Early versus late alveolar bone grafting in unilateral cleft lip and palate: Dental arch relationships in pre-adolescent patients

Siegenthaler, Marina; Bettelini, Lisa; Brudnicki, Andrzej; Rachwalski, Martin; Fudalej, Piotr

doi:10.1016/j.jcms.2018.09.031

Cited by 18 publications

(14 citation statements)

References 19 publications

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“…The observed negative effect of SABG on maxillary length (distance from condylion to point A) was not confirmed by other measurements of maxillary size and/or position. This is consistent with our other results, that is, the assessment of occlusal relationship following early versus late SABG (Siegenthaler et al, 2018).…”

Section: Discussionsupporting

confidence: 93%

Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

Brudnicki¹,

Sawicka²,

Brudnicka³

et al. 2019

The Cleft Palate Craniofacial Journal

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Objective: To evaluate the effect of the timing of secondary alveolar bone graft (SABG) on craniofacial morphology in patients with complete unilateral cleft lip and palate (UCLP). Design: Single-center retrospective assessment of consecutively treated nonsyndromic patients with complete UCLP. Participants: One hundred sixty-seven patients (108 males, 59 females) with complete UCLP in whom the cleft was repaired with 1-stage method at approximately 8 months of age. The age of 128 patients at SABG varied from 1.4 to 11.5 years (SABG group), while 39 patients still awaited SABG at the moment of cephalometric evaluation (no-SABG group). Methods: Craniofacial morphology was assessed on lateral cephalograms taken at 10 years of age (standard deviation = 0.8; range: 7.5-12.3) using linear and angular measurements. T tests and regression models were made to analyze data. Results: Regression models demonstrated that the effect of SABG on the craniofacial morphology was limited—cephalometric variables which were statistically significantly different between SABG and no-SABG groups showed no association with the timing of SABG when (1) age of primary repair of the cleft, (2) age of cephalometric evaluation, (3) cleft side, (4) gender, and (5) operator were controlled for. Only the length of the maxilla (Condylion-point A) was affected—1-year delay of SABG corresponded with an increase in Co-point A distance by 0.52 mm. However, adjusted R 2 of the model was 0.11. Conclusions: Our findings cautiously indicate that SABG performed before 8 years of age can have limited negative effect on craniofacial morphology. Nevertheless, our results should be confirmed by cleft centers practicing alternative surgical repairs of the cleft.

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Section: Discussionsupporting

confidence: 93%

Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

Brudnicki¹,

Sawicka²,

Brudnicka³

et al. 2019

The Cleft Palate Craniofacial Journal

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“…The timing for the bone graft is a variable that clinicians should consider because it can influence the bone graft prognosis, endangering the support provided for teeth eruption, the continuity of dental arch and the closure of the oronasal fistula [50]. Despite the difference in the selected studies' age groups, the majority performed the bone graft after 8 years of age, which is by the ideal timing reported in the literature [13,51,52]. Furthermore, a recent study by Brudnicki et al reported that bone grafts performed before 8 years old might have a limited negative effect on craniofacial morphology [50].…”

Section: Discussionmentioning

confidence: 99%

Regenerative Strategies in Cleft Palate: An Umbrella Review

et al. 2021

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(1) Background: Alveolar bone defects or decreased alveolar bone height and width may have different causes, such as cleft palate. Regenerative procedures in oro-dental defects are challenging due to anatomical factors and the distinct cell populations involved. The iliac crest bone graft remains the gold-standard for cleft palate closure. However, tissue regeneration approaches have been employed and their outcome reviewed, but no conclusions have been made about which one is the gold-standard. (2) Methods: this umbrella review aims to critically appraise the effectiveness of the current approaches in bone defects regeneration in non-syndromic patients with cleft palate. A search was performed in PubMed, Cochrane Library, Scopus, Web of Science and EMBASE databases. (3) Results: Systematic reviews of randomized and non-randomized controlled trials with or without meta-analysis were included. Nine articles were included in the qualitative analysis and five in the quantitative one. The included studies quality was evaluated with AMSTAR2. (4) Conclusions: The use of new regenerative strategies, such as bone morphogenic protein 2, appears to provide similar results regarding bone volume, filling, and height to the standard technique with the iliac crest bone graft.

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“…6 Alveolar cleft deformities are largely repaired secondarily during the period of mixed dentition as to avoid maxillary growth restriction and subsequent malocclusion. 7,8 The optimal time to repair alveolar clefts is based on the skeletal maturity of the maxilla which varies patient-to-patient; however, craniofacial surgeons generally aim to correct alveolar cleft deformities before 9 years of age to increase the odds of the lateral incisors erupting normally. [7][8][9] Coronavirus disease 2019 (COVID-19) has greatly impacted healthcare facilities throughout the United States.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 The optimal time to repair alveolar clefts is based on the skeletal maturity of the maxilla which varies patient-to-patient; however, craniofacial surgeons generally aim to correct alveolar cleft deformities before 9 years of age to increase the odds of the lateral incisors erupting normally. [7][8][9] Coronavirus disease 2019 (COVID-19) has greatly impacted healthcare facilities throughout the United States. Despite children exhibiting a milder clinical course than adults, pediatric healthcare facilities saw significant reductions in surgical volume.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on Cleft Surgical Care

Ferry

Beh

Dibbs

et al. 2021

FACE

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Background: Coronavirus disease 2019 (COVID-19) has greatly impacted pediatric healthcare facilities throughout the United States due to widespread case rescheduling and the implementation of supplementary COVID-19 perioperative protocols. To our knowledge, no studies have investigated the impact of COVID-19 on case volume, surgical timing, or operational aspects of cleft surgical procedures. The aim of this study is to investigate the impact that COVID-19 has had on cleft surgical care at our institution. Methods: A retrospective study comparing cleft surgical care in 2019 (the pre-pandemic cohort) and 2020 (the COVID-19 cohort) was designed. All patients who underwent a cleft surgical procedure from April 1st to August 31st in 2019 and 2020 were included for analysis. Procedures were stratified into 4 groups: primary cleft lip repairs, primary cleft palate repairs, alveolar bone grafting procedures, and revisional/secondary repair procedures. Variables investigated in this study included: surgical volume, number of patients receiving timely surgery, causes for untimely surgery, number of combined cases, number of delayed cases, delay time, time under anesthesia, and procedure length. Results: A total of 191 cleft surgeries, 102 in 2019 and 89 in 2020, were identified during the study period. We observed no statistically significant differences in cleft surgical volume and other investigated variables across all surgical subgroups from 2019 to 2020. Conclusion: Cleft surgical care was largely unaffected by COVID-19 despite high rates of case rescheduling and the addition of supplementary perioperative safety protocols. More studies are needed to assess the impact of COVID-19 on cleft surgical care at other cleft centers and to investigate the long-term outcomes of these patients.

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Early versus late alveolar bone grafting in unilateral cleft lip and palate: Dental arch relationships in pre-adolescent patients

Cited by 18 publications

References 19 publications

Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

Regenerative Strategies in Cleft Palate: An Umbrella Review

Impact of COVID-19 on Cleft Surgical Care

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