engleski

Implants in a patient with bilateral cleft lip and palate

Background: Dentoalveolar rehabilitation in patients with cleft lip and palate represents a clinical challange. Conventional treatment options including fixed prosthesis and/or assistant orthodontic treatment are nowadays increasingly replaced by endosseous implants. Besides the most frequently lacking or malformed lateral incisors there is often not enough bone volume after primary bone grafting. Aim: Secondary bone grafting prior to dental implant placement in a patient with a bilateral cleft lip and palate. Materials and methods: We present a case of a 28-year-old male patient with a bilateral cleft lip and palate who rejected the conventional rehabilitation with fixed partial prosthesis and insisted on placement of two dental implants. The treatment was preceeded by augmentation of alveolar bone. Prior to treatment CBCT was performed and showed only narrow alveolar bone bridges at the cleft positions. At the upper right lateral incisor position bone bridge was more palatal, at the left position more vestibular. Only one mandibular ramus block was harvested, splitted and mixed with particulate xenograft (Bio-Oss®, Geistlich, Germany) as an onlay vestibular graft at the right position and as onlay palatal graft at the left. Six months later two dental implants (Ankylos ®, Dentsply Friadent, Germany) were placed at augmented places that after three more months were loaded with metal cheramic crowns. Bone and soft tissue volume were satisfactory. Result: After a two-year follow-up a satisfactory esthetic and functional result could be observed. Conclusion: These patients require secondary bone grafting not only to achieve sufficient osseous support for functionally loaded implants, but also to achieve an appropriate alveolar bone volume for a satisfactory esthetic result. Moreover, functional stimulation of the implant limits resorption of the grafted bone.

dental implants ; cleft lip and palate ; bone graft ; Ankylos ; BioOss ; BioGraft

nije evidentirano