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This one is about: Who Needs a Bone Graft?

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Who Needs a Bone Graft?

A parent writes:

I have a question - How do you know if your child needs a bone graft, and if they do, when is it normally done? I know it's taking bone from one place in the body and using it in another place, but that's about all I know about bone grafts.

Joanne Green responds:

They can tell by x-ray if they need one. Most clefts that cut through the alveolar ridge (gumline) will need a bone graft. The very narrow ones may not, and if a periostoplasty was done and succeeded, a bone graft can be avoided, but the vast majority of kids born with cleft do in fact have a bone graft. It is now being done around age 8 or so by MOST teams, while many will do it as early as 5 and some even earlier than that. They used to do it at around 10 - 12, but the trend has been to do it earlier and earlier.

During bone graft, they don't take a piece of bone per se - rather, they take bone cells. The older method is to go in, incise the bone and take bone scrapings from beneath the incision. While a newer method is to go in, incise the bone (much smaller incision) and then use a hypodermic to draw out the needed bone cells. The result is far less trauma from the donor site. The cancellous bone cells are then packed into the area of the alveolar ridge where bone is missing where it is then encouraged to "take" and turn into bone that will bridge the gap left by the cleft, and provide a bony foundation for the permanent teeth to root.

Joanne Green
Director and Founder, Wide Smiles

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