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The aim of this retrospective study was to evaluate the outcomes of secondary alveolar bone grafting and late secondary alveolar bone grafting in 66 unilateral cleft lip and palate patients.The total patients were 66 unilateral cleft lip and palate patients, out of which 19 patients underwent secondary alveolar bone grafting and 47 patients underwent late secondary alveolar bone grafting. Autogenous anterior iliac crest cancellous bone graft was harvested and used for grafting the alveolar clefts. Radiographic assessment based on Enemark's scoring according to the marginal bone levels was done on the intraoral periapical radiographs taken 6 months after performing the surgery.Twelve (63%) out of the 19 patients on whom secondary alveolar bone grafting was done achieved score 1 (optimal marginal bone levels), whereas only 12 (25%) out of the 47 patients achieved score 1 amongst the late secondary alveolar bone graftings. Overall results showed, probability,This study reaffirmed the fact that alveolar bone grafting when done in preadolescent age group (secondary alveolar bone grafting) gives better results in terms of marginal bony consolidation and maintaining the continuity of the alveolar arch, but the late presentation (late secondary alveolar bone grafting) should not be the refusal criteria for performing the alveolar bone grafting. Although the latter patients may not be rewarded in terms of bony consolidation as much as the preadolescent patients the potential of successful surgery in them still exists in terms of providing a platform for the dental implant placement, improvement in the soft tissue symmetry and aesthetics of the face.La présente étude rétrospective visait à évaluer le résultat des alvéoloplasties secondaires et des alvéoloplasties secondaires tardives chez 66 patients ayant une fente labio-palatine unilatérale.Au total, 66 patients ayant une fente labio-palatine unilatérale ont participé à l’étude, dont 19 ont subi une alvéoloplastie secondaire et 47, une alvéoloplastie secondaire tardive. Les plasticiens ont prélevé de l’os spongieux autologue au niveau de la crête iliaque pour le greffer dans la fente alvéolaire. Six mois après l’opération, ils ont attribué un score d’Enemark à la hauteur de l’os marginal d’après leur examen des radiographies périapicales intraorales.Douze des 19 patients (63 %) qui avaient subi une alvéoloplastie secondaire ont obtenu un score de 1 (hauteur optimale de l’os marginal), par rapport à seulement 12 des 47 patients (25 %) qui avaient subi une alvéoloplastie secondaire tardive. Les résultats globaux ont démontré une probabilitéLa présente étude confirme que l’alvéoloplastie réalisée chez des préadolescents (alvéoloplastie secondaire) assure une meilleure consolidation osseuse marginale et la continuité de l’arc alvéolaire, mais une présentation tardive (alvéoloplastie secondaire tardive) ne devrait pas constituer un critère pour refuser l’alvéoloplastie. Même si les patients plus âgés ne profitent pas d’une aussi bonne consolidation osseuse que les préadolescents, il se peut tout de même que l’opération leur fournisse la plateforme nécessaire pour installer l’implant dentaire, améliorer la symétrie des tissus mous et l’esthétisme du visage.

Wider alveolar clefts/fistulae and maxillary dentoalveolar defects pose problems in achieving complete closure because of the requirement of a greater volume of bone as a graft. Segmented osteotomies have been used successfully for the repositioning of minor segments; however, in major segmented movements, the closing of the flap and the blood supply of the osteotomized segment may be compromised. Interdental distraction osteogenesis has overcome this problem by creating a segment of new alveolar bone and complete approximation of wider alveolar defects. This case report shows an effective and efficient way of distraction using a modified Hyrax appliance.

Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb. This modified speech bulb is a combination of hard acrylic and soft lining material. The hard self-curing acrylic resin covers only the hard palate area and a permanent soft silicone lining material covering the soft palate area. A claw-shaped wire component was extended backwards from acrylic and was embedded in soft silicone to aid in retention and approximation of two materials. The advantage of adding the soft lining material in posterior area helped in covering the adequate superior extension and margins for maximal pharyngeal activity. This also improved the hypernasality, speech, comfort and overall patient acceptance.

Rhinolith is a calcareous secretion that occurs in the nasal cavity and is usually discovered during routine radiographic examination as it is rare, unilateral, and asymptomatic. It can sometimes lead to nasal obstruction, fetid odor, and purulent secretion. This case report is about the accidental finding of rhinolith during conventional diagnostic procedure. A 10-year-old female had an ovoid radiopacity in the right side of the nasal cavity. Although the patient had no symptoms of prevalence of this mass, it was found during routine radiographic examination. After the complete investigation of the radiopaque mass with the help of cone-beam computed tomography, the rhinolith was endoscopically removed.

The aim of this study was to compare the transverse dimensions of the dental arches and alveolar arches in the canine, premolar, and molar regions of Class II division 1 and Class II division 2 malocclusion groups with normal occlusion subjects. This study was performed using measurement on dental casts of 60 normal occlusion (mean age: 20.2 years), 60 Class II division 1 (mean age: 20.3 years), and 30 Class II division 2 (mean age: 20.5 years) malocclusion subjects.