Dental Implants in Cleft Lip, Alveolus, and Palate Patients: A Systematic Review

Purpose: Missing teeth are a major problem in cleft patients, who require specialized prosthetic management, including dental implants. The aim of this review was to investigate the optimal date for implant insertion in patients born with cleft lip and palate after bone grafting and to assess the long-term prognosis of the inserted dental implants. Materials and Methods: A systematic review of the current literature electronically in several databases and additional hand searching were performed. Relevant publications were assessed with regard to their evidence according to the guidelines of the Oxford Centre for Evidence-Based Medicine. Results: Forty-nine publications (prospective and retrospective clinical studies, case series, and case reports) were included for analysis, but only 18 clinical papers reported survival rates for dental implants (in all, 670 implants in 460 cleft patients). Most studies were evidence level 3b (case-control studies) or 4 (case series, case reports). Reported 5-year survival rates for dental implants in cleft patients ranged from 80% to 96% (mean, 88.6%). Implant placement is favored after growth is complete and is generally recommended within 4 to 6 months after bone grafting. Conclusions: Dental implants in patients with cleft lip and palate show high success rates and allow for sufficient oral rehabilitation. However, because of a lack of sufficient prospective clinical studies on dental implants in cleft patients, the available evidence is poor and insufficient. Keywords: bone grafting, cleft lip and palate, dental implants, implant survival, osteoplasty, review