Use of Endosseous Implants for Dental Reconstruction of Patients With Grafted Alveolar Clefts

Purpose: The purpose of this study was to investigate the clinical application of endosseous implants placed into grafted alveolar clefts and to evaluate the short-term outcome. Patients and Methods: Nineteen patients (6 males and 13 females; mean age, 17.9 years; range, 9.7 to 33.6 years at first implant surgery), including 11 with unilateral cleft lip and palate, and eight with unilateral cleft lip and alveolus, were studied. All patients except for one who underwent periosteoplasty received grafts of autogenous particulate cancellous bone and marrow (PCBM) obtained from the ilium. After bone bridge formation, orthodontic treatment and preparation for implant placement were performed. Results: A total of 21 implants were placed in the bone-grafted alveoli of the 19 patients. The most frequently used length was 15 mm. In five patients with insufficient alveolar bone height, a chin bone onlay graft was combined with simultaneous implant insertion. The follow-up period ranged from 1 year to almost 3 years after implant placement, and the clinical outcome was excellent in all except one patient. In this short-term study, the overall survival rate was 90.5%. Conclusion: The grafted alveoli were well suited to the placement of endosseous implants, and this treatment was shown to be a viable option for the dental reconstruction of alveolar clefts. However, the interdental alveolar bone height was insufficient for implant installation in a few patients. Further longitudinal studies are required to determine the optimal timing between secondary bone grafting and implant placement.