An Analysis of Mandibular Symphyseal Graft Sufficiency for Alveolar Cleft Bone Grafting

The purpose of this study was to evaluate the sufficiency of the mandibular symphysis as a donor site for unilateral and bilateral alveolar grafting, measuring both the alveolar cleft volume and maximum bone graft volume that can be harvested from the mandibular symphysis using 3-dimensional computed tomography (CT) and software in children and adults. Computed tomography data obtained from 20 unilateral and bilateral cleft lip palates patients in the preoperative period were used in this study. The patients were divided into 2 groups: children (female, n = 5; male, n = 5) and adults (female, n = 5; male, n = 5). The required bone graft volume for grafting and the maximum bone graft volume that can be harvested from the mandibular symphysis were measured based on cone beam CT data and software. The average required bone graft volume (cleft volume) for unilateral alveolar grafting was 963.51 +/- 172.31 mm(3) in the children and 1001.21 +/- 268.16 mm(3) in the adults. The average required bone graft volume for bilateral alveolar grafting was 1457.82 +/- 148.18 mm(3) in the children and 2189.59 +/- 600.97 mm(3) in the adults. The average the mandibular symphysis bone graft volume was 819.29 +/- 330.85 mm(3) in the children and 2164.9 +/- 1095.86 mm(3) in the adults. The results demonstrated that the mandibular symphysis region provided an adequate bone volume for alveolar grafting in adults with unilateral alveolar clefts. However, it is difficult to standardize these results, due to cleft volume and graft volume that could be harvested from the mandibular symphysis are highly variable among individuals.