The effect of alveolar bone grafting on the prosthodontic/reconstructive treatment of patients with unilateral complete cleft lip and palate.

ABSTRACT

This study compared the effect that the introduction of mixed dentition alveolar bone grafting and subsequent orthodontic treatment has had on the prosthodontic/reconstructive habilitation of patients with unilateral cleft lip and palate. Two groups, each consisting of 40 consecutive patients with unilateral cleft lip and palate, were compared at the end of their dental treatment. In the group treated prior to the advent of bone grafting, all subjects received a fixed partial prosthesis in the cleft area, and a total of 87 abutment teeth were prepared for complete coverage crowns. In contrast, in the group of patients for whom the alveolus was restored by bone grafting, it was possible to obtain a complete dental arch without prosthodontic intervention in 36 patients (90%). Thirteen subjects in the bone grafting group had the crown anatomy of anterior teeth modified using resin composite or resin-bonded porcelain veneers. Two patients had a premolar transplanted to the anterior region of the dental arch. On average the dental treatment was completed 3 years earlier in the bone grafting group. Thus, alveolar bone grafting with subsequent orthodontic treatment, together with advances in dental materials, have markedly reduced the need for prosthodontic procedures and have also allowed the completion of the dental treatment at an earlier age.