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Alveolar Bone Grafting
Rational
Age
Type of Bone and Donor Site
Timing of Maxillary Expansion
Techniques
Alveolar Bone Grafting
Rational
Autogenous
– Cancellous- iliac crest
Block
Particulate
– Cortical- calvarium, mandible
Bone dust
Blocks
– Cortico-cancellous- iliac, rib, tibia, mandible (tibia
and mandible only in late secondary grafting)
Type of Bone
Allogeneic
– Graft resorbs, remodels, may contribute to osteoinduction and
osteoconduction
Nique T, Fonseca RJ, et al: Particulate allogeneic bone grafts
into maxillary alveolar clefts in humans- A preliminary report. J
Oral Maxillofac Surg 45: 386-392, 1987
Alloplast
– Bone grows into, around alloplast
– No active osteoinduction but some osteoconduction
– Teeth do not erupt through alloplast
Horswell BB, El Deeb M: Nonporous HA in the repair of alveolar
cleft defect in a primate model. J Oral Maxiilofac Surg 47:946-
952, 1989
Timing of Maxillary Expansion
PM
Alveolar Bone Graft
Technique
Placement of particulate
cancellous bone into defect
Alveolar Bone Graft
Technique
Alveolar Bone Graft
Technique