Online ISSN: 2515-8260

Transport distraction osteogenesis for closure of alveolar clefts – A clinical experience.

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Gaurav Deshpandey1 , Abdullah Alnazeh2 , Imran Khalid3 , Alok Dubey4 , Vasavi Rakesh Gorantla5 , Sheetal Mujoo6 , Dharnappa Poojary

Abstract

Treatment of an alveolar defect in a case of cleft lip and palate remains an onerous task to cleft surgeons. Alveolar bone grafting using autogenous bone grafts, has unanimously remained the treatment of choice for closure of alveolar defect in almost all cleft centers around the world. However, this treatment option is far from ideal. The success rate of alveolar bone grafting exponentially decreases with the increase in the size of the defect. Complications like graft resorption, wound dehiscence and recurrence of fistulae make alveolar bone grafting unpredictable for large defects. Management of soft tissues in an alveolar cleft defect poses an equally arduous challenge. Closure of soft tissues under too much tension almost always gives way to wound dehiscence. The principles of distraction osteogenesis have been exploited in treating osseous defects in orthopedics and maxillofacial surgeries. It would seem prudent to incorporate this phenomenon in treating alveolar clefts too. In this article we have described our clinical experience in using this novel technique of transport distraction osteogenesis in treating alveolar cleft defects and have reported four of our cases with their clinical outcomes.

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