Comparison of 2-D Calculations from Periapical and Occlusal Radiographs versus 3-D Calculations from CAT Scans in Determining Bone Support for Cleft-Adjacent Teeth following Early Alveolar Bone Grafts

Abstract

Objective This investigation was conducted to determine the agreement between three-dimensional (3-D) calculations from CAT scans and two-dimensional (2-D) calculations from standard dental radiographs in evaluating bone support for cleft-adjacent teeth after primary bone grafting. Design This retrospective study utilized CAT scans and dental radiographs taken of the alveolar cleft in patients an average of 11 years after primary bone grafting. Setting The subjects were patients treated by the Cleft Palate Team at Children's Memorial Hospital and Loyola University Medical Center, Chicago, Illinois. Patients Fourteen UCLP patients (9 males, 5 females) agreed to participate In this study by undergoing CAT scan assessment of their alveolar cleft sites. They also had to have periapical or occlusal radiographs of the grafted cleft site taken within 6 months of the CAT scan. Interventions All patients underwent primary lip repair, placement of a passive palatal plate, primary alveolar bone grafting (mean age 6.4 months), and palatoplasty before 1 year of age. Major tooth movement through final orthodontics was completed by the time of the radiographic assessment. Main Outcome Measures CAT scan sections were reformatted and reconstructed to three-dimensionally calculate the percentage of root covered by bone support for the 15 teeth adjacent to the grafted cleft sites. Dental radiographs of the same teeth were also traced and digitized. Percentages of root supported by bone were also established using the dental radiographs by dividing the amount of root covered by bone, by the anatomic root length. Results A paired, two-sample t test revealed no significant differences between the two methods of assessment, while linear regression showed a statistically significant correlation between the CAT scan assessment and the percentages found on the radiographs. Conclusions Routine dental radiographs were able to estimate the total 3-D bone support for the roots of cleft adjacent teeth as determined by CAT scan to a statistically significant degree when groups where compared. The clinical significance for evaluation of individual cases was less impressive with a wide range of variability and a level of agreement that required acceptance of differences up to 25%.

Early Bone Grafting with the Functional Cleft Lip Repair

“…This study had a mean follow-up of 11 years and these numbers compared favorably with those for patients who had received secondary grafts at the Lancaster Clinic, where the mean follow-up was 3 years; the ridge heights reported in this group were 80% and 87%, respectively. 14 When cephalometric radiographs of the authors' patients were examined by others, no growth constraints were found, 15 and when compared with 13 other centers our group, with primary alveolar bone grafts, had the least amount of mandibular protrusion. 16 The maxillomandibular relationship of the primary grafted patients and facial growth have been shown to be similar to those of nongrafted patients 17 and secondary grafted patients.…”

Correlation of tuned aperture computed tomography with conventional computed tomography for evaluation of osseous healing in calvarial defects

“…8,9 Accurate noninvasive determination of defect resolution is a challenging task, for which advanced imaging modalities are typically used. [10][11][12][13][14] This study served to demonstrate that TACT could be used for this purpose with relative ease.…”

Orthodontics in Relation with Alveolar Bone Grafting in CLP Patients

“…It has been used to quantify the average volume of the graft, location of the bone loss, and periodontal bone support of the cleft-adjacent teeth. CBCT-derived volumetric assessment of alveolar grafts has been reported as a reliable method [24,29,37,39,40] (Figure 2). The success rate of an alveolar graft has been found to be significantly lower with volumetric evaluation than that with conventional radiographic imaging [39,41,42].…”