A novel method for alveolar bone grafting assessment in cleft lip and palate patients: cone-beam computed tomography evaluation

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.

Regenerative Strategies in Cleft Palate: An Umbrella Review

“…Regarding the postoperative newly formed bone evaluation, most included studies used computed tomography. Even though this method has several advantages when compared with two-dimensional tools (e.g., control teeth eruption process into the bone graft and the assessment of the dimensional location of the bone graft), it has some limitations when compared with cone-beam computed tomography (CBCT) [53][54][55][56]. CBCT scans have a lower radiation dose, minimal scanning time (10-70 s) and allow the clinicians to scan a small region for specific diagnosis with less image artefact [57].…”

Secondary bone grafting for alveolar clefts: surgical timing, graft materials, and evaluation methods

“…However, the alveolar thickness was underestimated on computed tomography compared to plain radiography. Therefore, 3D analysis using conebeam computed tomography (CBCT) has gained attention because it involves less radiation multidirectional computed tomography and offers the possibility of volumetric analysis [ 59 ]. However, there are diverse methods to analyze volume which obscure criteria for success.…”

Correlation between alveolar cleft morphology and the outcome of secondary alveolar bone grafting for unilateral cleft lip and palate

“…A method presented by Stasiak et al [ 27 ] to qualitatively evaluate the SABG results was applied. Standardization was obtained after reorientation of the images according to the long axes of central incisors on the corresponding side.…”

“…Most previous reports used the alveolar height and thickness after SABG to determine the categorical outcomes [ 14 , 20 , 24 – 26 ], but there was limited scope of application depend on canine eruption status, and failed to present the generalization of the measurements to evaluate the final result of SABG as well. Stasiak et al [ 27 ] presented a novel method which solved the above limitations and considered the potential of root resorption. Certain position of bone resorption can be observed via this method and give guidance for further orthodontic movement.…”