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Background <p>Tertiary alveolar bone grafting (TABG) is frequently required in adult cleft patients due to resorption of previously grafted bone resulting in alveolar deficiency. While essential for dental implant-based rehabilitation, TABG presents challenges due to anatomical and soft tissue complexity, with limited evidence on associated complication patterns.</p> Materials and Methods <p>13 congenital cleft alveolus patients undergoing TABG with autologous iliac or mandibular symphyseal bone combined with platelet-rich fibrin were evaluated over six months. Postoperative clinical, radiological, and implant-related observations were recorded. A structured clinical pattern analysis was performed to identify recurring complications trends.</p> Results <p>Mean cleft defect volume was 319.75 ± 187.11 mm<sup>3</sup>. All subjects experienced at least one postoperative complication, with mucosal fenestration observed universally, predominantly as minor soft tissue exposures. Additional complications included graft instability, limitations in achieving primary implant stability, and implant-related failures. These events demonstrated recurring patterns, particularly linking soft tissue compromise with graft- and implant-related challenges.</p> Conclusion <p>Within limitations of this case series, TABG in adult cleft patients is associated with high complication burden characterized by identifiable clinical patterns. Soft tissue compromise appears central to these outcomes, highlighting the need for a more integrated approach to treatment planning beyond conventional outcome-based assessments.</p>

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Clinical Challenges in Tertiary Alveolar Bone Grafting for Implant-Based Rehabilitation of Congenital Alveolar Cleft Patients

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Rizwana Mallick,
  • J. M. Madhava Rao Thumati,
  • Srinivas Gosla Reddy,
  • Sweta Kale Pisulkar,
  • Vanshika Jain

摘要

Background

Tertiary alveolar bone grafting (TABG) is frequently required in adult cleft patients due to resorption of previously grafted bone resulting in alveolar deficiency. While essential for dental implant-based rehabilitation, TABG presents challenges due to anatomical and soft tissue complexity, with limited evidence on associated complication patterns.

Materials and Methods

13 congenital cleft alveolus patients undergoing TABG with autologous iliac or mandibular symphyseal bone combined with platelet-rich fibrin were evaluated over six months. Postoperative clinical, radiological, and implant-related observations were recorded. A structured clinical pattern analysis was performed to identify recurring complications trends.

Results

Mean cleft defect volume was 319.75 ± 187.11 mm3. All subjects experienced at least one postoperative complication, with mucosal fenestration observed universally, predominantly as minor soft tissue exposures. Additional complications included graft instability, limitations in achieving primary implant stability, and implant-related failures. These events demonstrated recurring patterns, particularly linking soft tissue compromise with graft- and implant-related challenges.

Conclusion

Within limitations of this case series, TABG in adult cleft patients is associated with high complication burden characterized by identifiable clinical patterns. Soft tissue compromise appears central to these outcomes, highlighting the need for a more integrated approach to treatment planning beyond conventional outcome-based assessments.