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.

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.

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.

scholarly journals Alveolar Volume Following Different Timings of Secondary Bone Grafting in Patients with Unilateral Cleft Lip and Palate. A Pilot Study

2021 ◽  
Vol 10 (16) ◽  
pp. 3524
Author(s):  
Andrzej Brudnicki ◽  
Piotr A. Regulski ◽  
Ewa Sawicka ◽  
Piotr S. Fudalej
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Pearson Correlation ◽  
Alveolar Volume ◽  
Alveolar Bone Grafting ◽  
The Mean ◽  
The Relationship ◽  
Secondary Alveolar Bone Grafting

This study was intended to evaluate the relationship between secondary alveolar bone grafting (SABG) timing and the alveolar volume in patients with unilateral cleft lip and palate (UCLP). The material consisted of CTs of 35 patients (17 males, 18 females) with UCLP who underwent a one-stage primary cleft repair at a mean age of 8.4 months and SABG at different timings ranges of 1.8–18.8 years. The mean age at CT was 17.2 years. The relative coefficient (Ꞷ) which was independent from factors such as individual maxillary size, gender or age at the CT was introduced in order to compare volumes of the cleft-side in relation to the non-cleft-side alveolus. Pearson correlation coefficient r between Ꞷ coefficient and SABG timing was weak negative (r = −0.34, p = 0.045). The multiple regression analysis implied that the dependent variable-Ꞷ coefficient was associated with independent variables (cleft repair and SABG timings and age at CT) with r2 = 0.228. Only patient’s age at SABG explained the dependent variable (p = 0.003). The study cautiously indicates a tendency to larger alveolar volume following earlier timing of SABG. Nevertheless, the further research on a larger group of patients should be performed before formulating any clinical indications.

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.

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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