Retrospective analysis of clinical outcomes in bilateral cleft lip and palate patients after secondary alveolar bone grafting and premaxilla osteotomy, using a new dento-maxillary scoring system

Bittermann, Gerhard Koendert Pieter; Ruiter, Adrianus P. de; Bittermann, Arnold J. N.; Koole, R.; Rosenberg, Antoine J.W.P.

doi:10.1016/j.jcms.2020.12.006

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…9,14,33 This concern increases in bilateral alveolar grafts associated with premaxillary osteotomy due to greater complexity, tissue manipulation and risk of premaxillary devitalization. 6,8,12,14 Accordingly, the present study evaluated AG + PO radiographic outcomes based on previously validated rating scales in order to prove that rhBMP-2 and iliac crest bone have similar success rates, both with better outcomes when surgeries are performed before canine eruption on the cleft side.…”

Section: Discussionmentioning

confidence: 99%

“…4 Different protocols for protruding premaxillary management are cited in the literature, including secondary alveolar bone grafting with premaxillary osteotomy and early secondary alveolar bone grafting with premaxillary osteotomy. 5,6 Orthodontic intrusion to treat premaxillary vertical excess according to patient age and defect severity has also been suggested. However, the protocol is not effective for vertical excesses greater than 7-8 mm.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Radiographic Outcomes of Alveolar Graft Associated with Premaxillary Osteotomy Performed with rhBMP-2

Leal

Rocha

Carvalho

et al. 2023

The Cleft Palate Craniofacial Journal

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Objective To evaluate the influence of filling material and timing of surgery on radiograph outcomes of alveolar grafting with premaxillary osteotomy. The null hypothesis was that radiographic outcomes would be similar with both rhBMP-2 (rhBMP-2G) and cancellous bone from the iliac crest (IG), regardless of the timing of surgery. Design Cross-sectional study with consecutive sampling of 56 periapical or occlusal radiographs taken 12 months after surgery. Setting A single tertiary craniofacial center. Patients/Participants Twenty-eight patients with complete bilateral cleft lip and palate and mean age of 13 years. The individuals underwent bilateral alveolar grafting associated with premaxillary osteotomy (AG + PO) with rhBMP-2 or cancellous bone from the iliac crest. Interventions Experienced maxillofacial surgeons used the same surgical technique in both groups. AG + PO were assigned as success or failure by 3 blinded raters based on modified Bergland and SWAG scales. Main Outcome Measures The influence of filling materials and timing of surgery on radiographic outcomes was verified by Fisher's exact test and chi-square test ( P < .05). Results There was no significance variation between the mean age of participants in the rhBMP-2G and IG ( P = .471). Scales showed almost perfect reliability (agreement rate = 96.4%; K = 0.85). rhBMP-2G and IG had similar success rates with modified Bergland scale (85.7% and 82.1%) and SWAG scale (92.9% and 82.1%), respectively. However, only modified Bergland scale found influence of age on radiographic outcomes ( P = .025). Conclusions AG + PO performed with rhBMP-2 and iliac crest bone showed similar radiographic success rates, regardless of the timing of surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Radiographic Outcomes of Alveolar Graft Associated with Premaxillary Osteotomy Performed with rhBMP-2

Leal

Rocha

Carvalho

et al. 2023

The Cleft Palate Craniofacial Journal

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“…Even more serious condition is that these patients show obvious daytime sleepiness. Moreover, the CLP has a dangerous influence on the function of the pharyngeal airway (Bittermann et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

The study on the morphological changes of oropharynx in patients with complete unilateral cleft lip and palate after palatopharyngeal closure

Chen

Zhang

2022

Front. Neurosci.

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Cleft lip and palate can be treated as one of the most common craniofacial congenital malformations in humans. Such disease influences tens of millions of patients all over the world. Cleft lip and palate deformity affects many important physiological functions, including breathing, swallowing, speech, chewing, and aesthetics. This work focuses on investigating the morphology and airway volume of oropharynx patients with unilateral complete cleft lip and palate after palatopharyngeal closure. In addition, this work evaluated the similarities and differences between patients with cleft lip and palate and those without such an issue. The employed data, selected from the Department of Stomatology of Xuzhou First People's Hospital, are based on the conical beam CT images. The study sample was divided into two groups: the selected experimental group, who confronted the cleft lip, cleft palate, and velopharyngeal closure surgery, and the selected control group, who are healthy children at the corresponding age. The parameters, including the airway volume, the airway volume of velopharyngeal and oropharyngeal segments, the minimum cross-sectional area of the pharynx, the horizontal plane airway area of the hard palate and soft one, the horizontal airway area of the hyoid bone, and the vertical distance between the hard palate and soft palate, can be measured by Dolphin. These parameters were analyzed with a statistical approach. The analysis of the above-mentioned parameters reveals that the airway volume, the minimum cross-sectional area of the pharynx, the horizontal cross-sectional area of the hyoid, and the distance between the hard palate and soft palate tip in patients with complete unilateral cleft lip and palate show significant differences between the experimental group and the control group. Meanwhile, other parameters, including the horizontal cross-sectional area of the airway in the horizontal plane of the hard palate and the horizontal plane of the soft palate, did not show noticeable differences in the two groups. The patients, who confronted the unilateral complete cleft lip and palate, can improve with the velopharyngeal closure surgery. Furthermore, the length and vertical distance of the soft palate and the volume of each segment of the airway exhibit differences between the experimental group and the control group.

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“…During late childhood (after 8 y.o. ), the goals are the same but the surgery is postponed in order to minimize the maxillary growth impact (Hayward, 1983; Marinho et al, 1995) and favor alveolar bone grafting ([Carlini et al, 2009; Bittermann et al, 2021]. In adults, the objective is to achieve both functional and aesthetic results.…”

Section: Introductionmentioning

confidence: 99%

Surgical Repositioning of the Premaxilla: Incidence, Indications and Growth Study About a 189 Bilateral Cleft Lip ± Palate Population

Drilleaud

Corre

Perrin

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective We aimed to evaluate the rate of patient requiring Surgical Repositioning of the Premaxilla in a population carrying BCL ± P, retrieve age and operative indication. Our secondary objective was to present further facial growth characteristics. Settings This was a retrospective, single-center cohort study conducted in Nantes University Hospital, Oral and Maxillofacial Surgery department, tertiary cleft center. Patients Patients with BCL ± P born between 1980 and 2019 treated at Nantes University Hospital were included. Main outcome measure Our primary outcome measure was the rate of patient requiring SRP. Results Over the whole period, 189 patients with BCL ± P were identified. Three patients (1,58%) underwent SRP. Patients who underwent SRP all had BCLP. SRP was performed during their primary dentition period. The indication for surgical repositioning was always premaxilla vertical overgrowth with an overbite over 10 mm. Facial growth features in the three patients were mostly comparable with a population carrying BCLP who had no premaxillary surgery. Conclusion Our results showed a low incidence of SRP. No SRP was necessary during early infancy (ie, before lip repair) or during adulthood. Surgical repositioning of the premaxilla is beneficial for patient with orthodontically uncorrectable vertical premaxillary excess, even more since facial development compared with other patients with BCLP appears comparable.

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Retrospective analysis of clinical outcomes in bilateral cleft lip and palate patients after secondary alveolar bone grafting and premaxilla osteotomy, using a new dento-maxillary scoring system

Cited by 10 publications

References 39 publications

Evaluation of Radiographic Outcomes of Alveolar Graft Associated with Premaxillary Osteotomy Performed with rhBMP-2

Evaluation of Radiographic Outcomes of Alveolar Graft Associated with Premaxillary Osteotomy Performed with rhBMP-2

The study on the morphological changes of oropharynx in patients with complete unilateral cleft lip and palate after palatopharyngeal closure

Surgical Repositioning of the Premaxilla: Incidence, Indications and Growth Study About a 189 Bilateral Cleft Lip ± Palate Population

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