Patient Specific Dual Surgical Guidance for Alveolar Cleft Grafting

Objectives: To investigate the clinical and radiological outcomes of acomputer guided technique using dual surgical guidance to generate apatient-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 whofulfilled the other inclusion criteria, 11 completed the follow-up period (4males, 7 females, mean age 8.1 years).Main Outcome Measure: Assess the dual surgical procedures using theclinical and radiographic outcomes in terms of facial expression scale(FES) to the donor site pain, cleft defect volume and bone graft volumeat 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 iliaccrests was 12.2 mm (range11.1 – 13.1 mm) and it exceeded the meanlabio-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 reaching7.7 ± 1.6, and then decreased to 2.6 ± 0.93 at 1wk. No majorcomplications were observed. Minor complications were labial flapdehiscence, labial cortex necrosis, hematoma, gait disturbance andneurological injury.Conclusion: Within our selection criteria, dual computer guided bonegrafting procedures from the iliac crest has a role in treating AC defects.