Abstract
This paper reports the application of alveolar bone grafting for a 23-year-old woman with right unilateral cleft lip and palate who had unoperated hard palate and alveolus. Preoperative intraoral view revealed a large oronasal fistula at the hard palate 13mm in width and 32 mm in length. Alveolar bone grafting was carried out in the usual fashion. The mucoperiosteum on the medial and lateral side of the cleft was elevated and separated into the nasal and oral side from the labial alveolar bone surface to the end of the palatal cleft. The nasal side mucoperiosteal flaps were sutured to form a nasal side closure. The enlarged and bulbous inferior turbinate was partially reduced to facilitate the nasal side closure. The oral side closure was also made in the same manner. Particulate cancellous bone harvested from the anterior iliac crest was densely packed into the palatal and alveolar bony defect. The postoperative course was uneventful. Intraoral findings two years after the surgery showed complete closure of the hard palate and alveolus. Periapical radiograph and CT showed adequate bone formation around the hard palate and alveolar area. These results suggest that alveolar bone grafting is a considerably useful surgical intervention not only for the repair of alveolar bony defects but also the closure of large oronasal fistulas situated in the hard palate.
