Mesial and distal alveolar bone morphology in maxillary canines moved into the grafted alveolar cleft: Computed tomography evaluation

2017 ◽  
Vol 151 (5) ◽  
pp. 869-877 ◽  
Author(s):  
Daniela Garib ◽  
Camila Massaro ◽  
Marilia Yatabe ◽  
Guilherme Janson ◽  
José Roberto P. Lauris
2021 ◽  
Vol 9 ◽  
pp. 1
Author(s):  
Padminii Ellapakurthi ◽  
Gotike Siva Prasad Reddy

Objectives: The purpose of this study is to assess the effectiveness of mineralized plasmatic matrix in the soft tissue closure of naso-alveolar fistula, to estimate the postoperative bone fill and volume of the graft placed in the alveolar cleft defect using cone-beam computed tomography (CBCT) at 3rd- month and 6th- month. Material and methods: 10 patients, in the age group of 15‑30 years were included in this study. They were diagnosed with unilateral cleft lip and alveolus defects with or without a cleft palate requiring late secondary alveolar bone grafting. Alveolar cleft defects were closed with mineralized plasmatic matrix (MPM), a combination of autogenous iliac bone graft and platelet rich plasma (PRP) and platelet rich fibrin (PRF). Results: The mean defect volume pre-operatively is 0.75 cm3 and at the end of 3rd-month postoperatively is 0.51 cm3 and at 6th-month postoperatively is 0.27 cm3. The average percentage of bone fill between preoperative (A) & 3th- month postoperatively (B) is 33.4% and between 3rd-month (B) and 6th-month post operatively (C) is 49.5%. Conclusions: Utilization of this new matrix (MPM), has shown to be effective in the closure of the cleft defect, oro-nasal fistula and also reduction in the volume of the residual cleft defect seen with sequential cone-beam computed tomography (CBCT) radiographs.


Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak

Abstract Objectives This retrospective cross-sectional study aimed to present a new method for secondary alveolar bone grafting (SABG) assessment and to qualitatively evaluate the SABG results in unilateral cleft lip and palate patients. Materials and methods Research was conducted according to the STROBE guidelines. The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography (CBCT) was performed at least 1 year after grafting. The experimental side was the cleft side, and the contralateral side without a congenital cleft was the control. Measurements were performed at four levels of the maxillary central incisors’ roots according to the new scale with scores from 0 to 3. The sum of the scores provided a general assessment of bone architecture. The Wilcoxon signed-rank test was used for intergroup comparisons, and a Kappa coefficient was used for reproducibility measurements. Results High individual variability was found, and the bone architecture was significantly worse on the cleft side than on the noncleft side. The results showed 28.57% failure, 33.33% poor, 19.05% moderate, and 19.05% good results from the surgical procedure. Kappa coefficients produced results from 0.92 to 1.00 for intra-rater and from 0.81 to 1.00 for inter-rater reproducibility. Conclusions CBCT provides detailed information about alveolar bone morphology. The new assessment method is useful at every treatment stage and provides excellent repeatability. SABG did not provide good bone morphology, in most cases. Clinical relevance This research presents a new universal alternative for the assessment of SABG by utilizing CBCT.


2019 ◽  
Vol 57 (3) ◽  
pp. 273-281
Author(s):  
Najmeh Movahhedian ◽  
Mehrdad Vossoughi ◽  
Mahtab Hajati-Sisakht

Objective: To evaluate the bony support around the teeth adjacent to the unilateral cleft lip and palate (ULCLP) using cone-beam computed tomography. Methods and Materials: Cone-beam computed tomographies of 48 cleft-adjacent teeth (28 anterior and 20 posterior to the cleft) and 48 noncleft control teeth were evaluated. The alveolar bone thickness at 3 and 6 mm apical to the cement–enamel junction (CEJ), the distance between the alveolar crest and CEJ (Alv-CEJ), and the presence of fenestration were assessed in buccal, palatal, and proximal surfaces. Results: The alveolar bone on the buccal and palatal sides of the teeth anterior to the cleft was significantly thinner than the noncleft teeth (all P < .05). The Alv-CEJ was significantly greater on the buccal and distal surfaces of the teeth anterior to the cleft ( P < .001 and P = .010, respectively) and on the palatal and mesial surfaces of the teeth posterior to the cleft ( P = .024 and P = .003, respectively) when compared to the noncleft teeth. The frequency of reduced alveolar bone height (>2 mm) was higher than noncleft side for buccal and distal sides of the teeth anterior to the cleft ( P = .016 and .006, respectively) and the buccal and mesial sides of the teeth posterior to the cleft ( P = .008 and <.001, respectively). The teeth anterior to the cleft had a higher prevalence of fenestration ( P = .004). Conclusion: Reduced alveolar bone height is more common in the cleft side compared to the control side. The teeth anterior to the ULCLP have thinner alveolar bone support and higher frequency of fenestration.


2021 ◽  
Vol 159 (3) ◽  
pp. 258-270
Author(s):  
Gustavo Armando Ruíz-Mora ◽  
Luis Ernesto Arriola-Guillén ◽  
Yalil Augusto Rodríguez-Cárdenas ◽  
Aron Aliaga-Del Castillo ◽  
Mariana Boessio-Vizzotto ◽  
...  

2021 ◽  
pp. 105566562110026
Author(s):  
Ema Zubovic ◽  
Gary B. Skolnick ◽  
Abdullah M. Said ◽  
Richard J. Nissen ◽  
Alison K. Snyder-Warwick ◽  
...  

Objective: To determine the rate of revision alveolar bone grafting (ABG) in patients with cleft lip and palate (CLP) before and after the introduction of postoperative computed tomography (CT). Design: Retrospective case–control study analyzing the incidence of revision ABG in patients with and without postoperative CT scans for graft success evaluation. Setting: Academic tertiary care pediatric hospital. Patients: Eighty-seven patients with CLP or cleft lip and alveolus treated with autologous iliac crest bone grafting for alveolar clefts over a 10-year period (January 2009 to March 2019) with minimum 6-month follow-up. Fifty patients had postoperative CT evaluation; 37 did not. Interventions: Postoperative CT to determine ABG success, versus standard clinical examination and 2-dimensional radiographs. Main Outcome Measures: Requirement for revision ABG, defined as failure of the original graft by clinical or radiographic examination. Results: Fifty-eight percent of patients underwent a postoperative CT scan at median interval of 10 months after surgery. Patients with postoperative CT evaluation had a 44% rate of revision ABG (22/50) for inadequate graft take, compared to 5% (2/37) in patients without postoperative CT ( P < .001; 95% CT, 31%-58% in the CT group, 1%-16% in the non-CT group). Conclusions: Computed tomography evaluation after ABG is associated with a significantly increased revision rate for inadequate graft take. The presence of a secondary palatal fistula at the time of original ABG is not associated with revision requirement. Lack of standardized dental and orthodontic records complicates the study of ABG outcomes and presents an area for systems-based improvement.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kyungmin Lee ◽  
Gyu-Hyoung Lee

Abstract Background Radiographs are integral in evaluating implant space and inter-root distance. The purpose of this report is to introduce a method for evaluating the 3D root position with minimal radiation using a 3D tooth model composed of an intraoral-scanned crown and a cone-beam computed tomography (CBCT)-scanned root. Materials and methods Intraoral scan and CBCT scan of the patient were obtained before treatment. In the CBCT image, tooth segmentation was performed by isolating individual teeth from the maxillary and mandibular alveolar bone using software program. The 3D tooth model was fabricated by combining segmented individual teeth with the intraoral scan. Results A post-treatment intraoral scan was integrated into the tooth model, and the resulting position of the root could be predicted without additional radiographs. It is possible to monitor the root position after a pretreatment CBCT scan using a 3D tooth model without additional radiographs. Conclusion The application of the 3D tooth model benefits the patient by reducing repeated radiation exposure while providing the clinician with a precise treatment evaluation to monitor tooth movement.


2021 ◽  
pp. 105566562110076
Author(s):  
Caroline Dissaux ◽  
Laetitia Ruffenach ◽  
Catherine Bruant-Rodier ◽  
Daniel George ◽  
Frédéric Bodin ◽  
...  

Introduction: Since the early stages of alveolar bone grafting development, multiple types of materials have been used. Iliac cancellous bone graft (ICBG) remains the gold standard. Design/Methods: A review of literature is conducted in order to describe the different bone filling possibilities, autologous or not, and to assess their effectiveness compared to ICBG. This review focused on studies reporting volumetric assessment of the alveolar cleft graft result (by computed tomography scan or cone beam computed tomography). Results: Grafting materials fall into 3 types: autologous bone grafts, ICBG supplementary material, and bone substitutes. Among autologous materials, no study showed the superiority of any other bone origin over iliac cancellous bone. Yet ICBG gives inconsistent results and presents donor site morbidity. Concerning supplementary material, only 3 studies could show a benefit of adding platelet-rich fibrin (1 study) or platelet-rich plasma (2 studies) to ICBG, which remains controversial in most studies. There is a lack of 3-dimensional (3D) assessment in most articles concerning the use of scaffolds. Only one study showed graft improvement when adding acellular dermal matrix to ICBG. Looking at bone substitutes highlights failures among bioceramics alone, side-effects with bone morphogenetic protein-2 composite materials, and difficulties in cell therapy setup. Studies assessing cell therapy–based substitutes show comparable efficacy with ICBG but remain too few. Conclusion: This review highlights the lack of 3D assessments in the alveolar bone graft materials field. Nothing dethroned ICBG from its position as the gold standard treatment at this time.


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