Successful unilateral cleft alveolus repair with iliac bone graft

A girl with unilateral cleft lip and palate was brought to our hospital by her parents with the complaints of mal aligned teeth and escape of water through the nose due to the cleft defect. Primary cleft lip and palate repair was done elsewhere. 

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct her alveolar cleft defect using iliac bone grafting technique according to her parents’ request. With very minimal incision line in the hip region, the iliac crestal bone was successfully harvested. The incision made was approximated in such a way resulting in very minimal scarring. The harvested graft was placed in the alveolar cleft defect region and approximated to the extent of defect. 

Patient was comfortable to have a very minimal incision mark left after surgery in her hip region resulting in good healing with very minimal scarring.  Her parents were also happy to have her daughter to feel comfortable after surgery. They returned to their home place and were asked to come for further follow-ups and cleft management.

Pre operative frontal view showing unilateral cleft defect

Intra oral view showing alveolar cleft defect with malaligned teeth

Iliac bone graft harvested using trap door technique

Harvested site approximated with very minimal incision line

Intra oral view showing alveolar cleft defect after raising gingivomucoperiosteal flap

Harvested iliac bone graft jam packed in the alveolar cleft defect

Water tight closure of the gingivomucoperiosteal flap