Evaluation of Alveolar Cleft Grafting Using Khoury Shell Technique

Iliac cancellous bone is considered the gold standard graft material for secondary ABG, which was applied as a block or granules, and difficult to be stabilized in the recipient site causing dislodgment of the graft which in turn leads to resorption and/or continuity between nasal and oral cavities. On the other hand, the cortico-cancellous block graft produces more mechanical strength and stability, but the cortical part is less vascular, and so establishment of nutritional supply to cortical cells is a slow process. Therefore, this graft generally resorbs and is replaced by invasion of bone cells originating from the recipient site. Khoury F. and Khoury CH. made a variation by splitting the solid cortical bone into two thinner shells, so more vascular chips can be packed and take the advantage of more and early revascularization of cancellous bone plus the advantage of cortical bone in terms of mechanical stability and restoring the labial plate. In this study, we evaluate the regenerated bone following alveolar cleft grafting using Khoury shell technique.