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Introduction: Orthodontic treatment is commonly undertaken in cleft patients for space closure in cleft region. However, it is only able to achieve 50%-75% closure, resorting to use of dental prosthesis in form of removable or fixed partial dentures. Dental implant-based rehabilitation provides a suitable solution however their success depends on the quality and quantity of the residual bone. Resorption of bone graft is a known scientific fact and thus, it is important to know the minimum time after which the implant can be placed so that the grafted bone is minimally lost. However, this time gap between final bone grafting and implant placement in cleft patients has not been well established. Aim: To determine whether the clinical and/or radiological success of dental implant-based rehabilitation depends on the time elapsed between the last grafting procedure and dental implant placement in cleft region with missing permanent teeth in a unilateral or bilateral alveolar cleft patient. Materials and Methods: The systematic review was registered in PROSPERO (International Prospective Register of Systematic Reviews) via registration number CRD42020187709. Systematic review was done at GSR Institute of Craniomaxillofacial and Facial Plastic Surgery, Hyderabad, Telangana, India, between March 2020 to July 2020 wherein articles in electronic databases (PubMed, ScienceDirect, Web of Science, (Literatura Latino-Americana de Ciencias da Saude), Cochrane Library and Google scholar, published between January 2011 to February 2020 were searched. Combination of Medical Subject Headings (MeSH) terms used included "cleft palate", "cleft lip", "alveolar bone grafting", and "survival" as some of the key terms. Additional information was sought by contacting the corresponding authors. Search items included were cleft, alveolar bone grafting and dental implants. Only studies with details of time gap between last grating procedure and implant placement were included. Data extraction was done independently by two authors using pre-defined fields. Results: Total of 12 studies were included wherein 255 dental implants were placed in 180 patients. In patients undergoing tertiary grafting, a time of 0 to 26 months was given prior to implant placement while in patients where tertiary grafting was not done, a time of 24 to 144 months was seen between two procedures. A high implant success of 95%-100% was seen irrespective of the grafted bone. The JBI (Joanna Briggs Institute) tool of risk of bias assessment was used. Low level of evidence was presented by case reports and case series. Conclusion: In case of tertiary grafting, a healing period of 3-6 months was seen to be sufficient for successful implant treatment however, a need for more comprehensive studies was recognised due to lack of mutual assessment parameters and shared information in the currently reviewed literature. [ABSTRACT FROM AUTHOR]

Traumatic injuries are a primary cause of anterior tooth loss and associated soft and hard tissues damage. Management of lost teeth necessitates a multidisciplinary approach. While the simplest approach in such cases remains that of a Removable Partial Denture (RPD), problems with support and retention can often lead to functional limitations and patient discomfort. Further, patients generally prefer to have a fixed solution over a removable prosthesis. Conventional bridgework also does not provide with suitable replacement in patients with large edentulous spans, thereby, leaving dental implants as the only predictable rehabilitation option. Dental implants present with their own limitations in terms of need for sufficient bone volume for optimum biomechanical foundation for implant placement, adequate space between present teeth and vestibule depth to avoid impingement of the placed implant. This present report illustrates a case of 24-year-old male patient who experienced Road Traffic Accident (RTA) leading to multiple injuries and loss of permanent mandibular anterior teeth. Being dissatisfied with his current removable prosthesis, implantbased treatment was planned. Various clinical findings indicated towards need for onlay grafting and laser assisted periodontal surgery. Thus, a staged multidisciplinary approach was adopted. Postoperative clinical and radiographic findings showed clinically successful treatment. The patient too was satisfied with prosthesis functionality and achieved aesthetics. [ABSTRACT FROM AUTHOR]