The Use of Tibial Autogenous Cancellous Bone for Late Secondary Alveolar Bone Grafting in Cleft Patients: A Prospective Study.

Abstract

To evaluate the management of alveolar cleft defects with proximal tibia bone grafts by late secondary alveolar bone grafting. Fifteen patients were studied, nine males and six females within age range of 21-32years. All the patients were treated with cancellous portion of the proximal tibial bone graft, harvested through the medial approach. Intraoperatively, sufficient amount of bone was harvested which ranged from 19 to 24ccs (mean 20.7 ccs). In two patients, moderate bleeding had occurred, whereas in remaining patients, mild bleeding was observed. Operative time ranged between 1.25 and 1.50h (mean 1.36h). Infection was reported in one patient (7%), which resolved by the end of one and a half months. Complete elimination of the oronasal fistula was achieved in all cases. Neurosensory disturbance (parasthesia) at the donor site was observed in two patients (13%) from the first postoperative week and subsided within 8 months. Gait disturbance was not reported in any of the cases. However, in two patients (13%), intermittent pain during daily activities remained for more than 2months, which completely resolved by the end of the third month. Tibial graft is a reliable donor site option for grafting in cleft alveolus for which the advantage being minimal donor site morbidity. The resorption rate of the graft is also minimal in the present study.