Autogenous particulate marrow and cancellous bone grafting in maxillary and alveolar clefts: Orthodontic rehabilitation of permanent dentition

The grafting of autogenous particulate marrow and cancellous bone grafting in maxillary and alveolar clefts is currently considered essential to ensure good alignment and stable occlusion of permanent dentition in cleft palate patients having bony defects of the primary palate. Bony bridge formation was successful when the bone grafting was undertaken at an early age and prior to the child's eleventh birthday. Therefore, bone grafting using particulate marrow and cancellous bone should be performed before the age of eleven, when bone chips sufficient to completely fill the cleft can still be readily harvested from the iliac bone. The frequency of successful bony bridging was low in patients in whom the average width of the maxillary and alveolar cleft exceeded 11 mm. Also, the outcome in bilateral cleft lip and palate patients was not as good as that in other clefts types. Finally, the good results of long-term orthodontic care and treatment, combined with secondary bone grafting were demonstrated in a female patient with complete left-sided cleft lip and palate and in a male patient with complete bilateral cleft lip and palate.