Mandibular Ramus Cortical Tenting Graft and Particulate Allograft in the Management of Unilateral Alveolar Cleft

BACKGROUND: Alveolar bone grafting in the mixed dentition stage is an important step in the management of cleft lip/palate patients. Intraoral donor sites are favored by patients and their parents. OBJECTIVE: This study investigated a novel bilaminar cortical tenting grafting technique. The technique used a combination of autogenous mandibular ramus cortical bone and particulate allograft in unilateral cleft lip/palate patients during the mixed dentition stage. MATERIALS AND METHODS: Five patients with nonsyndromic unilateral cleft lip and/or palate, in mixed dentition stage, were included in the study. RESULTS: The operation was performed on five patients, and patients were followed up at least for one-year postoperation. Permanent maxillary canine erupted in the grafted alveolar region spontaneously in 80% of the patients. One wisdom tooth bud that had been exposed during the ramus bone harvest was removed. There was no alteration in the sensation of the lower lip as checked by light static and two discrimination tests. CONCLUSION: Unilateral alveolar clefts can be repaired using mandibular cortical block ramus bone in the form of bilaminar tenting grafts combined with particulate allografts.