The role of endosseous implants in the management of alveolar clefts.

In individuals with cleft lip and palate, there is a high prevalence of hypodontia, particularly of the maxillary lateral incisor on the cleft side. The edentulous space in patients with a repaired alveolar cleft was traditionally treated with a fixed or removable partial denture, but this approach is not optimal. The purpose of this paper was to review the dental literature for infant orthopedic treatment, timing of alveolar bone grafting, timing of implant placement, and type of implants used in individuals with repaired alveolar clefts. There seems to be a consensus in the literature that the optimal timing for initial secondary alveolar bone grafting is between 8 and 11 years of age. Implants cannot be placed this early but should be placed within 6 months of augmentation bone grafting to avoid resorption of the grafted area. Longer implants--those at least 13 mm in length--reportedly have a higher survival rate compared to shorter implants. Other implant parameters such as surface characteristics and diameter do not seem to influence significantly the long-term longevity of implants placed into grafted alveolar clefts.