A prospective study of chin bone graft harvesting for unilateral maxillary alveolar cleft during mixed dentition

Publication date: Available online 10 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): AliReza Shirzadeh, Amin Rahpeyma, Saeedeh khajehahmadi
BackgroundThe chin is a common donor site for alveolar cleft bone grafting. The amount of bone available at this site may be limited, as conservative harvesting with mixed dentition must consider the incisive nerve, the unerupted mandibular canine, and the integrity of the inferior mandibular border.Materials and methodsPatients with nonsyndromic unilateral alveolar cleft in the mixed dentition stage were selected for this study. The volume of the bone obtained from the mandibular symphysis (symphysis menti), degree of alteration in lower-lip sensation, anterior tooth vitality, remaining bone in the alveolar cleft, and bone defects at the donor site 1 year after surgery were evaluated.ResultsEighteen patients enrolled in this study. Mean volume of the bone harvested from the symphysis was 2.1 mL (range, 1.6 to 2.3 mL). For all cases, the bone volume harvested from the symphysis was not enough to fill the alveolar cleft defect, and allograft had to be added to completely fill the cleft. Allograft was admixed in the range of 0.5 to 1 mL with autogenous bone harvested from the mandible. Lower-lip sensation and vitality of the anterior teeth of the mandible were within a normal range one year after the operation in all cases. Fourteen of 18 patients (77.8%) had either normal bone height or bone height at least three-fourths of expected height in the grafted alveolar cleft after 1 year; only 10% of the defect remained in the mandible.ConclusionThe amount of bone yielded by conservative monocortical bone harvest from the mandibular symphysis during the mixed dentition stage for unilateral alveolar cleft bone grafting is not sufficient in volume and should be mixed with allograft. However, donor site morbidity is low with this approach.



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