J Korean Soc Plast Reconstr Surg.
1999 Sep;26(5):775-780.
Correction of Secondary Alveolar Cleft with Gingival Mucoperiosteal Flap and Iliac Bone Grafting:Use of a Percutaneous Bone Biopsy Set
Abstract
- Correction of alveolar cleft with bone grafting has become a well-established step in the integral management of cleft lip and palate patients. Secondary bone graft at mixed dentition is a widely accepted protocol and iliac bone graft is recommended as the gold standard by a multitude of cleft centers. However, grave morbidities of the iliac donor site have discouraged cleft surgeons from adopting this reliable method. In this study, percutaneous bone biopsy set was used to avoid the morbidities of conventional iliac bone graft. Iliac bone graft was performed on 20 patients with alveolar cleft during the period from January 1995 to February 1999. The tube saw of the bone biopsy set was introduced through a small incision of less than 1 cm, and cancellous bone cores were harvested from the iliac crest. After the pericoronal incision, a wide gingival mucoperiosteal flap was elevated at both sides of the cleft. A soft tissue pocket that was created by closure of the nasal and palatal lining was filled with harvested bone cores. Medial transposition and water-tight closure of both gingival mucoperiosteal flaps provided coverage of the bone graft. During the follow-up period from 5 to 50 months (mean, 29 months), completion of the goals of the alveolar bone graft was observed. There was no serious complication except for one case the exposure of the bone graft, and this was resolved spontaneously. Bone harvest with a percutaneous bone biopsy set enables early ambulation by reducing postoperative pain, and it may be faster and simpler than any other method introduced so far. Furthermore, blood loss was minimal, while the scar was small and acceptable. Iliac bone graft with percutaneous bone biopsy is a reliable method for correction of the alveolar cleft and it has many advantages over conventional iliac bone graft and other sources of bone.
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