Long-term follow-up of tibial bone graft for correction of alveolar cleft

AIMS: The aim of this prospective study was to evaluate the quality and stability of autogenous tibial bone graft for the correction of alveolar bone defects in cleft patients in a long-term study as well as to evaluate the postoperative morbidity and risk of complications. MATERIALS AND METHODS: A total of 47 patients with 55 donor sites were involved in this study. The first author performed all the procedures from 2003 to 2011. Medial and lateral approaches were used to harvest the bone with standardized surgical technique. Evaluation in both donor and recipient sites was done by clinical examination, postoperative pain and recovery, and radiographic examination by Panoramic and occlusal X-rays and lateral X-ray for the tibia. Moreover, the donor site was assessed for functionality and mobility based on the Lysholm score. Finally, the patient's experience was evaluated subjectively utilizing a visual analog scale. RESULTS: The surgical outcome was satisfied in all except two cases with total graft resorption for unknown reasons. Regarding the postoperative patient experience we found that patients experienced pain in the recipient site more than they did at the donor site at 24-hour and two-week follow-ups. CONCLUSION: We conclude that the proximal tibia is a safe site from which cancellous bone graft can be harvested to repair the alveolus as it carries less early and late morbidity. Thus, we suggest that the tibia is an excellent choice as a donor site for alveolar bone grafting in children and adult with cleft lip and palate with satisfactory long-term stability.