Impact of a new combined preoperative cleft assessment on dental implant success in patients with cleft and palate: a retrospective study

Abstract

Background Bone height assessment alone is frequently used to guide rehabilitation choice, without consideration for soft tissues or adjacent teeth. This study aimed to evaluate the impact of different preoperative cleft assessments on implant success and patient satisfaction. Methods The study involved a retrospective assessment of records from 40 patients with cleft lip and palate (CLP). The alveolar cleft score (ACS; clinical criteria), interdental alveolar bone height (IABH) score (radiological criteria), patient compliance score (dental hygiene, medical visit observance, and smoking), and a novel combined score (IABH-ACS-Compliance) were assessed from patient records. Patients who required prosthetic tooth rehabilitation in the cleft dental arch space were included. Twenty-six patients (Group 1) were treated with dental implants, and 14 patients (Group 2) selected another prosthetic option (fixed prosthodontics, removal prosthesis), orthodontic space closure, or no rehabilitation. The main outcomes measured were relative implant success (no implant loss involving marginal bone loss ≤ 1.9 mm) for patients treated with dental implant therapy (Group 1) and patient satisfaction for all patients (Groups 1 and 2). Results Forty dental implants were placed in the patients in Group 1. Four implants in four patients (Group 1 relative failure, RF) were lost (implant survival rate of 90%) after 36 (± 12.4) months of follow-up. Twenty-two patients who received implants belonged to the relative implant success group (Group 1 RS). The average “IABH-ACS-Compliance” scores were significantly different (p < 0.05): 16.90 ± 2.35 and 12.75 ± 0.43 for the Group 1 RS and RF groups, respectively. Conclusions Preoperative cleft parameters have an impact on relative implant success and patient satisfaction. The new cleft assessment combined-score (“IABH-ACS-Compliance”) allows an accurate selection of cleft cases eligible for dental implants, thereby improving postoperative outcomes.

Effectiveness, Esthetics, and Success Rate of Dental Implants in Bone-Grafted Regions of Cleft Lip and Palate Patients: A Systematic Review and Meta-Analysis

“…Also, a funnel plot (Figure 3) shows MBL in cleft patients and other patients in follow-up after implant. Most of the studies included in the systematic review performed bone grafting using either autogenous iliac crest (AUIC) or allergenic bone grafts, which have shown excellent outcomes in managing cleft patients [12][13][14][15][16][17][18][19][20].…”

“…The existing database emphasizes the multiple benefits of dental implants in CLP patients [12][13][14][15][16][17][18][19][20]. Other parameters assessed by the authors included in the review are summarised in Table 3.…”

“…Their study, as well as the study done by Savoldelli et al, 2022, used the interdental alveolar bone height (IABH) index for the assessment of bone height, as shown in Table 4 . In the two studies, the success rate of implants was 90% and 100%, respectively [ 14 , 19 ].…”

Measures of oral health-related quality of life in patients with bone graft and implant prosthetic rehabilitation at the anterior of mandible/maxilla among young and middle-aged adults: a retrospective pilot study

“…The estimated global prevalence of total tooth loss decreased from 4.3% in 1990 to 4.1% in 2015 [ 15 ]. However, in patients with mandibular or maxillary tumors [ 16 , 17 ], maxillofacial injuries, [ 18 ] or cleft lip and palate (CLP) [ 19 ], tooth loss is common even among young and middle-aged patients. In such cases, jawbone reconstruction using free vascularized bone grafts, iliac particulate cancellous bone marrow (PCBM) grafts, or bone block (BB) grafts are often performed to improve facial contours and allow the insertion of a dental implant.…”

The circadian clock component BMAL1 regulates osteogenesis in osseointegration

“…Cleft lip and palate (CLP) are one of the most common craniofacial congenital malformations in humans ( 1 ). It has been estimated lately that, with ethnic and geographic variation, approximately 1.5–1.7 of every 1,000 infants are born with CLP, which sorely hampers the development of important physiological functions, including breathing, swallowing, speech, chewing, and esthetics ( 2 , 3 ).…”