Late Results of the Secondary Alveolar Bone Grafting in Complete Unilateral Cleft Lip and Palate Patients

The reconstruction of the continuity of the cleft alveolar process is one of the necessary conditions in reaching complete rehabilitation of patients with total congenital cleft of upper lip, alveolar process of the maxilla and palate. The aim of this study was to evaluate late results of the secondary alveolar bone grafting (SABG). In the case of unilateral cleft, 76 SABG were performed during the period from 1994 to 2002. The operation was performed using transposional mucoperiosteal flaps by bone grafting with cortical bone plate and cancelous bone chips. The height of bone bridge was estimated at minimum 3 years after SABG. The study material comprised 50 patients with unilateral cleft alveolus. The early SABG was performed for 35 patients (70%) and late SABG for 15 ones (30%).The primary wound healing and bone bridging was observed in all cases. More bone tissue remained in the cleft area when early SABG was performed (p = 0.000). The general height of newly formed bone bridge was 80.39 ± 13.8 % of normal septal height (in the group of early SABG 85.74 ± 11.24 and in the late SABG group 67.9 ± 11.01). In the early SABG group, positive results (type I and II by Bergland) were for 91.4 % of patients (n = 32) and negative results (type III) were for 8.6 % of patients (n=3). The height of fixed gingiva in the cleft site was bigger than the height of mobile gingiva. In the present study, correlation between the height of newly formed bone bridge and width of cleft was determined. The less was the distance between the closest cleft area teeth the bigger was the height of bone bridge. It was no correlation between newly formed bone bridge height and fixed or mobile gingiva height or height ratio. Key words: unilateral cleft alveolus, secondary alveoloosteoplasty, bone graftin