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 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 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.

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.

Preliminary Report of Two-Stage Secondary Alveolar Bone Grafting for Patients with Bilateral Cleft Lip and Palate

2003 ◽  
Vol 40 (5) ◽  
pp. 449-452 ◽  
Author(s):  
S. Kamakura ◽  
T. Yamaguchi ◽  
S. Kochi ◽  
A. Sato ◽  
K. Motegi
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Contralateral Side ◽  
Two Stage ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Bilateral Cleft Lip ◽  
Secondary Alveolar Bone Grafting

Objective To overcome the difficulties of one-stage secondary alveolar bone grafting for patients with bilateral cleft lip and palate (BCLP) who have a broad alveolar cleft, the value of two-stage alveolar bone grafting was examined. Patients Three patients (2 girls and 1 boy) with BCLP were treated by two-stage alveolar bone grafting. The procedure consisted of a first-stage surgery (mean age 8 year 6 months ± 7.8 months), which consisted of alveolar bone grafting for one side of the BCLP, and second-stage surgery for the contralateral side several months later. For the postoperative assessment, radiographs of the operated site were examined. Results The average amount of implanted bone per operation and per patient was 6.8 ± 1.1 g and 13.7 ± 1.0 g, respectively. Postoperative clinical and radiographic examinations revealed that an appreciable alveolar bone ridge had formed, and there were no major complications. Conclusions Two-stage alveolar bone grafting, which makes it possible to reduce the amount of implanted bone, could be an optional surgical procedure for patients with BCLP and a broad alveolar cleft.

Outcomes of 44 Consecutive Complete Bilateral Cleft Lip and Palate Patients Treated with Secondary Alveolar Bone Grafting and Premaxillary Osteotomy

2017 ◽  
Vol 54 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Rupert Scott ◽  
Julia Scott ◽  
Sami Stagnell ◽  
Steve Robinson ◽  
Tim Flood
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Alveolar Bone Grafting ◽  
Bilateral Cleft Lip ◽  
Safe Technique ◽  
The Mean ◽  
Secondary Alveolar Bone Grafting

Objective To report the surgical outcomes of secondary alveolar bone grafting with premaxillary osteotomy in a single surgeon cohort of complete bilateral cleft lip and palate patients. Design Retrospective review of 44 consecutive patients using hospital notes and radiographs. Setting Single specialist cleft lip and palate center, UK. Patients Consecutive patients with complete bilateral cleft lip and palate who were being treated with secondary alveolar bone grafting incorporating premaxillary osteotomy. Outcome Measures Assessment of success of bone graft by Kindelan score; canine eruption; closure of fistulae and assessment of morbidity. Results Between January 6, 2000, and August 8, 2013, 44 patients with complete BCLP underwent secondary ABG with a premaxillary osteotomy as a one-stage procedure. The mean follow-up was 7.3 years (range 1.4 to 14.6). Eighty-five percent of ABGs were successful (a Kindelan score of 1 or 2), and canine eruption was 89%. Failure of the ABG occurred in 7%. Fistulae recurrence rate was 11%, all of which were asymptomatic. No premaxillae were devitalized. Conclusion Incorporating a premaxillary osteotomy into the secondary ABG surgical protocol can be a safe technique that gives excellent surgical exposure for fistula repair.

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