The bone grafting for the repair of cleft lip, alveolar cleft and cleft palate is an important problem at the viewpoint not only esthetic effect for the lip and nostril area but functional relation of alveolar arch and palate. Since commencement of 1963, we have preformed the bone transplantation to fill or bridge the cleft space and prevent the collaps of the maxilla. At this report we referd to clinical obserbation and distant results for the 55 patientgroup (57 operation cases), they are treated in a year in 1963. In 20 of all 57 cases, autogenous local bone-chips were used as a graft. In 22 cases, heterogenous bone grafts (Kiel Bone) and in remained 15 cases, heterogenous bone grafts mixed with a small quantity of local bone-chips were used as a graft. The idea of utilizing the bone chips for implant material in various bone defects, created by surgical procedures in alveolar process and jaw bone, has been first suggested by M. Hirakawa, senior author of the present article. By the surgical closure of cleft deformities, especialy secondary repair, there are many amount of bone materials have been capable, which obtained from removal of overhanging bone of the maxilla and alveolus or correction of bone margins of the extraction wounds. We utilized these bone chips for a graft to fill the cleft space of maxilla, after prior antibiotics procedures. About principle technique to form the accept space for the graft, it is necessary an original idea and means, corresponding to each cleft types. We divided and discussed our opinions under five heads. As regard to the healing of operation wounds, we have satisfactory result, there are no tendency of remaining fistula or necrosis of transplnted bone in all 57 cases. At the clinical and X-ray observation on regeneration process of transplanted bone, we found fairly difference between the group of use of local bone-chip and the group of the heterogenous bones. In the cases where local bone chips were used, a remarkable new bone formation taking place around them was observed about 3 weeks after the operation, and a perfect restoration of the cleft space was observed by about 3 months after the operation. And yeareslater we observed functional reconstrucion of newly formed bone, corresponding to the mechanical reqiament on this site.
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