One of the purposes of alveolar bone grafting (ABG) on the alveolar cleft is to induce eruption of the permanent tooth adjacent to the cleft portion. We experienced three cases in which difficulties of tooth eruption were expected, and all of which showed improvement in eruption direction and successful final arch alignment after completion of ABG.
All the cases were treated at the orthodontic clinic of Iwate Medical University Hospital Dental Center. The cases included the bilateral cleft of the lip and alveolus, the unilateral cleft of the lip and palate, and the unilateral cleft of the lip and alveolus.
Un-erupted teeth and the pre-/post-surgical conditions of the cleft portions were evaluated using X-ray images and CT images.
Within 17 to 30 months after ABG, all cases showed completion of the eruption of the teeth, including the canine parallel to the nasal floor, the canine adjacent to the lateral wall of the nasal cavity, and the central incisor laterodistal to the nasal floor.
The retention of the bone bridge in the new alveolus after ABG was affected by the existence of the tooth in this portion. Therefore, the genesis of the new bone induced the eruption of the adjacent tooth, and the effect of the occlusion with this tooth was expected to support the retention of the bone bridge.
The induction of eruption will be easier if the malposition of the un-erupted tooth is improved by ABG. We conclude that ABG should be performed in cleft cases with serevely malpositioned teeth.
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