Long-Term Treatment Outcomes of Primary Alveolar Bone Grafts for Alveolar Clefts: A Qualitative Systematic Review

2021 ◽  
pp. 105566562199504
Author(s):  
M. Kristine Carbullido ◽  
Riley A. Dean ◽  
George N. Kamel ◽  
Greta L. Davis ◽  
Michael Hornacek ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Graft Survival ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Inclusion Criteria ◽  
Long Term Outcomes ◽  
Qualitative Systematic Review ◽  
Alveolar Bone Grafting

Background: Alveolar bone grafting is utilized to manage alveolar clefts in patients with cleft lip and palate. However, the timing of bone grafting is variable with conflicting evidence supporting the use of primary alveolar bone grafting (PABG) in clinical practice. Primary Aim: To provide a qualitative systematic review analysis of long-term outcomes after PABG. Materials and Methods: A qualitative systematic review was performed following the Cochrane Handbook and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Summative findings were evaluated using Confidence in the Evidence from Reviews of Qualitative research to assess the quality of evidence supporting the findings. Results: After removing duplication, 2182 publications were identified, and 2131 were excluded after screening through titles and abstracts. Inclusion criteria for this study included patients who underwent PABG at 24 months of age or younger and a minimum of 5 year follow-up. Thirty-two publications met the inclusion criteria and were included for qualitative analysis. Primary outcome measures included cephalometric analysis, bone graft survival, occlusal analysis, hypomineralization, tooth eruption, radiograph analysis, and arch relationships. Four assessment themes were characterized from the systematic review: (1) bone graft survival, (2) craniofacial skeletal relationships, (3) occlusion and arch forms, and (4) recommendations for utilizing PABG in practice. Conclusion: The reported systematic review provides evidence that performing PABG leads to poor long-term outcomes related to bone graft survival and maxillary growth restriction despite some reported positive outcomes.

scholarly journals Cancellous Bone Versus Tricalcium Phospate (TCP) For Bone Grafting: A Literature Review And Case Report Of Alveolar Bone Grafting In Cipto Mangunkusumo Hospital

2018 ◽  
Vol 4 (2) ◽  
pp. 124-130
Author(s):  
Muhammad Iqbal Maulana ◽  
Akmal Primadian ◽  
Julieta Pancawati ◽  
Kristaninta Bangun
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Bone Grafting ◽  
English Language ◽  
Alveolar Bone ◽  
Inclusion Criteria ◽  
Hydroxy Apatite ◽  
Synthetic Materials ◽  
Surgical Methods ◽  
Alveolar Bone Grafting

Background: In the last decade, there are various methods of bone grafting in plastic surgery. Cancellous bone is more often used as bone graft than cortical bone due to its high osteoconductivity and osteogenic capability. The synthetic materials for bone graft such as tricalcium phospate (TCP) and hydroxy-apatite can be use as new alternative for bone grafting surgery. Methods: The PubMed®  databases were searched using the terms: ‘bone graft OR bone grafting’ AND ‘cancellous bone OR iliac crest OR tibia’ AND ‘tricalcium phospate OR tricalciumphospate OR tri calcium phospate’, restricted to English language, and to a publication period from January 2010 to January 2017. The inclusion criteria were any kind of research paper that compared the utility of TCP synthetic graft and autograft as a bone graft. Results: Out of 139 selected studies, only 8 met the inclusion criteria.  In 6 publications TCP graft has similar outcome and in 1 publication have a better result in reducing post operative complication.  Conclusion: TCP graft can be used as substitution for autograft in particular clinical conditions and surgical methods.

scholarly journals Effectiveness of Secondary Alveolar Bone Graft on Canine Eruption: Systematic Review

2021 ◽  
Author(s):  
Rogério Lacerda-Santos ◽  
Rhaslla Gonçalves Batista ◽  
Samantha Silva Neves ◽  
José Lucas dos Santos Araújo ◽  
Rayssa Amaral Vieira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Risk Of Bias ◽  
Tooth Eruption ◽  
Lateral Incisor ◽  
Alveolar Bone Grafting

Abstract There are controversies related to the effects of bone grafts on tooth eruption and impaction in patients with cleft lip and palate. The aim of this systematic review was to evaluate the effectiveness of bone grafting on eruption of canines in patients with unilateral cleft lip and palate (UCLP). An electronic search was conducted in six electronic databases and gray literature, without limitations on year of publication or language. The primary outcome was the increase in rate of canine eruption; the secondary outcomes were success of the bone graft, canine impaction due to agenesis of the lateral incisor, and effect of orthodontic treatment before and after bone grafting. The risk of bias was analyzed by means of the tool Cochrane risk of bias in nonrandomized controlled trials (NRCTs) of interventions (ROBINS-I). The certainty of the evidence was assessed for outcomes reported through a narrative synthesis using grading of recommendations, assessment, development and evaluation (GRADE) approach. Four NRCTs were included, with a total of 360 patients, 283 UCLP and 77 bilateral cleft lip and palate (BCLP). The studies reported association between the increase in the rate of tooth eruption and bone graft with very low certainty of evidence, and greater experience of surgical success, with low certainty of evidence. The majority of the studies found an association between increase in the rate of canine impaction and agenesis of the lateral incisor, with very low certainty of evidence. There was very low certainty of the efficacy of secondary alveolar bone grafting for increasing the rates of eruption and reducing impaction of the maxillary canine.

Long Term Effects of the Latham Presurgical Maxillary Orthopedic Appliance, Including Effects on Tooth Growth

2000 ◽  
Vol 8 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Michel C Samson ◽  
Donald H Lalonde ◽  
Donald Fitzpatrick ◽  
Gerald L Sparkes
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Consistent Difference ◽  
Long Term Effects ◽  
Beneficial Effects ◽  
Alar Base ◽  
Alveolar Bone Grafting ◽  
Base Elevation

Reported beneficial effects of presurgical maxillary orthopedics in cleft lip include reduction of the cleft width, alignment of the maxillary segments, elevation of the alar base on the cleft side, diminished need for alveolar bone grafting and lip closure without tension. Possible adverse effects of presurgical maxillary orthopedics include tooth root damage and inability of periosteoplasty to make bone over the cleft. A series of wide cleft lip patients (n=15) treated with the Latham appliance at the time of lip closure were retrospectively compared with a similar group treated without the Latham appliance. The Latham appliance group (seven unilateral clefts, eight bilateral clefts; mean follow-up 9.5 years; range four to 18 years) was treated between the years 1980 and 1994. None of the 15 patients treated with the appliance had any tooth loss or damage attributable to the pins, and bone formation in the alveolar cleft was observed radiographically in all 13 of the patients who had a periosteoplasty at the time of lip repair, possibly obviating the need for secondary bone grafting. Five of these Latham group patients demonstrated clinical and radiographic evidence of tooth eruption into the periosteoplasty-formed bone. There was no consistent difference in the level of nasal alar base elevation in the two groups.

Early Alveolar Bone Grafting Is Associated with Lower Regraft Rates and Improvements in Long-Term Psychosocial Outcomes

2021 ◽  
Vol 149 (1) ◽  
pp. 60e-67e ◽  
Author(s):  
Allison C. Hu ◽  
Nirbhay S. Jain ◽  
Candace H. Chan ◽  
Sri Harshini Malapati ◽  
Brian N. Dang ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Psychosocial Outcomes ◽  
Alveolar Bone Grafting

Cleft Width and Secondary Alveolar Bone Graft Success

1995 ◽  
Vol 32 (5) ◽  
pp. 420-427 ◽  
Author(s):  
Ross E. Long ◽  
Barbara E. Spangler ◽  
Mimi Yow
Keyword(s):  
Bone Graft ◽  
Root Length ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Distal Segment ◽  
Distortion Correction ◽  
Distal Margin ◽  
Maxillary Central Incisor ◽  
Alveolar Bone Grafting ◽  
Graft Success

Fifty-six cleft sites were reviewed prior to alveolar bone grafting and subsequently evaluated for graft success using study models, periapical and occlusal radiographs from the Lancaster Cleft Palate Clinic. All patients in this sample had presurgical orthodontics to expand and align the maxillary arch prior to alveolar bone grafting. Ninety-five percent of the grafts were done using iliac crest, the remaining 5% were cranial grafts. The alveolar bone grafting technique used was as described by Boyne and Sands (1972, 1976). Cleft width was measured on a radiograph taken no more than 1 month preoperatively, following the completion of all orthodontic expansion. Cleft width was determined by inspection at its narrowest point. A distortion correction was attempted by determining the ratio of the radiographic width of the maxillary central incisor adjacent to the cleft compared with the actual width of this tooth measured on study models. The radiographic cleft width was then multiplied by this factor to approximate true cleft width. Alveolar contour was measured at least 6 months postoperatively using ratios of actual bone heights measured at the mesial, middle, and distal margin of the previous cleft compared with root length of adjacent teeth. This was to eliminate the radiographic distortion factors of foreshortening and elongation. Regression analysis was carried out to see if there was a correlation between preoperative cleft width and eventual success of the graft as measured on postsurgical radiographs. The success rate for achieving a bony bridge across the cleft was 91%. Mean alveolar crest height achieved was 93% of the anatomic root length of the tooth in the proximal segment and 96% of the anatomic root length of the tooth in the distal segment. There was significant, but low, negative correlation between presurgical cleft width and alveolar bone attachment of teeth adjacent to the grafted cleft site, after a mean radiographic follow-up of 3.1 years. Notching of the alveolar ridge in the region of the bone graft had a statistically significant low positive correlation with differing cleft widths.

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