The influence of bone grafting age on dental abnormalities and alveolar bone height in patients with unilateral cleft lip and palate

1989 ◽  
Vol 11 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Viveca Brattström ◽  
John McWilliam
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Dental Abnormalities ◽  
Bone Height

Dental Abnormalities, Bone Graft Quality, and Periodontal Conditions in Patients with Unilateral Cleft Lip and Palate at Different Phases of Orthodontic Treatment

2003 ◽  
Vol 40 (4) ◽  
pp. 343-350 ◽  
Author(s):  
G. Dewinter ◽  
M. Quirynen ◽  
K. Heidbüchel ◽  
A. Verdonck ◽  
G. Willems ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Root Resorption ◽  
Periodontal Condition ◽  
External Root Resorption ◽  
Dental Abnormalities

Objectives To evaluate the dental and periodontal condition of patients with unilateral cleft lip and palate (UCLP) before orthodontic treatment and evaluate whether the dental and periodontal condition of these patients during and after orthodontic treatment was jeopardized by the duration of the orthodontic and surgical treatment. Design Seventy-five individuals with UCLP (52 males, 23 females), between ages 8 and 20 years, participated in a retrospective study during their final follow-up visit with regard to dental abnormalities, such as hypodontia, external root resorption, crown and root malformation, and supernumerary teeth. Alveolar bone height and periodontal attachment loss on the cleft side were also screened before or after bone grafting and at different stages of orthodontic treatment. Results Hypodontia of the lateral incisor was found in more than 50% of the patients on the cleft side. Second premolars and/or lateral incisors outside the cleft area were missing in 27.2% of the patients. In 32%, malformations of the teeth near the cleft were noticed. In general, the teeth around and in the cleft of the patients showed normal septal bone heights and a healthy periodontium. Sixty of the 75 patients received a bone graft to restore the interrupted alveolar process. In 93.3% of these patients, the cleft was grafted before the eruption of the canine. Conclusion The periodontium of the teeth in and around the cleft in patients with UCLP observed during and after orthodontic treatment can cope relatively well with the long orthodontic treatment and combined surgical interventions. The children, who had not yet started treatment, also showed enough bone support and no periodontal problems of the teeth besides the cleft. Early secondary bone grafting seems to give optimal periodontal results.

Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 173-179
Author(s):  
Fatemeh Jabbari ◽  
Laila Wiklander ◽  
Erika Reiser ◽  
Andreas Thor ◽  
Malin Hakelius ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Dental Restoration ◽  
Dental Restorations ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting ◽  
Bone Height

Objective: To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height. Design: Observational follow-up study. Setting: Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden. Patients: 40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate. Interventions: Clinical examination, CBCT, and occlusal radiographs. Main Outcome Measurements: Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up. Results: The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total ( P = .045) and by subgroup with dental restoration ( P = .0078). This was positively correlated with the gingival bleeding index (GBI) ( r = 0.51, P = .0008) and presence of dental restorations in the cleft area ( r = 0.45, P = .0170). There was no difference in the Bergland index generated from scoring the alveolar bone height on occlusal radiographs as with the equivalent index on CBCT. Conclusion: Patients rehabilitated with complex dental restoration seems to be at higher risk for progression of bone loss in the cleft area. Supportive periodontal therapy should be implemented after complex dental restorations in cleft patients. Conventional occlusal radiographs provide an adequate image for evaluating postoperative bone height in clinical follow-up.

Mind the Gap: Alveolar Bone Graft Revision in the Era of Computed Tomography

2021 ◽  
pp. 105566562110026
Author(s):  
Ema Zubovic ◽  
Gary B. Skolnick ◽  
Abdullah M. Said ◽  
Richard J. Nissen ◽  
Alison K. Snyder-Warwick ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Tertiary Care ◽  
Radiographic Examination ◽  
Graft Take ◽  
Alveolar Bone Grafting ◽  
Ct Evaluation

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.

scholarly journals Permanent maxillary central incisor and first molar rotations in the mixed dentition in repaired complete unilateral cleft lip and palate and their relationship with absence of teeth in their vicinity

2018 ◽  
Vol 88 (5) ◽  
pp. 567-574
Author(s):  
Sunjay Suri ◽  
Suteeta Disthaporn ◽  
Bruce Ross ◽  
Bryan Tompson ◽  
Diogenes Baena ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Permanent Tooth ◽  
Mixed Dentition ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Anterior Teeth ◽  
Alveolar Bone Grafting

ABSTRACT Objectives: To describe qualitatively and quantitatively the directions and magnitudes of rotations of permanent maxillary central incisors and first molars in the mixed dentition in repaired complete unilateral cleft lip and palate (UCLP) and study their associations with absence of teeth in their vicinity. Materials and Methods: Dental casts and orthodontic records taken prior to orthodontic preparation for alveolar bone grafting of 74 children with repaired UCLP (53 male, 21 female; aged 8.9 ± 1.0 years) were studied. Directions and magnitudes of permanent maxillary central incisor and first molar rotations were recorded. Tooth absence was confirmed from longitudinal radiographic records. Incisor and molar rotations were analyzed in relation to the absence of teeth in their vicinity. Results: Distolabial rotation of the permanent maxillary central incisor was noted in 77.14% on the cleft side, while distopalatal rotation was noted in 82.19% on the noncleft side. Incisor rotation was greater when a permanent tooth was present distal to the cleft side central incisor, in the greater segment. The permanent maxillary first molar showed mesiopalatal rotation, which was greater on the cleft side and when there was absence of one or more teeth in the buccal segment. Conclusions: Presence and absence of teeth were associated with the severity of incisor and molar rotations in UCLP. Crowding of anterior teeth in the greater segment was associated with a greater magnitude of rotation of the cleft side permanent central incisor. Absence of one or more buccal segment teeth was associated with greater magnitude of rotation of the molar.

Surgical Repositioning of the Premaxilla in Combination with Two-Stage Alveolar Bone Grafting in Bilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Mitsuyoshi Iino ◽  
Tomokazu Sasaki ◽  
Shoko Kochi ◽  
Masayuki Fukuda ◽  
Tetsu Takahashi ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Surgical Procedure ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Two Stage ◽  
Alveolar Bone Grafting ◽  
Bilateral Cleft Lip

Objective This paper introduces a surgical technique for premaxillary repositioning in combination with two-stage alveolar bone grafting for the correction of the premaxillary deformity of patients with bilateral cleft lip and palate (BCLP). The paper also reports on two patients with BCLP who underwent this surgical management. Surgical Procedure The operation is usually performed when the patient is 8 to 14 years of age. In the first stage of surgery, the side more accessible to the septopremaxillary junction is selected, and an osteotomy of the premaxilla and unilateral alveolar bone grafting are performed. Approximately 4 to 12 months after the first stage of surgery, contralateral alveolar bone grafting is carried out. Conclusion We have found that this surgical procedure is highly effective, because it ensures the blood supply to the premaxilla and minimizes the potential for surgical failure. Moreover, it affords wide exposure of the premaxillary bone surface, facilitating sufficient boney bridging and allowing for orthodontic tooth movement.

Does Early Secondary Alveolar Bone Grafting Influence Need for Additional Maxillary Advancement Procedures in Cleft Lip and Palate?

2021 ◽  
pp. 105566562110427
Author(s):  
Kathlyn K. Powell ◽  
Paul Lewis ◽  
Rae Sesanto ◽  
Peter D. Waite
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Treated Patient ◽  
Tertiary Care ◽  
Mixed Dentition ◽  
Maxillary Advancement ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

Objective To determine if secondary alveolar bone grafting (SABG) timing in patients with cleft lip and palate (CLP) influences the future need for additional maxillary advancement procedures, particularly Le Fort I osteotomy with rigid external distraction (RED). Design Retrospective cohort study. Groups were separated by SABG timing: early mixed dentition (ages 68 years) or late mixed dentition (ages 9-11 years). The criterion for RED was negative overjet ≥8 mm, and sufficient dental development for RED. Setting Single tertiary care institution. Patients Patients with CLP that underwent SABG from 2010 to 2015. Exclusion criteria included syndromic conditions, SABG surgery at age >12 years, current age <12 years, and <2 years follow-up. 104 patients were included. Main outcome measures The number of RED candidates and treated patients. Results There was no statistical difference in the number of RED candidates ( P  =  .0718) nor treated patients ( P  =  .2716) based on SABG timing; stratification by laterality was also insignificant. Early SABG is associated with higher odds of being a RED candidate (pooled, unilateral, bilateral) and treated patient (pooled and unilateral); however, there were no statistically significant associations between SABG timing and the number of RED candidates and treated patients as determined by logistic regression models. Conclusion There is no statistically significant association between SABG timing and the odds of being a RED candidate or treated patient. Future prospective studies are recommended to assess the relationship between SABG timing and maxillary growth in patients with CLP.

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