Nonprosthodontic management of alveolar clefts with 2 incisors missing on the cleft side: A report of 5 patients

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 122; no. 6; pp. 587 - 592
• Main Authors: Czochrowska, Ewa M., Semb, Gunvor, Stenvik, Arild
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2002
• Subjects: Adolescent; Alveolar Process - abnormalities; Alveolar Process - surgery; Alveoloplasty; Anodontia - complications; Anodontia - surgery; Bicuspid - transplantation; Bone Transplantation; Child; Cleft Palate - surgery; Dentistry; Female; Humans; Incisor - abnormalities; Jaw Abnormalities - complications; Jaw Abnormalities - surgery; Male; Oral Surgical Procedures - methods; Orthodontic Space Closure - methods; Reconstructive Surgical Procedures - methods
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1067/mod.2002.127915

A treatment combining autotransplantation of developing premolars and orthodontic space closure is described as an alternative to prosthodontics in the management of patients with alveolar clefts when 2 cleft-side incisors are missing. We report on 5 consecutive patients with unilateral clefts in whom 2 cleft-side incisors were congenitally missing, severely malformed, ectopically erupting, or lost because of trauma. In each instance, a mandibular premolar with a partly developed root was transplanted to the central incisor region (3 patients had previously undergone alveolar bone grafting). Root growth continued in all transplants. After an observation period of 2 years 6 months to 7 years 8 months, all transplanted teeth were present and fulfilled the established success criteria. The physiologic status of the transplanted premolars compared favorably with that of the central incisor on the noncleft side. The appearance of the reshaped transplants was found to match the noncleft incisor in 3 patients and deviated somewhat in 2. We concluded that an acceptable clinical outcome can be obtained by tooth transplantation combined with orthodontic space closure in patients with alveolar clefts and 2 missing cleft-side incisors. (Am J Orthod Dentofacial Orthop 2002;122:587-92)