*2.1.1.3.2 Bone grafts*

Pre-orthodontic Osseous surgeries.

Osseous craters - these do not repair or improve with orthodontic treatment hence they should be treated before any orthodontics is initiated [23]. They are inter proximal two walled defects which may be maintainable non-surgically, however if correction or intervention is required then it can be managed with shaping the defect and reducing the pocket depth. The need for surgery is based on many factors like patient compliance, location of the defect, resistance to treatment by the periodontium [24].

3 walled defects- these usually require auto generous bone grafts or allografts with resorbable membranes [25]. If the results of periodontal therapy are stable post 3-6 months after, then orthodontic treatment maybe considered.

Types of bone grafts used.


Bone grafting is very commonly done at many stages for cleft patients as an adjunct to the orthodontic treatment planning [26]. It has even been found that the canines organically are guided into the graft site also [27]. Hence grafting has been very essential part of orthodontics especially for cleft palate patients [28, 29].

Also it aids during cortication procedures. Many times to aid in tooth movements and to prevent the onset of any Osseous defects cortication is carried with a bone graft and the results are usually sound periodontium and excellent tooth movements. In many cases it also allows regeneration and restoration of the periodontium. With the help of a graft many difficult tooth movements can be continued in an otherwise compromised periodontium [30].
