Combined orthodontic-surgical treatment of alveolar clefts.

After more than four years of postoperative follow-up, 224 patients receiving secondary bone grafting of alveolar clefts were examined. Patients were classified into three groups according to age and eruption stage of the cleft side canine tooth at surgery. Each group was then subdivided according to the diagnoses cleft lip alveolar process only, unilateral cleft lip and palate, and bilateral cleft lip and palate. The treatment results were evaluated with respect to bone level in the cleft area, gingival and periodontal condition, orthodontic treatment result, growth of the jaws after surgery, and complications. The best results were achieved when the bone grafting was performed before eruption of the cleft side canine. In half of these patients orthodontic treatment could be finished with a closed dental arch without the need for prosthodontic treatment. The sagittal growth of the jaws was unaffected by the bone grafting, whereas the anterior height of the maxilla was reduced apparently without any clinical significance.