Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. IV. A radiographic study of the incorporation of the bone grafts.

The development of bone grafts in complete alveolar clefts was studied with standard radiographic methods. The patients were divided into three groups: one unilateral group of 39 children operated on between 1960-1965 without preoperative orthopedics, another unilateral group of 46 children operated on between 1965-1972 after preoperative orthopedics ("T-traction") and one group of bilateral clefts with 19 children operated on 1960-1972 after premaxillary retropositioning pressure if necessary combined with outward rotation of the lateral segments. All children had bone grafts inserted with "a four-flap" technique. The results were compared with those operated on with early bone grafting by a different method. The results were similar with good healing and incorporation of the transplanted bone. The group bone grafted after preoperative "T-traction", which facilitates the surgical procedure, showed the highest alveolar bone level. The amount of bone seemed to increase with increasing age of the patient and migration of teeth into the grafted region.