Abstract
Objective: The aim of this study was to assess patients subjected to replacement surgery of the pre maxilla with bone graft, having as donor area the iliac crest and chin, and the relation with upper canines erupted in grafted areas. Materials and Methods: 54 records were evaluated from cleft patients that were under treatment at CAIF - Center of Attention to Clefts in Curitiba, PR, Brazil, both sexes, with unilateral and bilateral lip and palate clefts. Patients younger than fourteen years old, both sexes, that lost the surgical segment or did not continue the treatment at same welcoming institution, were excluded. The surgical segment average was 5.72 years. Results: Using both descriptive and chi-square statistics, we observed a statistically significant distinction regarding the eruption of upper canines in the region of secondary bone grafts when using iliac crest and chin grafts, which 62.8% of the sample that was treated with chin grafts happened to have an eruption of upper canines, and 37.2% were successful with iliac crest grafts (value-p 0.028). Conclusions: It is necessary to carry out a study with a larger sample size and where the samples are paired in order to confirm the superiority the iliac crest donor area as the gold standard for this surgical procedure.
Highlights
Among congenital anomalies of the mouth, oral clefts stand out, ranging from those that may occur as an isolated or associated disorder to anomalies of varying degrees
During January, 1975 until December, 1994, we recorded 16,853 new cases of oral clefts in Brazil, having the southeast region contributed with 61% these news cases [1]
Surgical treatment in bilateral clefts patients can have serious implication, because manipulating the pre maxilla can result in changes of bone growth in the region
Summary
Among congenital anomalies of the mouth, oral clefts stand out, ranging from those that may occur as an isolated or associated disorder to anomalies of varying degrees. Treatment of pre maxilla in patients with bilateral clefts there are surgical procedures, such as complete refurbishment of the pre maxilla, promoting a better sealing lip [10], and the repositioning of pre upper jaw with autogenous bone graft [11]. Surgical treatment in bilateral clefts patients can have serious implication, because manipulating the pre maxilla can result in changes of bone growth in the region. Among the patients that were subjected to the reposition of the pre maxilla, and the filling in of the clefted area with iliac crest bone graft, 34.3% of the patients had upper canines, right and left, erupted. For the patients in whom autogenous bone graft was used, having the chin as the donor area, 65.7% of the patients presented with, after the abovementioned surgical segment, the two upper canines erupted (p≤0.028) (Table 4)
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