Cortico-Cancellous Bone And Deep Fascia In Alveolar Cleft Reconstruction

This case report presents an innovative technique utilizing cortico-cancellous iliac bone grafts combined with autologous deep fascia as a barrier membrane to enhance alveolar cleft repair outcomes. A 15-year-old male with congenital left maxillary alveolar cleft underwent secondary reconstruction. Surgical steps included: (1) mucoperiosteal flap elevation to create a pouch-like recipient bed; (2) harvesting a 2.5×1.5 cm cortico-cancellous iliac bone block and deep fascia; (3) graft placement stabilized with titanium plates/screws, augmented by deep fascia coverage to guide tissue regeneration. One-year CBCT revealed successful osseous bridging at the cleft site (21-23) with stable bone integration, despite minor tooth displacement. The cortico-cancellous architecture provided structural support and osteogenic cells, while the deep fascia served as a resorbable barrier to isolate the graft from soft tissue interference. This dual strategy surpasses conventional cancellous-only grafts by improving volume retention and minimizing membrane-related complications. The technique leverages biological principles of guided bone regeneration without synthetic materials. This approach demonstrates the synergistic benefits of cortico-cancellous bone and autologous fascia in alveolar cleft repair, offering a clinically viable solution to enhance bone healing and long-term stability in complex craniofacial reconstructions.