A Survey of Bone Grafting Practice Patterns in North American Cleft Surgeons

Qamar, Fatima; Cray, James J.; Halsey, Jordan N.; Rottgers, S. Alex

doi:10.1177/10556656221104937

Cited by 6 publications

(6 citation statements)

References 62 publications

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“…This was supported by researchers who reported that secondary bone grafting after expansion of the maxilla was the most popular practice among oral surgeons and others who reported that the iliac crest was considered to be the best donor site for an alveolar bone graft. It helped in the stabilization of the cleft maxilla after expansion and aided in maintaining the continuity of the arch [ 8 , 9 ]. Clinicians radiographically proved similar advantages of secondary bone grafting with expertise in cleft care [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary Treatment of a Case With Unilateral Cleft Lip and Palate in the Mixed Dentition

Sanchla¹,

Shrivastav²,

Bhola³

et al. 2023

Cureus

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A 10-year-old girl had reported to Sharad Pawar Dental College. Her parents had chief complaints of lip and palate deformity. On examination, it was found that the patient had unilateral cleft lip and palate on the right side. The aim was to expand the maxilla with alveolar bone grafting in the cleft region to facilitate the eruption of permanent canine and further reduce the deformity to prepare the patient for face mask therapy, reduce morbidity in the permanent dentition, and avoid Le Fort one surgery in the future. She had been previously operated on for cleft lip repair and palatal fistula closure eight years back. The present condition in the mixed dentition needed arch expansion, bone in the cleft region for the eruption of permanent canine, and further arch alignment for facemask therapy. This would reduce the severity of skeletal deformity and later on avoid the surgical advancement of the maxilla.

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Section: Discussionmentioning

confidence: 99%

Interdisciplinary Treatment of a Case With Unilateral Cleft Lip and Palate in the Mixed Dentition

Sanchla¹,

Shrivastav²,

Bhola³

et al. 2023

Cureus

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“…[2][3][4]15,16 Among North American cleft surgeons, 23% report using allograft bone products, and 31% employed rhBMP-2. 6 This study presents a novel approach for alveolar reconstruction by combining CBM with rhBMP-2 for revision ABG in UCLP and BCLP following failed autologous ABG. Outcomes were evaluated using operative and orthodontic FACE 5 (1) data and volumetric analysis with cone beam computed tomography (CBCT).…”

Section: Introductionmentioning

confidence: 99%

“…5 Parents often desire an alternative to ABG with an autologous iliac crest graft, and cleft surgeons are utilizing an increased number of non-autologous materials. 6 Allografts, which utilize bone graft substitutes, offer an alternative to alveolar ridge reconstruction. These allograft materials are readily available, user-friendly, reduce operative times, and eliminate donor site pain.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of rhBMP-2 and Cellular Bone Matrix in the Revision of Alveolar Bone Grafting

Harrison,

Hallac,

Seaward

et al. 2023

FACE

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Objective: This study presents a novel approach that utilizes recombinant human bone morphogenic protein 2 (rhBMP-2) and cellular bone matrix (CBM) for revision alveolar bone graft (ABG) in unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) patients following failed autologous ABG. Methods: A case series of 14 UCLP and 4 BCLP patients who had failed autologous ABG with revision ABG with rhBMP-2 and CBM. Review of demographics, operative data, Bergland score, and alveolar cleft gap volume was performed. Results: Revision ABG had short operative times and low blood loss in both UCLP and BCLP. No postoperative complications were found in either revision group. Repeat ABG surgery was required in one patient. Bergland score improved from 3.86 ± 0.53to 1.21 ± 0.80 in the UCLP group and from 3.75 ± 0.50to 1.00 ± 0.00 in the BCLP group. The cleft volume decreased by 83.62 ± 9.78% in UCLP and by 86.73 ± 13.65% in the BCLP group. Conclusions: Revision ABG with rhBMP-2 and CBM is a successful and reliable approach. This method has decreased operative time and no postoperative complications. Most patients achieved clinically successful grafting with canine eruption. Both UCLP and BCLP groups saw a significant decrease in alveolar cleft gap volume.

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“…When ABG is carried out after the cleft lip and palate have been repaired, it is defined as secondary ABG. The timing generally assumed as the optimal timing for ABG is between the ages of 9 and 11 years, when the root of the permanent canine at the cleft side has reached between 50 and 75% of its final length [3][4][5][6][7]. This approach, called late secondary ABG, has proven to be more successful for subsequent maxillary growth compared to the previously used primary bone grafting [8].…”

Section: Introductionmentioning

confidence: 99%

Alveolar Bone Grafting in Unilateral Cleft Lip and Palate: Impact of Timing on Palatal Shape

Brudnicki,

Petrova,

Dubovska

et al. 2023

JCM

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Alveolar bone grafting (ABG) is a critical surgical intervention in patients with a cleft of the alveolus, aimed at reconstructing the alveolar ridge to facilitate proper eruption, periodontal support, and alignment of adjacent permanent teeth. The optimal timing for ABG remains debated, with late secondary ABG between the ages of 9 and 11 being widely adopted. This study compared the palatal shapes of 28 children at a mean age of 9.5 years (SD = 0.7) who underwent early secondary ABG at a mean age of 2.1 years (SD = 0.6) or 33 children at a mean age of 10.8 years (SD = 1.5) who underwent late secondary ABG at a mean age of 8.6 years (SD = 1.3) to 60 non-cleft controls at a mean age of 8.6 years (SD = 1.2). The palatal shapes were captured with 239 landmarks digitized on the palate on a digital model. Utilizing geometric morphometric methods, i.e., generalized Procrustes superimpositions, principal component analysis, and permutation tests, we assessed the impact of ABG timing on palatal morphology. The first five principal components (PCs) explained 64.1% of the total shape variability: PC1 = 26.1%; PC2 = 12%; PC3 = 11.9%; PC4 = 7.8%; and PC5 = 6.4%. The Procrustes distance between both cleft groups and the control group was more than twice as large as the Procrustes distance between the early ABG and late ABG groups. Nonetheless, all intergroup differences were statistically significant. Our findings suggest that early ABG has a limited negative effect on palatal shape, providing comparable outcomes to late ABG. The study highlights the potential suitability of early ABG, challenging conventional practices and encouraging further exploration into its long-term effects on maxillary growth.

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A Survey of Bone Grafting Practice Patterns in North American Cleft Surgeons

Cited by 6 publications

References 62 publications

Interdisciplinary Treatment of a Case With Unilateral Cleft Lip and Palate in the Mixed Dentition

Interdisciplinary Treatment of a Case With Unilateral Cleft Lip and Palate in the Mixed Dentition

Efficacy of rhBMP-2 and Cellular Bone Matrix in the Revision of Alveolar Bone Grafting

Alveolar Bone Grafting in Unilateral Cleft Lip and Palate: Impact of Timing on Palatal Shape

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