Early secondary closure of alveolar clefts with mandibular symphyseal bone grafts and β-tri calcium phosphate (β-TCP)

Alveolar reconstruction of bony defects in cleft lip and palate patients is a widely accepted treatment regimen for which multiple donor sites can be used. For 25 years, autogeneous bicortical mandibular symphyseal bone grafts have been used at the authors' centre. In cases in which the alveolar defect was too large to match the volume of the mandibular symphyseal bone transplant, beta-TCP granules were packed against the bone transplant to fill the defect completely. In a retrospective study, 18 patients, who were treated with mandibular symphyseal bone wrapped in beta-TCP granules, were compared with 29 patients, who were treated with mandibular symphyseal bone only. To assess alveolar height, occlusal radiographs were taken directly postoperatively and 1 year later. Mean alveolar bone loss was calculated and compared between groups using Student's t-test and linear regression analysis. No statistically significant difference in alveolar height was found between the two groups. It was concluded that mandibular symphyseal bone grafts enriched with beta-TCP granules can be used successfully in cases in which the alveolar cleft is too large to be grafted with mandibular symphyseal bone alone.