Factors Related to the Outcomes of Secondary Alveolar Cleft Bone Grafting Using Two-Dimensional Radiographic Analysis: A Retrospective Study

Abstract

Background

Secondary alveolar bone grafting (SABG) is essential for correcting alveolar defects in patients with cleft lip and palate. While clinical evaluation combined with 2-dimensional (2D) radiography is a practical and cost-effective method for assessing surgical success, inadequate grafting outcomes often necessitate repeat surgeries.

Objective

To evaluate the clinical variables influencing SABG outcomes in cleft patients using 2D radiographic images.

Materials and Methods

This retrospective study reviewed data from 63 patients who underwent SABG at the Faculty of Dentistry, Prince of Songkla university between 2013 and 2023. Variables analyzed included age, cleft type/size, surgical techniques, graft materials, and orthodontic timing. Efficacy was assessed via 2D radiographs (18 conventional, 45 digital) using the Chelsea scale for bone bridging and ImageJ software for bone density. Statistical analyses involved Chi-square tests and multiple logistic regression (P < 0.05).

Results

Overall analysis revealed that patient age and cleft type were the only significant predictors of SABG success, with odds ratios of 10.46 and 5.19, respectively. Subgroup analyses indicated that the timing of post-surgical orthodontic movement was the most significant factor in the conventional radiography group, whereas cleft type was the primary determinant in the digital group.

Conclusion

Patient age and cleft type significantly impact SABG outcomes. Patients aged 10-12 years and those with unilateral cleft deformities exhibit significantly higher success rates compared to other age groups and bilateral deformities.