Abstract
Objectives
To evaluate the management of alveolar cleft defects with proximal tibia bone grafts by late secondary alveolar bone grafting.
Materials and Methods
Fifteen patients were studied, nine males and six females within age range of 21–32 years. All the patients were treated with cancellous portion of the proximal tibial bone graft, harvested through the medial approach.
Results
Intraoperatively, sufficient amount of bone was harvested which ranged from 19 to 24 ccs (mean 20.7 ccs). In two patients, moderate bleeding had occurred, whereas in remaining patients, mild bleeding was observed. Operative time ranged between 1.25 and 1.50 h (mean 1.36 h). Infection was reported in one patient (7%), which resolved by the end of one and a half months. Complete elimination of the oronasal fistula was achieved in all cases. Neurosensory disturbance (parasthesia) at the donor site was observed in two patients (13%) from the first postoperative week and subsided within 8 months. Gait disturbance was not reported in any of the cases. However, in two patients (13%), intermittent pain during daily activities remained for more than 2 months, which completely resolved by the end of the third month.
Conclusion
Tibial graft is a reliable donor site option for grafting in cleft alveolus for which the advantage being minimal donor site morbidity. The resorption rate of the graft is also minimal in the present study.
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References
Boyne PJ, Sands NR (1972) Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg 30:87–91
Hall HD, Posnick JC (1983) Early results of secondary bone grafts in 106 alveolar clefts. J Oral Maxillofac Surg 41:289–294
Jia YL, James DR, Mars M (1998) Bilateral alveolar bone grafting: a report of 55 consecutively-treated patients. Eur J Orthod 20:299–307
Kalaaji A, Llilja J, Friede H, Elander A (1996) Bone grafting in the mixed and permanent dentition in cleft lip and palate patients. Long-term results and the role of the surgeon’s experience. J Craniomaxillofac Surg 24:29–35
Bergland O, Semb G, Abyholm F (1986) Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J 23:175–205
Abyholm F, Bergland O, Semb GR (1981) Secondary bone grafting of alveolar clefts. Scand J Plast Reconstr Surg 15:127–140
Enemark H, Sindet-Pedersen S, Bundgard M (1987) Long term results after secondary bone grafting of alveolar clefts. J Oral Maxillofac Surg 45:913–918
Catone GA, Reimer BL, Mcneir D et al (1992) Tibial autogenous cancellous bone as an alternative donor site in maxillofacial surgery: a preliminary report. J Oral Maxillofac Surg 50:1258–1263
Ilankovan V, Stronczek M, Telfer M et al (1998) A prospective study of trephined bone grafts of the tibial shaft and iliac crest. Br J Oral Maxillofac Surg 36:434–439
O’keeffe JRM, Riemer BL, Butterfield SL (1991) Harvesting of autogenous cancellous bone graft from the proximal tibial metaphysis: a review of 230 cases. J Orthop Trauma 5:469–474
Van Damme PA, Merkx MA (1996) A modification of the tibial bone-graft harvesting technique. Int J Oral Maxillofac Surg 25:346–348
Alt V, Nawab A, Seligson D (1999) Bone grafting from the proximal tibia. J Trauma 47:555–557
Meeder PJ, Eggers C (1994) Techniques for obtaining autogenous bone graft. Injury 25(suppl 1):a5
Medcino RW, Leonheart E, Shromoff P (1996) Techniques for harvesting autogenous bone graft of the lower extremity. J Foot Ankle Surg 35:428–435
Kindelan JD, Nashed RR, Bromige MR (1997) Radiographic assessment of secondary autogenous alveolar bone grafting in cleft lip and palate patients. Cleft Palate Craniofac J 34:195–198
Catinella FP, De Laria GA, De Wald RL (1990) False aneurysm of the superior gluteal artery—a complication of iliac crest bone grafting. Spine 15:1360–1362
Coventry MB, Tapper EM (1972) Pelvic instability—a consequence of removing iliac bone for grafting. J Bone Joint Surg 54a:83–101
Escales F, Dewald RL (1977) Combined traumatic arteriovenous fistula and ureteral injury: a complication of bone grafting. J Bone Joint Surg 59a:270–271
Kurz LT, Garfin SR, Booth RE (1989) Harvesting autogenous iliac bone graft: a review of complication and techniques. Spine 14:1324–1331
Lotem M, Maor P, Haimoff H, Woloch Y (1971) Lumbar hernia at an iliac bone graft donor site. Clin Orthop 80:130–132
Reale F, Gambacorta D, Mencattini G (1979) Iliac crest fracture after removal of two bone plugs for anterior cervical fusion. J Neurosurg 51:560–561
Reynolds AF, Turner PT, Loeser JD (1978) Fracture of the anterior superior iliac spine following anterior cervical fusion using iliac crest. J Neurosurg 48:809–810
Summers BN, Eisenstein SM (1989) Donor site pain from the ilium: a complication of lumbar spine fusion. J Bone Joint Surg 71b:677–680
Ubhi CS, Morris DL (1984) Fracture and herniation of bowel at bone graft donor site in the iliac crest. Injury 16:202–203
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Vura, N., Gaddipati, R., Ramisetty, S. et al. The Use of Tibial Autogenous Cancellous Bone for Late Secondary Alveolar Bone Grafting in Cleft Patients: A Prospective Study. J. Maxillofac. Oral Surg. 20, 276–281 (2021). https://doi.org/10.1007/s12663-020-01350-x
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DOI: https://doi.org/10.1007/s12663-020-01350-x