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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 ]
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.
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 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 ...
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.
Note: Additional shades of passive articulation are sometimes specified using pre-or post-, for example prepalatal (near the border between the postalveolar region and the hard palate; prevelar (at the back of the hard palate, also post-palatal or even medio-palatal for the middle of the hard palate); or postvelar (near the border of the soft ...
The presence of buccal exostosis can be diagnosed by both clinical examination and radiological interpretation of the oral cavity. Clinically, buccal exostoses appear as single, broad-based masses, usually situated bilaterally in the premolar and molar region on the facial surface of the maxillary alveolar bone. [11]
The mucosa of the cheeks and floor of the mouth are freely moveable and fragile, whereas the mucosa around the teeth and on the palate are firm and keratinized. Where the two tissue types meet is known as a mucogingival junction. There are three mucogingival junctions: on the facial of the maxilla and on both the facial and lingual of the mandible.