Patient Specific Dual Surgical Guidance for Alveolar Cleft Grafting

Document Type : Original Article


Oral and Maxillofacial surgery Dept., Faculty of Oral and Dental Medicine, South Valley University.


Objectives: To investigate the clinical and radiological outcomes of a

computer guided technique using dual surgical guidance to generate a

patient-specific bone graft to reconstruct unilateral alveolar cleft (AC).

Design: Prospective cohort study.

Setting: Patients with unilateral complete AC.

Participants: Out of 14 non-syndromic children with complete ACs who

fulfilled the other inclusion criteria, 11 completed the follow-up period (4

males, 7 females, mean age 8.1 years).

Main Outcome Measure: Assess the dual surgical procedures using the

clinical and radiographic outcomes in terms of facial expression scale

(FES) to the donor site pain, cleft defect volume and bone graft volume

at 6 months plus the incidence of clinical complications.

Results: Females comprised 63.6% (7) with a mean age of 8.1years

(range 7-9.5 yrs). The mean mediolateral width of the superior iliac

crests was 12.2 mm (range11.1 – 13.1 mm) and it exceeded the mean

labio-palatal depth of the contra-lateral non-clefted maxilla by 3.5 mm.

The mean volume of the reconstructed cleft defect was 940.9 mm3

(range 630 - 1125 mm3) which decreased after 6 months to 805.3 mm3

(range 576 – 993 mm3). FES peaked 2 days after the operation reaching

7.7 ± 1.6, and then decreased to 2.6 ± 0.93 at 1wk. No major

complications were observed. Minor complications were labial flap

dehiscence, labial cortex necrosis, hematoma, gait disturbance and

neurological injury.

Conclusion: Within our selection criteria, dual computer guided bone

grafting procedures from the iliac crest has a role in treating AC defects.