Intraoral bone transport in clefting

The advantages of this technique over the traditional alveolar reconstruction are as follows: no need for bone grafts, which involve a donor site, minimal surgical time, no hospitalization, progressive improvement with excellent psychological adaptation, bone height and width that are similar to the neighboring alveolus with excellent possibilities for dental implants, and a natural reconstruction that aids the orthodontist with final tooth movement. Finally, the morbidity is minimal. The disadvantages are few; long treatment requires patient cooperation and close follow-up. Implant placement ideally should happen 6 to 8 months after the initial surgery. A crestal incision is made to expose the newly developed alveolar bone, and a fixture of adequate size and length is inserted. If further bone augmentation is needed on the buccal side of the alveolus, the bone collected from the suction tramp may be mixed with alloplastic materials and layered over. A collagen membrane also may be used. The alternatives of taking grafts from the chin or tuberosity also may be considered. There is still the chance to augment the soft tissues at the uncovering stage by various surgical techniques to obtain an ideal alveolar ridge.