A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate

2019 ◽  
Vol 57 (3) ◽  
pp. 273-281
Author(s):  
Najmeh Movahhedian ◽  
Mehrdad Vossoughi ◽  
Mahtab Hajati-Sisakht
Keyword(s):  
Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Cone Beam ◽  
Bone Thickness ◽  
Bone Morphology ◽  
Computed Tomographic ◽  
Control Side ◽  
Bone Height

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.

scholarly journals A novel method for alveolar bone grafting assessment in cleft lip and palate patients: cone-beam computed tomography evaluation

2020 ◽  
Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Bone Architecture ◽  
Cone Beam ◽  
Bone Morphology ◽  
Alveolar Bone Grafting

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.

scholarly journals Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography

2018 ◽  
Vol 88 (3) ◽  
pp. 299-305 ◽  
Author(s):  
Yingdan Pan ◽  
Yunting Zeng ◽  
Zeyu Zhang ◽  
Yiqin Liu ◽  
Yi Jing ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Cone Beam ◽  
Bone Thickness ◽  
Computed Tomography Scans ◽  
Tooth Inclination ◽  
Bone Height

ABSTRACT Objectives: To evaluate alveolar bone support around cleft-adjacent maxillary central incisors (U1) in patients with unilateral cleft lip, alveolus and palate (UCLAP) in the late mixed dentition and to investigate the correlation between the alveolar bone thickness (ABT) and tooth inclination. Materials and Methods: Cone beam computed tomography scans of 45 subjects with UCLAP (29 boys, 16 girls; mean age = 10.74 ± 1.08 years) were assessed. The distance between the cementoenamel junction (CEJ) and alveolar bone crest (AC), and the ABTs at 3 mm, 6 mm, and the apex were measured on the labial, lingual and distal surfaces of U1. The cleft and normal sides were compared using a paired t-test and Pearson's χ2 test. Pearson's correlation was used to explore the association between the ABT and tooth inclination of cleft-adjacent U1 in the labiolingual and mesiodistal dimensions. Results: The CEJ-AC distances were significantly greater in cleft-adjacent U1 (P &lt; .01), with more bone height reduction observed labially and distally (P &lt; .001). The labial, lingual, and apico-distal ABTs were decreased on the cleft side (P &lt; .01). A positive correlation was found between the apico-labial ABT and the labiolingual inclination (r = 0.568, P &lt; .01). Conclusions: Patients with UCLAP have reduced alveolar bone support around the cleft-adjacent U1, and the apico-labial ABT tends to decrease with increasing lingual tooth inclination; however, the correlation was weak.

scholarly journals Alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients using cone-beam computed tomography evaluation

2021 ◽  
Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Contralateral Side ◽  
Cone Beam ◽  
Rank Test ◽  
Cross Sectional ◽  
Alveolar Bone Grafting

Abstract Purpose The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients and methods The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. Results The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. Conclusion The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.

Volumetric Assessment of Secondary Alveolar Bone Grafting Using Cone Beam Computed Tomography

2009 ◽  
Vol 46 (5) ◽  
pp. 503-511 ◽  
Author(s):  
Snehlata Oberoi ◽  
Radhika Chigurupati ◽  
Pawandeep Gill ◽  
William Y. Hoffman ◽  
Karin Vargervik
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Cone Beam ◽  
Alveolar Bone Grafting ◽  
Bilateral Cleft Lip ◽  
Secondary Alveolar Bone Grafting

Objective: To assess the radiographic outcome of secondary alveolar bone grafting in individuals with nonsyndromic unilateral or bilateral cleft lip and palate using cone beam computed tomography. Methods: This prospective study was conducted at the University of California at San Francisco Center for Craniofacial Anomalies on 21 consecutive nonsyndromic complete cleft lip and palate individuals between 8 and 12 years of age who required alveolar bone grafting. Seventeen unilateral and four bilateral cleft lip and palate individuals had preoperative and postoperative cone beam computed tomography scans that were analyzed using Amira 3.1.1 software. Results: The average volume of the preoperative alveolar cleft defect in unilateral cleft lip and palate was 0.61 cm3, and the combined average volume of the right and left alveolar cleft defects in bilateral cleft lip and palate was 0.82 cm3. The average percentage bone fill in both unilateral cleft lip and palate and bilateral cleft lip and palate was 84%. The outcome of alveolar bone grafting was assessed in relation to (1) type of cleft, (2) size of preoperative cleft defect, (3) presence or absence of lateral incisor, (4) root development stage of the maxillary canine on the cleft side, (5) timing, and (6) surgeon. None of these parameters significantly influenced the radiographic outcome of alveolar bone grafting. Conclusions: Secondary alveolar bone grafting of the cleft defect in our center was successful, based on radiographic outcome using cone beam computed tomography scans. Volume rendering using cone beam computed tomography and Amira software is a reproducible and practical method to assess the preoperative alveolar cleft volume and the adequacy of bone fill postoperatively.

scholarly journals Does Alt-RAMEC protocol and facemask treatment affect dentoalveolar structures?

2021 ◽  
Author(s):  
Elvan Önem Özbilen ◽  
Hanife Nuray Yılmaz ◽  
Yasemin Bahar Acar
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Alveolar Bone ◽  
Cone Beam ◽  
Distributed Data ◽  
Bone Thickness ◽  
Total Reduction ◽  
Computed Tomography Images ◽  
Significant Change ◽  
Bone Height

ABSTRACT Objectives To evaluate dentoalveolar changes immediately after the alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol and facemask (FM) treatment using cone-beam computed tomography images. Materials and Methods Cone-beam computed tomography images of 20 patients (mean age = 9.64 ± 1.3 years) who received the Alt-RAMEC protocol before FM treatment were retrieved in this retrospective study. Dental and alveolar inclinations, buccal and palatal alveolar bone thickness, and buccal and palatal alveolar bone height changes were measured before treatment (T0), after the Alt-RAMEC protocol (T1), and after FM treatment (T2). Measurements for right and left molars were performed separately. The Shapiro-Wilks test was used to assess the conformity of the parameters to the normal distribution. The paired t-test and repeated measures analysis of variance were used for normally distributed data. The Wilcoxon signed-rank test and Friedman test were used for non-normally distributed data. The Bonferroni correction was used to reduce the chances of obtaining false-positive results. Statistical significance was set at P &lt; .05. Results Buccal alveolar bone thickness and alveolar bone inclinations decreased significantly from T1 to T0 and showed no significant change from T2 to T1. The total reduction T2-T0 was statistically significant. The change in palatal alveolar bone thickness was not significant T1-T0 but increased significantly for T2-T1 and T2-T0. Buccal alveolar bone height, palatal alveolar bone height, and molar inclinations increased significantly T1-T0, but there was no significant change T2-T1. The total reduction at T2-T0 was statistically significant. Conclusions The results of this study revealed that the effects of the Alt-RAMEC protocol on dentoalveolar tissues were similar to the changes reported in the literature after rapid palatal expansion.

Relationship Between Crown to Root Ratio and Alveolar Bone Support in Patients With Unilateral Cleft Lip and Alveolus

2020 ◽  
pp. 105566562095015
Author(s):  
Sijing Huang ◽  
Yang Chen ◽  
Zhenqi Chen
Keyword(s):  
Root Length ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Care Center ◽  
Chinese Patients ◽  
Cone Beam ◽  
Bone Thickness ◽  
Crown Length ◽  
Tomography Data

Objectives: To evaluate the tooth lengths, crown to root ratios (CRRs), and alveolar bone support (ABS) around cleft-adjacent maxillary central incisors (U1s) in patients with unilateral cleft lip and alveolus (UCLA) and to investigate the relationships between CRR and ABS. Design: This is a retrospective study. Setting: Cleft Lip and Palate Care Center of Shanghai Ninth People’s Hospital, Shanghai, China. Patients: Fifty-eight Chinese patients with UCLA. Main Outcome Measure: Cone beam computed tomography data from 58 nonsyndromic patients with UCLA (36 males, 22 females; mean age = 12.65 ± 3.64 years) were evaluated. Crown length and root length, alveolar bone thickness (ABT), and the distances between the cementoenamel junction and alveolar bone crest on 4 surfaces of cleft-adjacent U1 were measured and compared with those of noncleft side in the same patients. Crown to root ratio and frequency of dehiscence were calculated and comparisons were also made between cleft and noncleft sides. Regression analysis was performed to explore the association between CRR and ABS. Results: The CRR of cleft-adjacent U1 and alveolar bone crest heights (ACHs) on the 4 surfaces were significantly greater than those of noncleft side ( P < .01). A 3 mm labial, all lingual, and apico-distal ABTs decreased on the cleft side ( P < .01). A positive correlation was found between lingual ACH and CRR ( R = 0.316, P < .05), between the 3 mm ( R = 0.417, P < .05) and 6 mm labial ( R = 0.448, P < .05) ABT and CRR. A negative correlation was found between the 3 mm and 6 mm labial ABTs and the root length. Conclusions: It can be suggested that the CRR is related to ACH and ABT. The lingual ACH, the 3 mm, and 6 mm labial ABTs tend to increase with the increasing CRR.

Alveolar Bone Morphology in Patients with Bilateral Complete Cleft Lip and Palate in the Mixed Dentition: Cone Beam Computed Tomography Evaluation

2012 ◽  
Vol 49 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Daniela Gamba Garib ◽  
Marília Sayako Yatabe ◽  
Terumi Okada Ozawa ◽  
Omar Gabriel da Silva Filho
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Bone Plate ◽  
Cone Beam ◽  
Axial Section ◽  
Bilateral Cleft Lip

Objectives To verify the thickness and level of alveolar bone around the teeth adjacent to the cleft by means of cone beam computed tomography (CBCT) in patients with complete bilateral cleft lip and palate prior to bone graft surgery and orthodontic intervention. Method The sample comprised 10 patients with complete bilateral cleft lip and palate (five boys and five girls) in the mixed dentition. The mean age was 9.5 years, and all subjects showed a G3 interarch relationship according to the Bauru index. The thickness of alveolar bone surrounding the maxillary incisors and the maxillary canines was measured in CBCT axial section using the software iCAT Xoran System. The distance between the alveolar bone crest and the cement-enamel junction (CEJ) was measured in cross sections. Results The tomography images showed a thin alveolar bone plate around teeth adjacent to clefts. No bone dehiscence was observed in teeth adjacent to clefts during the mixed dentition. A slight increase in the distance between the alveolar bone crest and the CEJ was observed in the mesial and lingual aspects of canines adjacent to cleft. Conclusion In patients with BCLP in the mixed dentition, teeth adjacent to the alveolar cleft are covered by a thin alveolar bone plate. However, the level of alveolar bone crest around these teeth seems to be normal, and no bone dehiscence was identified at this age.

Sign in / Sign up

Export Citation Format

Share Document