Evaluation of Bone Volume after Secondary Bone Grafting in Unilateral Alveolar Cleft Using Computer-Aided Engineering

2014 ◽  
Vol 51 (6) ◽  
pp. 665-668 ◽  
Author(s):  
Hayato Nagashima ◽  
Yoshiaki Sakamoto ◽  
Hisao Ogata ◽  
Junpei Miyamoto ◽  
Masaki Yazawa ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Bone Grafting ◽  
Three Dimensional ◽  
Bone Grafts ◽  
Bone Volume ◽  
Computer Aided Engineering ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Computer Aided

The purpose of this study was to evaluate the initial defect and the outcome of bone grafts for unilateral alveolar cleft. To determine the absorption of the bone graft in patients with unilateral cleft, computer-aided engineering (CAE) with multi-detector row computed tomography (MDCT) was used. MDCT scans of 29 patients were taken immediately preoperatively and at 1 month and 6 months postoperatively. The patients underwent bone grafting between 8 and 14 years of age using iliac crest bone grafts. Three-dimensional models were created in each period, and the defect at the alveolar cleft and volume of the bone graft were determined in each patient using CAE. Cleft volume and success of alveolar bone grafting were significantly correlated ( P < .01). Alveolar clefts with cleft palate required more bone volume than those without cleft palate ( P < .01), but the resorption rate did not significantly differ between alveolar clefts with and without cleft palate (0.48 ± 0.14 and 0.49 ± 0.18, respectively; P =.93). In conclusion, three-dimensional reconstruction of bone grafts using CAE based on MDCT provides a valuable objective assessment of graft volume.

Reduced Need for Alveolar Bone Grafting by Presurgical Orthopedics and Primary Gingivoperiosteoplasty

1998 ◽  
Vol 35 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Pedro E. Santiago ◽  
Barry H. Grayson ◽  
Court B. Cutting ◽  
Mark P. Gianoutsos ◽  
Lawrence E. Brecht ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Primary Study ◽  
Control Group ◽  
Dental Ct ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Presurgical Orthopedics

Objective The purpose of this study was to evaluate if narrowing and approximation of the alveolar cleft through presurgical alveolar molding followed by gingivoperiosteoplasty (GPP) at the time of lip repair reduces the need for a bone-grafting procedure. Design This was a retrospective blind study of patients with unilateral or bilateral alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon. Alveolar bone formation was assessed prior to the eruption of the maxillary lateral incisor or canine by clinical examination, panoramic and periapical radiographs, and/or a dental CT scan. The criterion for bone grafting was inadequate bone stock to permit the eruption and maintenance of the permanent dentition. Setting This study was performed at the Institute of Reconstructive Plastic Surgery by the members of the Cleft Palate Team. Patients All patients with unilateral (n = 16) or bilateral (n = 2) alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon from 1985 to 1988 were studied. The control population consisted of all alveolar cleft patients (n = 14) who did not undergo alveolar modeling or GPP during the same time period. Interventions Presurgical alveolar modeling was performed with an intraoral acrylic molding plate. This plate was modified on a weekly basis to align the alveolar segments and close the alveolar gap. The surgical intervention consisted of a modified Millard GPP. Main outcome Measures The primary study outcome measure was the elimination of the need for a secondary bone graft in patients who underwent presurgical alveolar molding and GPP. Results Of the 20 sites in the 18 patients who underwent GPP, 12 sites did not require an alveolar bone graft. Of the 8 sites requiring a bone graft, 4 presented minimal bony defects. All 14 patients in the control group required bone grafts. Conclusions In this series of 20 alveolar cleft sites treated with presurgical orthopedics and GPP, 60% did not need a secondary alveolar bone graft in the mixed dentition.

Alveolar Bone Grafting

2019 ◽  
pp. 95-98
Author(s):  
Raj M. Vyas ◽  
Gennaya L. Mattison
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Bone Grafting ◽  
Crucial Role ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting ◽  
Cleft Lip Repair

Alveolar bone grafting plays a crucial role in cleft reconstruction. When neonatal presurgical orthodontia is successful in aligning the cleft segments, alveolar reconstruction can be initiated as a gingivoperiosteoplasty during primary cleft lip repair. In children with cleft palate, alveolar bone grafting is usually done after transverse maxillary expansion with a palatal expander. Exact timing of bone grafting is controversial; most centers initiate orthodontic evaluation/expansion between ages 7 and 8 years (beginning of mixed dentition) with an aim to bone graft before age 10 in order to allow osteogenic incorporation prior to eruption of the permanent canine teeth.

scholarly journals Use of Three-Dimensional Computed Tomography to Classify Filling of Alveolar Bone Grafting

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Antonio Jorge V. Forte ◽  
Renato da Silva Freitas ◽  
Nivaldo Alonso
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Three Dimensional ◽  
Unaffected Side ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Grade Ii ◽  
And Function ◽  
Mean Time ◽  
Secondary Alveolar Bone Grafting

Several authors have proposed classifications to analyze the quality over time of secondary alveolar bone grafting. However, little discussion has been held to quantitatively measure the secondary bone grafting for correction of nasal deformity associated to cleft palate and lip. Twenty patients with unilateral alveolar cleft, who underwent secondary alveolar bone grafting, were studied with 3D computer tomography. The height between the inferior portion of the pyriform aperture and the incisal border of the unaffected side (height A) and the affected side (height B) was measured using a software Mirror. A percentage was then obtained dividing the height B by the height A and classified into grades I, II, and III if the value was greater than 67%, between 34% and 66%, or less than 33%. Age, time of followup, initial operation, and age of canine eruption were also recorded. All patients presented appropriate occlusion and function. Mean time of followup was 7 years, and mean initial age for operation was 10 years old. 16 patients were rated as grade I and 4 patients as grade II. No cases had grade III. We present a new grading system that can be used to assess the success of secondary bone grafting in patients who underwent alveolar cleft repair.

Optimal Timing of Alveolar Cleft Bone Grafting for Maxillary Clefts in the Cleft Palate Population

2018 ◽  
Vol 29 (6) ◽  
pp. 1551-1557 ◽  
Author(s):  
Arminder S. Kaura ◽  
Dhivya R. Srinivasa ◽  
Steven J. Kasten
Keyword(s):  
Cleft Palate ◽  
Bone Grafting ◽  
Optimal Timing ◽  
Alveolar Cleft

Secondary Bone Grafting of Alveolar Clefts: A Densitometric Comparison of Iliac Crest and Tibial Bone Grafts

2001 ◽  
Vol 38 (1) ◽  
pp. 11-14 ◽  
Author(s):  
V. Sivarajasingam ◽  
G. Pell ◽  
M. Morse ◽  
J. P. Shepherd
Keyword(s):  
Bone Density ◽  
Optical Density ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Objective Assessment ◽  
Bone Grafts ◽  
Orthodontic Appliances ◽  
Density Measurements ◽  
Tibial Bone ◽  
Alveolar Bone Grafting

Objective To evaluate changes in the optical density of secondary alveolar cleft bone grafts obtained from two different donor sites over time and to determine whether one donor site gives a higher recipient bone density than the other. Methods A prospective study was performed evaluating 40 healthy patients with congenital cleft lip and palate undergoing secondary alveolar bone grafting, 20 (14 boys and 6 girls) having iliac crest and 20 (12 boys and 8 girls) receiving tibial bone grafts. Bone harvest and grafting was carried out by one operator (G.P.). Optical density of iliac and tibial grafts measured using a computerized densitometer, was compared at 6 days, 6 weeks, and 3 months. Due to interference from orthodontic appliances, optical density measurements for 16 subjects were not possible, and these patients were excluded from the study. The length of hospital stay postoperatively for both grafting procedures were recorded. Results A significant decrease in relative bone density was demonstrated during the 3-month postoperative period in both iliac and tibial bone graft groups (p < .05). The difference in densities between iliac crest and tibial groups were not significantly different at any of the time points (paired t test, p > .05). Subjects undergoing iliac crest grafts stayed an average of 5 days in the hospital postoperatively, compared with subjects with tibial grafts who stayed an average of 3 days postoperatively. Conclusion Optical density measurements of bone grafted into alveolar clefts, reported here for the first time, provide a valuable objective assessment of graft progress. Tibial and iliac crest grafts gave similar optical densities at recipient sites over the first 3 months. Iliac crest grafts required significantly longer postoperative stay; an important consideration in selecting donor sites for secondary bone grafting.

Segment Distraction to Reduce a Wide Alveolar Cleft Before Alveolar Bone Grafting

2003 ◽  
Vol 40 (6) ◽  
pp. 561-565 ◽  
Author(s):  
Thomas Binger ◽  
Christos Katsaros ◽  
Martin Rücker ◽  
Wolfgang J. Spitzer
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting
Sign in / Sign up

Export Citation Format

Share Document