Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting

Abstract

ObjectiveTo determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting.MethodsA total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up.ResultsAnterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up.ConclusionsWider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning.

Maxillary Canine Impaction and Unilateral Cleft Lip and Palate: A Review of the Current Literature

“…The width of the cleft. However, Jabbari et al found the width of cleft has no effect either on the success or failure of the SABG [22,39] 6. The classification of malocclusion [39,40] 7.…”

“…However, Jabbari et al found the width of cleft has no effect either on the success or failure of the SABG [22,39] 6. The classification of malocclusion [39,40] 7. The canine position relative to the gap in its pre-eruptive phase [39,41].…”

“…The classification of malocclusion [39,40] 7. The canine position relative to the gap in its pre-eruptive phase [39,41]. Enemark et al, stated that if the canine tooth was impacted in the palate, bone height and orthodontic treatment can be postponed until or after the eruption of the canine tooth.…”

“…A study found that if the canine inclination increased, there will be a negative impact on SABG [39] There are many other variables that influence the outcome of a bone transplant of the cleft, such as the timing of the procedure [26] the type of cleft, [37] surgeon's experience, donor site, inter-operator differences [33] and the pre-surgical status of the alveolar gap, for example, the pre-surgical amount of supporting bone for the mesial and distal teeth that abut against the gap. Moreover, the timing of the bone graft was also more critical in unilateral and bilateral cleft patients than in patients with only a cleft lip and alveolar ridge [41]…”

Prevalence of dental anomalies in cleft affected subjects and their family members

“…The cleft size was measured on dental casts at the time point of primary lip plasty. It was found that the width of the cleft had a positive correlation with prevalence of enamel hypoplasia (Jabbari, Reiser et al 2016). Findings in another study mentioned earlier by Ruiz et al support this notion that the cleft itself may influence the prevalence of enamel defects.…”