To examine the changes in autogenous bone from 6 to 12 months after alveolar bone grafting (ABG) (T1) through completion of edgewise treatment (T2).
Design
Retrospective longitudinal study.
Setting
Multidisciplinary long-term follow-up at Kagoshima University Hospital.
Patients
Forty-three patients with unilateral cleft lip and palate or alveolus.
Main Outcome Measures
At T1 and T2, the bone bridge and quantity of grafted bone were evaluated using the Chelsea scale and the ABG scale. The cleft-adjacent tooth angles before ABG and at T2, as well as the number of orthodontic space closures, were examined. Patients were classified as having either adequate (type A or C; adequate group) or poor bone bridges (type B, D, E, or F; poor group) by the assessment at T1.
Results
At T1, the ABG scores for the cleft-adjacent central incisor side of patients in the adequate group were higher than those of patients in the poor group (P < .001). At T2, the adequate group had higher ABG scores for the cleft-adjacent central incisor side (P = .022) and the canine sides (P = .034). No significant differences in tooth angles or the number of orthodontic space closures were noted between the groups.
Conclusions
These results suggest that the quantity of grafted bone in the cleft-adjacent central incisor at 6 to 12 months post-ABG may be an indicator of the quantity of grafted bone that will be present after edgewise treatment.
AbyholmF.E., BerglandO., SembG.. Secondary bone grafting of alveolar clefts: a surgical/orthodontic treatment enabling a nonprosthodontic rehabilitation in cleft lip and palate patients.Scand J Plast Reconstr Surg.1981; 15: 127–140.
2.
BerglandO., SembG., AbyholmF.E.. Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment.Cleft Palate J.1986; 23: 175–205.
3.
BenlidayiM.E., TatliU., KurkcuM., UzelA., OztuncH.. Comparison of bovine-derived hydroxyapatite and autogenous bone for secondary alveolar bone grafting in patients with alveolar clefts.J Oral Maxillofac Surg.2012; 70: e95–e102.
4.
BoyneP.J., SandsN.R.. Secondary bone grafting of residual alveolar and palatal clefts.J Oral Surg.1972; 30: 87–92.
5.
EnemarkH., Krantz-SimonsenE., SchrammJ.E.. Secondary bone grafting in unilateral cleft lip palate patients: indications and treatment procedure.Int J Oral Surg.1985; 14: 2–10.
6.
EnemarkH., Sindet-PedarsonS., BundgaardM.. Long-term results after secondary bone grafting of alveolar clefts.J Oral Maxillofac Surg.1987; 45: 913–918.
7.
FreihoferH.P., BorstlapW.A., Kuijpers-JagtmanA.M., VoorsmitR.A., van DammeP.A., HeidbüchelK.L., Borstlap-EngelsV.M.. Timing and transplant materials for closure of alveolar clefts: a clinical comparison of 296 cases.J Craniomaxillofac Surg.1993; 21: 143–148.
8.
GiudiceG., GozzoG., SportelliP., GargiuoliF., De SiateA.. The role of functional orthodontic stress on implants in residual alveolar cleft.Plast Reconstr Surg.2007; 119: 2206–2217.
9.
GereltzulE., BabaY., OhyamaK.. Attitude of the canine in secondary bone-grafted and nongrafted patients with cleft lip and palate.Cleft Palate Craniofac J.2005; 42: 679–686.
10.
JacksonI.T., VandervordJ.G., McLennanJ.G., ChristieF.B., McGregorJ.C.. Bone grafting of the secondary cleft lip and palate deformity.Br J Plast Surg.1982; 35: 345–353.
11.
KinderlanJ.D., NashedR.R., BromigeM.R.. Radiographic assessment of secondary alveolar bone grafting in cleft lip and palate patients.Cleft Palate Craniofac J.1997; 34: 195–198.
12.
KochiS., TeshimaT.. Bone grafts in alveolar cleft using autogenous particulate marrow and cancellous bone: successful bone formation and related factor.Dent Japan.1994; 31: 62–66.
13.
KubotaY., TaniguchiT., YamashiroT., SuzukiA., NinomiyaT., TakenoshitaY., ShirasunaK.. Postoperative valuation of secondary particulate cancellous bone and marrow grafting to alveolar clefts.J Jpn Cleft Palate Assoc.2003; 28: 1–8.
14.
LandisJ.R., KochG.G.. The measurement of observer agreement for categorical data.Biometrics.1977; 33: 159–174.
15.
LeeC., NishiharaK., OkawachiT., IwashitaY., MajimaJ.H., NakamuraN.. A quantitative radiological assessment of outcomes of autogenous bone graft combined with platelet-rich plasma in the alveolar cleft.Int J Oral Maxillofac Surg.2008; 38: 117–125.
16.
LongREJr., SpanglerB.E., YowM.. Cleft width and secondary alveolar bone graft success.Cleft Palate Craniofac J.1995; 32: 420–427.
17.
MatsuiK., EchigoS., KimizukaS., TakahashiM., ChibaM.. Clinical study on eruption permanent canines after secondary alveolar bone grafting.Cleft Palate Craniofac J.2005; 42: 309–313.
18.
NishiharaK., NozoeE., MaedaA., HiraharaN., OkawachiT., MiyawakiS., NakamuraN.. Outcome following secondary autogenous bone grafting before and after canine eruption in patients with unilateral cleft lip and palate.Cleft Palate Craniofac J. In press.
19.
OkawachiT.. Evaluation of autogenous iliac bone grafting for alveolar cleft of cleft lip and palate patients [in Japanese].J Jpn Cleft Palate Assoc.2001; 26: 55–67.
20.
PeamkaroonrathC., GodfreyK., ChatrchaiwiwatanaS.. New clinical method for alveolar bone graft evaluation in cleft patients: a pilot study.Cleft Palate Craniofac J.2011; 48: 286–292.
21.
RussellK.A., McLeodC.E.. Canine eruption in patients with complete cleft lip and palate.Cleft Palate Craniofac J.2008; 45: 73–80.
22.
SharmaS., SchneiderL.F., BarrJ., AarabiS., ChibbaroP., GraysonB., CuttingC.G.. Comparison of minimally invasive versus conventional open harvesting techniques for iliac bone graft in secondary alveolar cleft patients.Plast Reconstr Surg.2011; 128: 485–491.
23.
ShawW.C., BrattströmV., MistedK., Prahl-AndersenB., RobertsC.T., SembG.. The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 5: discussion and conclusions.Cleft Palate Craniofac J.2005; 42: 93–98.
24.
Sindet-PedersonS., EnemarkH.. Comparative study of secondary and late secondary bone-grafting in patients with residual cleft defects: short-term evaluation.Int J Oral Maxillofac Surg.1985; 14: 389–398.
25.
TanA.E., BroganW.F., McCombH.K., HenryP.J.. Secondary alveolar bone grafting–five-year periodontal and radiographic evaluation in 100 consecutive cases.Cleft Palate Craniofac J.1996; 33: 513–518.
26.
TrindadeI.K., MazzottiniR., Silva FilhoO.G., TrindadeI.E., DevoniM.C.. Long-term radiographic assessment of secondary alveolar bone grafting outcomes in patients with alveolar clefts.Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2005; 100: 271–277.
27.
TurveyT.A., HallD.J.. Intraoral self-threading screw fixation for sagittal osteotomies: early experiences.Int J Adult Orthodon Orthognath Surg.1986; 1: 243–250.
28.
WalleN.M., ForbesD.P.. The effect of size characteristics of alveolar cleft defects on bone graft success: a retrospective study.Northwest Dent Res.1992; 3: 5–8.
29.
WitherowH., CoxS., JonesE., CarrR., WaterhouseN.. A new scale to assess radiographic success of secondary alveolar bone grafts.Cleft Palate Craniofac J.2002; 39: 255–260.
