Alveolar defect grafting with bone graft material

Patient with cleft lip and palate presents for implant surgery

The patient is a young man who was born with a cleft lip and cleft palate. He had undergone surgery for cleft repair as an infant. The patient has missing upper left central and lateral incisors at the region of the cleft. He is undergoing concurrent orthodontic treatment for teeth alignment. The patient wanted implants to replace the two missing teeth.

A rib graft surgery failed to correct the bony deficiency in the region of the cleft. There was still inadequate bony height for placement of implants. Prof S M Balaji, Cranio-maxillofacial surgeon, decided to augment the bone with Bio-Oss. The patient and his parents were in agreement with the treatment plan.

Placement of bone substitute in cleft region for implant

Under general anesthesia, a mucogingival flap was first raised. The screw used to fix the rib graft was then removed. Bio-Oss bone substitute was next mixed with blood and compacted into the bony defect. The flap was then sutured closed with interrupted sutures.

Treatment planning for implant placement

Implant placement would be undertaken once the Bio-Oss has consolidated into solid bone.

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