Comparison of tooth development stage of the maxillary anterior teeth before and after secondary alveolar bone graft: Unilateral cleft lip and alveolus vs unilateral cleft lip and palate

ABSTRACT Objectives: To describe qualitatively and quantitatively the directions and magnitudes of rotations of permanent maxillary central incisors and first molars in the mixed dentition in repaired complete unilateral cleft lip and palate (UCLP) and study their associations with absence of teeth in their vicinity. Materials and Methods: Dental casts and orthodontic records taken prior to orthodontic preparation for alveolar bone grafting of 74 children with repaired UCLP (53 male, 21 female; aged 8.9 ± 1.0 years) were studied. Directions and magnitudes of permanent maxillary central incisor and first molar rotations were recorded. Tooth absence was confirmed from longitudinal radiographic records. Incisor and molar rotations were analyzed in relation to the absence of teeth in their vicinity. Results: Distolabial rotation of the permanent maxillary central incisor was noted in 77.14% on the cleft side, while distopalatal rotation was noted in 82.19% on the noncleft side. Incisor rotation was greater when a permanent tooth was present distal to the cleft side central incisor, in the greater segment. The permanent maxillary first molar showed mesiopalatal rotation, which was greater on the cleft side and when there was absence of one or more teeth in the buccal segment. Conclusions: Presence and absence of teeth were associated with the severity of incisor and molar rotations in UCLP. Crowding of anterior teeth in the greater segment was associated with a greater magnitude of rotation of the cleft side permanent central incisor. Absence of one or more buccal segment teeth was associated with greater magnitude of rotation of the molar.

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Racial Disparities Affect Timing of Alveolar Bone Grafting for Patients With Cleft Lip and Palate: An Analysis of the 2012 Kids’ Inpatient Database

FACE ◽

10.1177/27325016211048504 ◽

2021 ◽

pp. 273250162110485

Author(s):

Alfredo Cepeda ◽

Mary T. Austin ◽

Phuong D. Nguyen ◽

John F. Teichgraeber ◽

Matthew R. Greives

Keyword(s):

Bone Graft ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Cox Regression ◽

Univariate Analysis ◽

Sociodemographic Factors ◽

Alveolar Bone Grafting ◽

Income Quartile ◽

Inpatient Database

Objective: The timing of alveolar bone graft (ABG) for patients with cleft lip and palate is critical to the success of the operation. Sociodemographic factors have been implicated in delaying surgery for other diagnoses but their impact on patients undergoing ABG is unknown. The purpose of this study is to examine the association of sociodemographic factors on the age of patients undergoing ABG. Methods: The Kids’ Inpatient Database (KID) from 2012 was used to define a cohort of patients with cleft lip and/or palate between the ages of 5 and 14. Patients were selected using ICD-9 procedure codes for repair of oronasal fistula and bone graft. Gender, race, income quartile, hospital region, and type of insurance were used as independent variables. Time to ABG was then calculated as hazard ratios (HR) of having surgery using Cox regression models with 95% confidence intervals. Results: A cohort of 395 patients was identified. Median age at ABG was 9 ± 0.15 years. On univariate analysis, Non-Hispanic Black (NHB) patients underwent surgery later than Non-Hispanic White (NHW) patients (11.13 ± 0.44 years vs 9.67 ± 0.19 years, P = .0026). Patients in the higher 2 income quartiles were more likely to have an early surgery as compared to those in the lowest quartile (9.16 ± 0.43 and 9.32 ± 0.43 years vs 10.20 ± 0.33, P = .016 and 0.043 respectively). No factor was significant on multivariate analysis. Conclusions: Patients who are NHB are associated with delayed time to ABG as compared to NHW. Conversely, those in the upper income quartile by zip code underwent surgery at an earlier age. While this study identifies demographic factors associated with delay of ABG, more research is needed to understand the direct causal effects for this delay in surgery and its implication for future growth and need for orthognathic surgery.

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Long-Term Stability of Alveolar Bone Graft in Cleft Lip and Palate Patients

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000008254 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Arezoo Jahanbin ◽

Elaheh Kamyabnezhad ◽

Mohammad Ali Raisolsadat ◽

Fahimeh Farzanegan ◽

Erfan Bardideh

Keyword(s):

Bone Graft ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Term Stability ◽

Long Term Stability

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Eruption of Impacted Teeth in Cleft Lip and Palate Patients following Alveolar Bone Graft

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-2383 ◽

2018 ◽

Vol 19 (9) ◽

pp. 1072-1075

Author(s):

Matheus C Bandeca ◽

Alvaro H Borges ◽

Mateus R Tonetto ◽

Suellen L Lima ◽

Andreza MF Aranha ◽

...

Keyword(s):

Bone Graft ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Impacted Teeth

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Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619866363 ◽

2019 ◽

Vol 57 (1) ◽

pp. 105-113 ◽

Cited By ~ 3

Author(s):

Andrzej Brudnicki ◽

Ewa Sawicka ◽

Renata Brudnicka ◽

Piotr Stanisław Fudalej

Keyword(s):

Bone Graft ◽

Regression Models ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Primary Repair ◽

Craniofacial Morphology ◽

Retrospective Assessment ◽

Lateral Cephalograms ◽

Negative Effect

Objective: To evaluate the effect of the timing of secondary alveolar bone graft (SABG) on craniofacial morphology in patients with complete unilateral cleft lip and palate (UCLP). Design: Single-center retrospective assessment of consecutively treated nonsyndromic patients with complete UCLP. Participants: One hundred sixty-seven patients (108 males, 59 females) with complete UCLP in whom the cleft was repaired with 1-stage method at approximately 8 months of age. The age of 128 patients at SABG varied from 1.4 to 11.5 years (SABG group), while 39 patients still awaited SABG at the moment of cephalometric evaluation (no-SABG group). Methods: Craniofacial morphology was assessed on lateral cephalograms taken at 10 years of age (standard deviation = 0.8; range: 7.5-12.3) using linear and angular measurements. T tests and regression models were made to analyze data. Results: Regression models demonstrated that the effect of SABG on the craniofacial morphology was limited—cephalometric variables which were statistically significantly different between SABG and no-SABG groups showed no association with the timing of SABG when (1) age of primary repair of the cleft, (2) age of cephalometric evaluation, (3) cleft side, (4) gender, and (5) operator were controlled for. Only the length of the maxilla (Condylion-point A) was affected—1-year delay of SABG corresponded with an increase in Co-point A distance by 0.52 mm. However, adjusted R 2 of the model was 0.11. Conclusions: Our findings cautiously indicate that SABG performed before 8 years of age can have limited negative effect on craniofacial morphology. Nevertheless, our results should be confirmed by cleft centers practicing alternative surgical repairs of the cleft.

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Time to Recovery of Feeding After Alveolar Bone Graft Is Associated With Postoperative Nausea and Vomiting Within 2 Hours in Children

Clinical Medicine Insights Pediatrics ◽

10.1177/1179556519855387 ◽

2019 ◽

Vol 13 ◽

pp. 117955651985538

Author(s):

Kaoru Yamashita ◽

Toshiro Kibe ◽

Sachi Ohno ◽

Minako Uchino ◽

Yurina Higa ◽

...

Keyword(s):

Bone Graft ◽

Postoperative Nausea ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

School Age Children ◽

Surgical Timing ◽

Significant Difference

Objective: To examine the relationship between the method of anesthesia for alveolar bone graft surgery and postoperative nausea and vomiting (PONV) based on the difference in surgical timing and to assess factors related to the postoperative quality of life. Design: Retrospective observational study. Setting: Hospital. Participants: Patients with cleft lip and palate who underwent alveolar bone graft surgery under general anesthesia. The subjects were divided into two groups based on surgical timing: secondary bone graft (SBG) and late secondary bone graft (LSBG) groups. Main Outcome Measures: Relationship between time to recovery of feeding and the types of anesthesia, PONV, and postoperative pain period. Results: The mean patient age was 9.97 ± 1.33 years in the SBG group and 15.39 ± 0.31 years in the LSBG group. In the SBG group, patients who were administered fentanyl or remifentanil had significantly higher incidence of PONV than those who were not administered these drugs. In the SBG group, the time to recovery of feeding was significantly longer in patients experiencing PONV within 2 hours or that lasted for 24 hours than in those without PONV. In the LSBG group, there was no significant difference regarding any of the above factors. Conclusions: Our results suggest that the occurrence of PONV within 2 hours or lasting for 24 hours postoperatively in school-age children prolonged the time to recovery of feeding. This indicates that the time to recovery of feeding can be predicted based on the occurrence of PONV within the first 2 hours.

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Rapid Maxillary Expansion after Secondary Alveolar Bone Graft in a Patient with Bilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/02-099.1 ◽

2004 ◽

Vol 41 (3) ◽

pp. 332-339 ◽

Cited By ~ 14

Author(s):

Arlete de Oliveira Cavassan ◽

Marcelo D'Albuquerque de Albuquerque ◽

Leopoldino Capelozza Filho

Keyword(s):

Bone Graft ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Bilateral Cleft Lip ◽

Maxillary Constriction ◽

Intercanine Distance ◽

Dental Casts

Objective To verify the effects of rapid maxillary expansion performed after secondary alveolar bone graft in one patient. Setting Department of Orthodontics of the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo. Patient(s) The patient had bilateral cleft lip and palate, had already had a bone graft, and showed a relapsing maxillary constriction in need of correction. Intervention A fixed dental-mucous-bone-supported expander corrected the maxillary constriction. Main Outcome Measure(s) Measurements were obtained from dental casts, including transverse dimensions (intercanine distance [IC], interfirst premolar distance [IP], and interfirst molar distance [IM]) and measurements of the grafted area (interfirst premolar/central incisors [IPI] and interfirst premolar/canine [IPC]) to observe the changes. Clinical and radiographic analyses were done through direct view. Results The occlusal radiograph of the maxilla after expansion showed opening of the intermaxillary suture in the premaxillary area, which was clinically confirmed by the diastema between the maxillary central incisors. No radiographic alteration was observed in the grafted area. The transverse measurements of the dental casts (IC, IP, and IM) showed a significant increase. The measurements of the teeth adjacent to the grafted area, IPI and IPC, increased. Conclusions The orthopedic effect of rapid maxillary expansion after bone graft was verified. Nevertheless, additional studies are necessary to define any side effects in patients submitted to bone graft.

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