Before giving the incision, the skin was retracted so that incision lied lateral to and below the crest instead of over the crest. The landmarks for the anterior iliac crest surgery include the antero-posterior iliac spine and the iliac crest as it curves superiorly and posterior from the spine.Īn incision was made through the skin and periosteum, starting approximately 1.0 cm lateral and inferior to the anterior iliac spine for 6–8 cm. The surgical site was prepared by standard methods. A sand bag was placed beneath the hip to elevate and slightly rotate the anterior iliac crest. The patient was placed in the supine position. Iliac crest was used as a donor site for harvesting the graft. To perform follow-up of cleft palate patients who have already undergone secondary alveolar bone grafting at this center. To observe the eruption of tooth in the vicinity of the cleft. To restore the proper occlusal relationship of the maxilla and mandible. To restore function and form by stabilizing the maxillary segments to form a continuous arch form. Postoperative clinical, radiological, and study model evaluation was done with the following aims and objectives: For the present study a suitable number of cases of residual alveolar cleft with unilateral or bilateral cleft lip and palate of mixed dentition irrespective of sex and socio-economic status were selected. Secondary bone grafting of the maxilla and the residual alveolar cleft at the stage of transitional dentition preceding eruption of the canine has become an adjunctive procedure aiming to further improve the functional and esthetic habilitation of patient with unilateral or bilateral cleft lip and palate patients who underwent maxillary expansion prior to surgery were more successful. The present thinking is that alveolar grafting should be ideally timed somewhere between 6 years of age and prior to eruption of teeth in the cleft region. The use of allogenic material during alveolar bone grafting did not show a statistical benefit. The ilium is used most frequently, as access is easy and a large amount of bones can be obtained from the area. The bone can be harvested from several sites. Fresh autogenous bone is the ideal bone graft material because it supplies living immunocompatible bone cells essential to osteogenesis. Prominent among these have been the studies of Bohn, Bjork and Skieller, Waite and Kersten and Boyne and Sands. Attention has been brought to these two problems and it is the latter which concerns and accordingly we have addressed ourselves to study this problem.Ĭonflicting claims have been made with regard to success and time of surgery in this area. While the repair of the cleft lip and palate was done primarily with excellent results it failed universally in the area of the nostrils and alveolar rides along with that of teeth in the cleft alveolus region.
It is the commonest congenital anomaly to affect the orofacial region and since the time of Veau (1931) at various times efforts have been made to classify and repair these anomalies. Cleft of the palate and lip have intrigued the clinician for a very long time.