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[8] [9] [10] The most common form is combined cleft lip and palate and it accounts for approximately 50% of cases, whereas isolated cleft lip concerns 20% of the patients. [11] People with cleft lip and palate malformation tend to be less social and report lower self-esteem, anxiety and depression related to their facial malformation.
The term free describes how the graft is completely removed from the donor site rather than remaining attached via a pedicle. The term autogenous, from the Greek root auto-("self"), describes how the individual who receives the graft is the same individual who provides the donor tissue. [3] The connective tissue is generally taken from the hard ...
Alveolar bone grafting in the mixed dentition is an essential part of the reconstructive journey for cleft lip and cleft palate patients. The reconstruction of the alveolar cleft can provide both aesthetic and practical advantages to the patient. [ 24 ]
The upper lip is formed earlier than the palate, from the first three lobes named a to c above. Formation of the palate is the last step in joining the five embryonic facial lobes, and involves the back portions of the lobes b and c. These back portions are called palatal shelves, which grow towards each other until they fuse in the middle. [30]
The upper surface of the palatine process is concave from side to side, smooth, and forms the greater part of the floor of the nasal cavity. It presents, close to its medial margin, the upper orifice of the incisive canal. The lateral border of the process is incorporated with the rest of the bone.
The hard palate is a thin horizontal bony plate made up of two bones of the facial skeleton, located in the roof of the mouth. The bones are the palatine process of the maxilla and the horizontal plate of palatine bone. The hard palate spans the alveolar arch formed by the alveolar process that holds the upper teeth (when these are developed).
The mouth consists of two regions: the vestibule and the oral cavity proper. The vestibule is the area between the teeth, lips and cheeks. [3] The oral cavity is bounded at the sides and in front by the alveolar process (containing the teeth) and at the back by the isthmus of the fauces. Its roof is formed by the hard palate.
In cleft palate patients bone grafting during the mixed dentition has been widely accepted since the mid-1960s. The goals of surgery are to stabilize the maxilla, facilitate the healthy eruption of teeth that are adjacent the cleft, improving the esthetics of the base of the nose, create a bone base for dental implants, and to close any oro-nasal fistulas.