Reconstruction of residual alveolo-palatal bone defects in cleft patients. A retrospective study.

The results of reconstruction of residual alveolo-palatal bone defects in 40 patients are evaluated clinically and radiographically in a retrospective study. Age at the time of surgery varied from 7.4 to 32.7 years. The patients were divided into two age groups: before and after 12 at the time of operation. Free autogenous anterior iliac crest bone grafts were used in 26 patients and free autogenous mandibular symphyseal bone grafts were used in 14 patients. The results show unsuccessful closure of the oronasal communication in the alveolo-palatal area of the cleft in 3 out of 31 patients. In 3 out of 40 patients, radiographic incorporation of the bone graft was unsuccessful. The radiographic success was not related to increasing experience of the surgeons. The study indicates that the best grafting results are achieved when grafting is performed before 12 years of age. The radiographic results of mandibular symphyseal bone grafts tend to be slightly better compared with results obtained with anterior iliac crest bone.