative course was uneventful, and 5 months after the bone graft, a self-tapping Brdnemark implant (length,13mm, diameter 3.75mm) was placed in the grafted bone. Four months after placement, the fixture was uncovered and a fixed prosthesis was set. The use of an alveolar bone graft with an osseointegrated implant enabled not only closure of the oronasal fistula but also full occlusal rehabilitation, without employing a conventional fixed bridge or a partial prosthesis. In conclusion, the method presented in this paper was considered to be very useful for the occlusion of residual alveolar clefts in adult patients with cleft lip and palate.
