Dental Abnormalities, Bone Graft Quality, and Periodontal Conditions in Patients with Unilateral Cleft Lip and Palate at Different Phases of Orthodontic Treatment

2003 ◽  
Vol 40 (4) ◽  
pp. 343-350 ◽  
Author(s):  
G. Dewinter ◽  
M. Quirynen ◽  
K. Heidbüchel ◽  
A. Verdonck ◽  
G. Willems ◽  
...  

Objectives To evaluate the dental and periodontal condition of patients with unilateral cleft lip and palate (UCLP) before orthodontic treatment and evaluate whether the dental and periodontal condition of these patients during and after orthodontic treatment was jeopardized by the duration of the orthodontic and surgical treatment. Design Seventy-five individuals with UCLP (52 males, 23 females), between ages 8 and 20 years, participated in a retrospective study during their final follow-up visit with regard to dental abnormalities, such as hypodontia, external root resorption, crown and root malformation, and supernumerary teeth. Alveolar bone height and periodontal attachment loss on the cleft side were also screened before or after bone grafting and at different stages of orthodontic treatment. Results Hypodontia of the lateral incisor was found in more than 50% of the patients on the cleft side. Second premolars and/or lateral incisors outside the cleft area were missing in 27.2% of the patients. In 32%, malformations of the teeth near the cleft were noticed. In general, the teeth around and in the cleft of the patients showed normal septal bone heights and a healthy periodontium. Sixty of the 75 patients received a bone graft to restore the interrupted alveolar process. In 93.3% of these patients, the cleft was grafted before the eruption of the canine. Conclusion The periodontium of the teeth in and around the cleft in patients with UCLP observed during and after orthodontic treatment can cope relatively well with the long orthodontic treatment and combined surgical interventions. The children, who had not yet started treatment, also showed enough bone support and no periodontal problems of the teeth besides the cleft. Early secondary bone grafting seems to give optimal periodontal results.

2020 ◽  
Vol 9 (2) ◽  
pp. 576
Author(s):  
Yu-Ying Chu ◽  
Frank Chun-Shin Chang ◽  
Ting-Chen Lu ◽  
Che-Hsiung Lee ◽  
Philip Kuo-Ting Chen

Secondary alveolar bone grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual alveolar bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual bone defect volume in both groups did not show significant difference (SABG 0.12 cm3 vs. EGPP at 0.14 cm3, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.


Author(s):  
Charan Teja Vemagiri ◽  
Damera Srikanth ◽  
Chandrababu V ◽  
Siva Ganesh

The secondary alveolar bone grafting is an integral component of contemporary rehabilitation of the patients with cleft lip and palate with alveolar defects. Iliac bone graft is frequent secondary graft used in the correction of alveolar defects. There is successful rehabilitation of osseous component post operatively.


1997 ◽  
Vol 34 (5) ◽  
pp. 455-458 ◽  
Author(s):  
John Daskalogiannakis ◽  
R. Bruce Ross

Objective: This study was conducted to evaluate the effects on facial growth of alveolar bone grafting in the mixed dentition for patients with UCLP. Design: Retrospective cephalometric study. Setting: Craniofacial Treatment and Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. Patients: The 58 patients participating in the study had a history of complete unilateral cleft lip and palate, all of which were repaired by the same plastic surgeon. Interventions: Twenty-one patients received an iliac-crest alveolar bone graft at a mean age of 10.3 years, while 37 did not receive an alveolar bone graft. Lateral cephalometric radiographs were obtained on all patients at two different times: at a mean age of 9.4 years (prior to bone grafting in the grafted group) and at a mean age of 15.2 years. Main Outcome Measures: All radiographs were traced and digitized by the same person, using cephalometric computer software. Superimposition and cephalometric analysis was undertaken to investigate the differences between the two groups in the 5.6-year experimental period. A two-way analysis of covariance was used for evaluation of the statistical significance of the results. Results: No statistically significant differences were found in 14 of the 15 cephalometric measurements performed. Harvold's maxillary unit length was statistically significantly shorter in the grafted group, although a lack of correlation with angular measurements and inherent problems with this specific measurement raise doubts in this finding. Conclusion: Mixed dentition bone grafting does not affect subsequent vertical and A-P development of the maxilla in complete unilateral cleft lip and palate patients during the first several postoperative years.


2022 ◽  
Vol 11 (1) ◽  
pp. e29111124969
Author(s):  
Luiza Roberta Bin ◽  
Eleonor Álvaro Garbin Júnior ◽  
Geraldo Luiz Griza ◽  
Natasha Magro Érnica ◽  
Mauro Carlos Agner Busato ◽  
...  

Cleft lip and palate is one of the most common facial deformities. During embryonic life, non-fusion of the maxillary and medial nasal plaques leads to cleft lip and palate. Fissures can produce a range of dental problems in terms of number, size, shape, and position, related to deciduous or permanent dentition. Besides this, the teeth most affected are those located in the fissure area. There are numerous treatment protocols, which, despite the lack of a consensus, start as soon as the child is born, going into adulthood, seeking functional and aesthetic rehabilitation. The surgical phases, lip repair, nasal repair, palatoplasty and alveolar bone grafting, are performed according to age. As for the bone graft, the most used option is the secondary graft, with the autogenous one being the most available. Thus, the objective of this work is to present a clinical case of secondary alveolar bone grafting in a 10-year-old female patient with an incomplete unilateral pre-foramen cleft.


2020 ◽  
pp. 105566562097042
Author(s):  
Sven W. C. Jensen ◽  
Kyle Stevens

We report a case of secondary alveolar bone grafting (ABG) without removal of a supernumerary tooth in a patient with unilateral cleft lip and palate. A conical supernumerary tooth located distal to the upper left central incisor within the cleft site was left in situ at the time of ABG. The tooth within the ABG site commenced resorption from both the apical and incisal edges until only minor tooth remnants remained at 22 months. Although external root resorption of teeth neighboring a cleft site has been described previously, this is the first report of almost complete tooth resorption following ABG.


2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Chun-Shin Chang ◽  
Christopher Glenn Wallace ◽  
Yen-Chang Hsiao ◽  
Yu-Ting Chiu ◽  
Betty Chien-Jung Pai ◽  
...  

Author(s):  
Ali Alqerban

The present review aims to investigate the effect of alveolar bone grafting in canine impacted unilateral cleft lip and palate patients. The goal of this review is to identify and highlight the factors that may cause maxillary canine impaction, the role of primary and secondary bone graft and dental anomalies that may affect canine impaction in patients with cleft lip and palate.


2017 ◽  
Vol 87 (6) ◽  
pp. 863-870 ◽  
Author(s):  
Aya Maeda-Iino ◽  
Minami Furukawa ◽  
Sangho Kwon ◽  
Kanako Marutani ◽  
Shoko Nakagawa ◽  
...  

ABSTRACT Objective: To evaluate the relationship between external apical root resorption (EARR) of the maxillary central incisors (U1), horizontal orthodontic tooth movement, and quantity of grafted bone in subjects with unilateral cleft lip and palate (UCLP) over an average duration of 8 years. Materials and Methods: Thirty subjects with UCLP were evaluated for EARR of U1 after edgewise treatment (T2). The teeth were classified as having no EARR, moderate EARR (combined into “no/moderate” EARR), or severe EARR. Frontal cephalometric radiographs acquired at eruption of U1 (T0), less than 6 months before secondary alveolar bone grafting (T1), and T2 were evaluated to determine the horizontal inclination (U1-axis angle) and distance of the root apex from the median line (U1-root–VL distance). On the cleft side, the quantities of grafted bone at less than 12 months postsecondary bone grafting and at T2 were evaluated using the alveolar bone graft (ABG) scale. Results: Cleft-adjacent teeth exhibited more severe EARR than did teeth on the noncleft side. The cleft side exhibited greater changes in U1-axis angle and U1-root–VL distance between T0 and T2 than did the noncleft side. On the cleft side, the ABG score at T2 in the severe EARR group was significantly lower than that in the no/moderate EARR group. These measurements were correlated with EARR grade. Conclusions: Cleft-adjacent U1 exhibited more severe EARR than did the U1 on the noncleft side, which might be associated with orthodontic treatment-induced changes in horizontal inclination and root apex movement. On the cleft side, severity of EARR may be correlated with the success of ABG.


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