restoration {alveolar bone graft}

What is an alveolar bone?

Some children who are born with both a cleft lip and a cleft palate also have a problem with the alveolar (al-vee-OLE-ar) bone, which makes up the gum ridge or front portion of the roof of the mouth. The alveolar bone is a thin layer of bone that forms the sockets around the roots of the upper teeth under the gum tissue.

When there is a cleft in the alveolar bone, it means there is a fistula (FIST-yoo-la) or hole from the mouth to the nose. This cleft in the bone and gums prevents teeth from growing properly and the floor of the nose from developing normally. 

What is an alveolar bone graft?

The alveolar bone graft repairs the hole in the gum ridge and stabilizes the bone arch, providing better support for the base of the nose and new bone for the roots of the developing teeth to grow into.

How is the graft done in surgery?

To do the bone graft, a piece of bone usually will be taken from your child’s iliac (ILL-ee-ack) crest, the upper ridge of the hip bone. The doctor will make a 1- to 3-inch incision (in-SIZZ-yun) or cut in the skin just over the hip bone and in the bone itself to remove the inner portion of the bone. This part of the bone, called cancellous (CAN-sell-us) bone, is soft and pasty and can be shaped to form the patch that will close the hole in the alveolar bone. Gum tissue inside your child’s mouth then will be closed around the bone and sutures (SOO-chers) or stitches will hold the tissue in place as it heals. 

This is the general lowdown on the surgery that Emma Kate will experience sometime this fall.  Today we drive an hour away to consult on that surgery with our oral-maxiofacial surgeon, Dr. Sampson.

I would be Dr. Sampson's favorite patient if I were 12.  Yes, it is true.  I was a complete nerd and hugely loved my headgear.  

I know.  Gasp with me.

And yes, I did share that lovely little tidbit at the cleft team meeting.  I'm sure the geneticist was feverishly jotting down notes about me.  Dr. Sidman laughed aloud and said Dr. Sampson loves the headgear.  Apparently those of us that do are few and far between.

Enough said.

Or, make a comment.  Come on!  You know you want to!  

If you could have seen me then...

Back to our regularly scheduled programming: Emma Kate.

We go today of all days because the timing of this surgery is crucial.  We need to fit it in after her sphincter pharyngoplasty {say that twelve times fast}, which is on July 25.  And it needs to occur before her permanent front teeth emerge.  Since she has started to lost bottom teeth, we are in the time range for doing it promptly.

How to be so glad your daughter can have all these surgeries to restore her mouth, and also so sad for her to have to endure so many surgeries?

She is grace personified.

After our neurological visit yesterday, I had the starch knocked out of me for the end part of the day.  I felt this tired feeling of relief.  I'm wishing we didn't have to go today, because I'd like instead to sit around and eat grilled cheese and tomato soup on the screen porch while the rain falls outside.  I'd like to cuddle up with the kiddos and ignore the rest of life's duties.  An ostrich day?  Head in the sand and all.

Nope.  We're off here shortly.  And I know when we are home, it will be good.  Worthwhile and important.  

Jeb only threw up twice this morning getting the molds of his teeth for his braces.  Wonder how Emma Kate will do having her very first panoramic x-rays.

I think I'm getting a latte.  Seriously.  :)

We'll update the sidebar on our "upcoming surgeries" when we know more!  

Thursday love from rainy 63 degree Minnesota!,

Sara