Radiographic outcome of secondary alveolar bone grafting in patients with alveolar clefts
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Date
2021
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Publisher
John Wiley & Sons
Abstract
Objective: To determine the outcome of secondary alveolar bone grafting (SABG) in a series of consecutive patients with clefts involving the alveolus.Design and Setting: Retrospective cohort study of consecutive operations per-formed between June 2011 and September 2016 by a single surgeon at a single United Kingdom cleft center.Participants: A total of 160 patients with a cleft/s involving the alveolus, inclusive of syndromic patients and those with atypical facial clefts.Interventions: A standard protocol involved an oral hygiene program, pre-surgical orthodontics where necessary and autologous bone grafting from the iliac crest.Main Outcome Measure(s): The Kindelan bone-fill index was used to evaluate suc-cess using occlusal radiographs. Weighted Cohen's kappa coefficient was used as a measure of intra- and inter- rater agreement. Fisher's exact test was used to examine the effects of type of cleft, pre-surgical orthodontics or age at time of SABG on ra-diographic outcome.Results: There were 200 SABGs assessed. Mean age at time of SABG was 9.1 years old (SD 1.1) with 99% (n =198) of grafts deemed successful. There were two fail-ures where re- graft was performed successfully during the study period. A grade 1 outcome was achieved for 92.5% (n = 185) of grafts and this did not appear to be af-fected by type of cleft (P= .290), pre-surgical orthodontics (P= .380) or age at time of SABG (P= .081).Conclusions: The high success rate reported in this study supports the favorable out-comes of a high-volume cleft surgeon. These findings can be used for comparative audit with similar units providing cleft care.
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Keywords
alveolar bone grafting, cleft lip, cleft palate, orthodontics
Citation
Radiographic Outcome of Secondary Alveolar Bone Grafting in Patients with Alveolar Clefts.ā Orthodontics and craniofacial research. 25.1 (2022): 128ā133