Clinical Evaluation of Surgical Orthodontic Procedure with Bone Grafts for Patients with Cleft Palate during Adolescence
Ravindra Manerikar
Department of Orthodontics, Rural Dental College and Hospital, Pravara Institute of Medical Sciences, Loni, Maharashtra, India.
Shilpa Pharande
Department of Orthodontics, Sinhagad Dental College, Pune, Maharashtra, India.
N. G Toshniwal
Department of Orthodontics, Rural Dental College and Hospital, Pravara Institute of Medical Sciences, Loni, Maharashtra, India.
Kishor Chougule
Department of Orthodontics, Tatyasaheb Kore Dental College, Kolhapur, Maharashtra, India.
Abhijit Misal
Department of Orthodontics, YCMM and RDF Dental College, Ahmednagar, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Cleft lip and palate is a congenital anomaly, presenting in a wide variety of forms and combinations. Successful cleft lip and cleft palate rehabilitation requires a multidisciplinary approach employing the skills of different specialists.
Aims & Objectives: The aim of this paper was to present orthodontic preparation of patients prior to alveolar bone grafting & to review our findings in a group of patients treated by secondary and delayed bone-grafting procedures at our institution.
Methodology: Thirty eight patients were examined for the type of cleft and the age at the time of examination. 10 patients were treated in our institution with presurgical orthodontics & operated by a delayed bone-grafting technique. Duration and type of expansion was noted at pre-operative, 2 months and 6 months. Crestal bone heights and the quality of the bone in the grafted areas was examined radiographically, along with presence of any fistulas.
Results: All the patients demonstrated improved alar base and upper lip support, also better dental stability was seen in the region of cleft.
Conclusion: All the patients included in this study appeared to benefit from the procedure with improved facial balance. In all ten patients the oronasal fistulas remained closed, hence was reported to be a success.
Keywords: Cleft Lip, cleft palate, birth defect, alveolar bone graft, pre- surgical orthodontics, maxillary expansion, quad helix