Surgery Spotlight: Bone Grafting of the Alveolar Cleft-Surgery Spotlight: Bone Grafting of the Alveolar Cleft

Surgery Spotlight: Bone Grafting of the Alveolar Cleft

Video Transcription

Video Summary

The video discusses bone grafting for alveolar cleft repair, which is usually performed before cleft rhinoplasty to create a firm foundation. The procedure involves collaboration with orthodontists to ensure the timing is optimal, avoiding any widening of the cleft caused by orthodontics. The surgery uses gingival and mucoperiosteal flaps, sometimes supplemented with acellular dermal matrix or advancement flaps. The process involves marking the cleft, making precise incisions, elevating soft tissues, and preparing the site for bone graft placement. The graft is harvested, often from the hip, to fill the alveolar gap. The grafting aims to stabilize teeth and facilitate orthodontic movements. The preferred timing for the grafting is typically between ages 8 and 12, dictated by dental development and individual circumstances, ensuring stability for teeth like canines. The video highlights the successful outcomes over many years and recommends the technique.

Asset Caption

In this video, Charles Verheyden, MD performs a bone grafting procedure to close the alveolar cleft in a 15-year-old male. He has previously had a lip repair and the secondary palate was not cleft. This video illustrates gingival and mucoperiosteal flaps, and the harvesting of bone from the iliac crest. Cancellous bone is inserted into the pocket created by closure of the flaps on both the anterior and posterior surfaces of the alveolus. The final result is a closed cleft that stabilizes the maxilla which now has a smooth anterior alveolar surface. This procedure creates a foundation that facilitates orthodontic manipulation as a subsequent step.

Surgeon Charles Verheyden, MD

Source Baylor, Scott & White Disclosure Dr. Verheyden has nothing to disclose. This product is not certified for CME.

Keywords

Surgical Videos

Craniofacial

Pediatric

Charles Verheyden MD

surgery spotlight; Memben

bone grafting

alveolar cleft repair

orthodontics

gingival flaps

acellular dermal matrix

dental development