Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine

Vandersluis, Yona R.; Fisher, David M.; Stevens, Kenneth N.; Tompson, Bryan; Lou, Wendy; Suri, Sunjay

doi:10.1016/j.ajodo.2019.11.012

Cited by 17 publications

(12 citation statements)

References 68 publications

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“…The current study's results corroborate the findings of some others, whonoted the greatest arch constriction at the unilateral cleft side [28]. The clinical ramification of arch collapse is that, during the introductory phase of orthodontics preceding alveolar grafting, expansion must be optimized and individualized [7,20]. Al-Gunaid [29] concluded that the maxillary arch forms in UCLP patients might play a preeminent role in the stabilization of the maxillary dental arch widths following orthodontic treatment and diminish the propensity to relapse.…”

Section: Axial View Measurements For Asymmetry Evaluationsupporting

confidence: 89%

“…Though the total nasal width was significant in the unilateral complete CLP group, there were no significant differences between the control and unilateral complete CLP groups in zygomatic arch width, maxillary, and condylar width, according to Abuhijleh et al [12]. Hence, the operator must be cognizant of the possible sagittal as well as transverse asymmetry of the bony alar base, upper midface (zygoma), and basal dentoalveolar complex for treatment planning utilizing alveolar bone grafts and orthognathic surgery [9,18,20].…”

Section: Frontal View Measurements For Asymmetry Evaluationmentioning

confidence: 99%

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Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study

Kochhar

Sidhu

Prabhakar

et al. 2020

IJERPH

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The current study was conducted to assess the extent of maxillary arch collapse on the cleft vis-a-vis non-cleft sides in the same individual presenting withunilateral cleft lip and palate (UCLP), using cone-beam computed tomography (CBCT). Thirty-one children (eighteen boys andthirteen girls) with surgically repaired UCLP, who met the inclusion criteria, were selected. Following the acquisition of CBCT scans, fourteen bilateral landmarks were selected. The distance of the bilateral landmark was calculated from the midsagittal plane on the cleft and non-cleft sides for both frontal and axial views. Tracings were done;the data obtained was subjected to statistical analysis;and intra-observer variability was checked with intraclass correlation coefficient (ICC) and two-way ANOVA. Subsequently, the measurements were subjected to paired t-tests at the 95% level of significance with Bonferroni correction. A significant reduction of pyriforme and an alveolar crest above the maxillary 1st molar were discerned in frontal analysis on the cleft side. In the axial view, the zygomatic arch, malar, porion and alveolar crest at the molar region were non-significant, but the alveolar crest at the premolar region (p < 0.004)) was significantly decreased. In the frontal analysis, pyriforme and the alveolar crest above the maxillary 1st molar, and, in the axial view, premolar widths, showed significant reduction when comparing the cleft vis-a-vis non-cleft sides.

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Section: Axial View Measurements For Asymmetry Evaluationsupporting

confidence: 89%

Section: Frontal View Measurements For Asymmetry Evaluationmentioning

confidence: 99%

Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study

Kochhar

Sidhu

Prabhakar

et al. 2020

IJERPH

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“…Rehabilitation protocol includes secondary alveolar bone grafting (SABG) that is performed when the patient presents with a mixed dentition [4]. The most favorable outcomes present when the lateral incisor or the canine erupts through the transplant and the bone are functionally loaded [5][6][7][8][9]. The purpose of the autogenous bone grafting is closure of the oronasal fistula and anatomical tissue continuity of the alveolar process in the maxilla [10].…”

Section: Introductionmentioning

confidence: 99%

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

2020

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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.

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“…There are several advantages to performing SABG during early mixed dentition that should be considered during treatment planning. Favorable outcomes include superior bone stock, improved periodontal support and esthetics of anterior teeth (Precious, 2009), decreased root resorption (Vandersluis et al, 2020), higher graft success (Dissaux et al, 2016), decreased morbidity, and shorter hospital stays (Miller et al, 2010; Anver et al, 2020). Opposition to this protocol primarily focuses on the potential for restricted growth due to early surgery (Ross, 1987) and thus increased risk for additional procedures such as RED or orthognathic surgery.…”

Section: Discussionmentioning

confidence: 99%

Does Early Secondary Alveolar Bone Grafting Influence Need for Additional Maxillary Advancement Procedures in Cleft Lip and Palate?

Powell

Lewis

Sesanto

et al. 2021

The Cleft Palate Craniofacial Journal

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Objective To determine if secondary alveolar bone grafting (SABG) timing in patients with cleft lip and palate (CLP) influences the future need for additional maxillary advancement procedures, particularly Le Fort I osteotomy with rigid external distraction (RED). Design Retrospective cohort study. Groups were separated by SABG timing: early mixed dentition (ages 68 years) or late mixed dentition (ages 9-11 years). The criterion for RED was negative overjet ≥8 mm, and sufficient dental development for RED. Setting Single tertiary care institution. Patients Patients with CLP that underwent SABG from 2010 to 2015. Exclusion criteria included syndromic conditions, SABG surgery at age >12 years, current age <12 years, and <2 years follow-up. 104 patients were included. Main outcome measures The number of RED candidates and treated patients. Results There was no statistical difference in the number of RED candidates ( P = .0718) nor treated patients ( P = .2716) based on SABG timing; stratification by laterality was also insignificant. Early SABG is associated with higher odds of being a RED candidate (pooled, unilateral, bilateral) and treated patient (pooled and unilateral); however, there were no statistically significant associations between SABG timing and the number of RED candidates and treated patients as determined by logistic regression models. Conclusion There is no statistically significant association between SABG timing and the odds of being a RED candidate or treated patient. Future prospective studies are recommended to assess the relationship between SABG timing and maxillary growth in patients with CLP.

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Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine

Cited by 17 publications

References 68 publications

Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study

Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study

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

Does Early Secondary Alveolar Bone Grafting Influence Need for Additional Maxillary Advancement Procedures in Cleft Lip and Palate?

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