Reconstruction of the alveolar cleft using a custom-made titanium mesh tray and particulate cancellous bone and marrow in an elderly patient with cleft lip and palate: A case report

Abstract

The patients with cleft lip and alveolar undergo specific cleft-related treatments at the appropriate time soon after birth. It is rarely to encounter an untreated case of cleft lip and alveolar in Japan, especially in older individuals. Among of them, many elderly patients with cleft lip and/or palate could not be undergone treatments as bone grafting and oro-fistula closure. We report here a rare case of alveolar cleft reconstruction in an elderly patient, for which a custom-made titanium mesh tray for maxillary reconstruction was found to be useful. To the best of our knowledge, this paper is first report of a reconstructive operation in an elderly patient with no prior treatment for cleft lip and alveolar in Japan. A pre-bent custom-made titanium mesh tray, as well as autogenous particle cancellous bone and marrow (PCBM) harvested from the ilium were used for reconstruction of the maxilla. The results included good occlusion, facial esthetics and oral cavity function with no complications. Use of custom-made titanium mesh and PCBM are helpful in case of cleft lip and alveolar, including both young and elderly patients. Details of this rare case of occlusal reconstruction in an untreated elderly patient for a cleft palate using dental implants are useful to the surgeons performing alveolar cleft reconstruction of elderly patients.