Alveolar cleft repair in adults using guided bone regeneration with mineralized allograft for dental implant site development: a report of 2 cases.

Alveolar bone grafting is an integral part of the surgical management of oral clefts. The rationale behind alveolar cleft repair includes maxillary arch stabilization, closure of the oronasal fistula, nasal base support, nasolabial soft tissue reconstruction, and creation of bony support for tooth eruption or dental implant placement. Currently, the graft material of choice is autogenous bone graft from the anterior iliac crest. Nonetheless, autogenous bone grafting carries the significant risk of donor-site morbidity, leads to postoperative pain, and entails an additional operative cost. With the success of allograft bone material in implant site development, we explore the option of using human mineralized cancellous bone allograft in alveolar cleft patients. This article reports on the success of using mineralized human allograft to treat 2 adult patients with severe alveolar cleft defects. The repairs were accomplished with a guided bone regeneration technique without the use of any autogenous bone, with subsequent successful placement of endosseous implants. This opens up the possibility of avoiding harvesting iliac crest bone graft and its associated morbidities and expense by use of only mineralized allograft and a guided bone regeneration technique in an outpatient office setting.