Orthodontically guided bone transport in the treatment of alveolar cleft: a case report
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Alonso Rodríguez, Estefanía; Gómez García, Elena; Otero, Marta; Berraquero, Rosario; Wucherpfennig, Begoña; Hernandez-Godoy, Juan; Guiñales Díaz de Cevallos, Jorge; Vincent Fraile, Germán; Burgueño García, Miguel
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Aquest document és un/a article, creat/da en: 2016
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Introduction: Conventional treatments are sometimes not possible in certain alveolar cleft cases due to the severity
of the gap which separates the fragments. Various management strategies have been proposed, including sequential surgical interventions or delaying treatment until adulthood to then carry out maxillary osteotomies. A further
alternative approach has also been proposed, involving the application of bone transport techniques to mobilise the
osseous fragments and thereby reduce the gap between lateral fragments and the premaxilla.
Case Report: We introduce the case of a 10-year-old patient who presented with a bilateral alveolar cleft and a severe gap. Stable occlusion between the premaxilla and the mandible was achieved following orthodontic treatment,
making it inadvisable to perform a retrusive osteotomy of the premaxilla in order to close the alveolar clefts. Faced
with this situation, it was decided we would employ a bone transport technique under orthodontic guidance using
a dental splint. This would enable an osseous disc to be displaced towards the medial area and reduce the interfragmentary distance. During a second surgical intervention, closure of the soft tissues was performed and the gap was
filled in using autogenous bone.
Conclusions: The use of bone transport techniques in selected cases allows closure of the osseous defect, whilst also
preserving soft tissues and reducing the amount of bone autograft required. In our case, we were able to respect the
position of the premaxilla and, at the same time, generate new tissues at both an alveolar bone and soft tissue level
with results which have remained stable over the course of time.
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