scholarly journals Clinical and Radiographic Assessment of Secondary Bone Graft Outcomes in Cleft Lip and Palate Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
W. Khalil ◽  
C. R. de Musis ◽  
L. E. R. Volpato ◽  
K. A. Veiga ◽  
E. M. M. Vieira ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Bone Grafts ◽  
Type I ◽  
Type Ii ◽  
Radiographic Assessment ◽  
Positive Correlation ◽  
Time Periods

Purpose. To compare the results of secondary alveolar bone grafts in patients with complete cleft lip and cleft lip and palate using 2 radiographic scales and according to the rate of canine eruption through the newly formed bone. Materials and Methods. We analyzed pre- and postoperative radiographs of 36 patients for the amount of bone in the cleft site according to the Bergland and Chelsea scales. The associations between the variables and the correlation between the scales were measured. Results. A total of 54.2% and 20.8% of cases were classified as type I and type II, respectively, using the Bergland scale, whereas 50% and 22.5% were classified as types A and C, respectively, using the Chelsea scale. A positive correlation between the 2 scales was observed. In 33.3% of males, 58.3% of females, 54.5% of unilateral cleft cases, and 12.5% of bilateral cleft cases, the permanent canines had erupted. Bone grafts performed prior to canine eruption achieved more satisfactory results. Conclusions. Our results suggest that both radiographic scales are important tools for the evaluation of bone grafts. Additionally, longer time periods of evaluation were associated with improved results for patients with secondary alveolar bone grafts.

A New Scale to Assess Radiographic Success of Secondary Alveolar Bone Grafts

2002 ◽  
Vol 39 (3) ◽  
pp. 255-260 ◽  
Author(s):  
H. Witherow ◽  
S. Cox ◽  
E. Jones ◽  
R. Carr ◽  
N. Waterhouse
Keyword(s):  
Bone Graft ◽  
Outcome Measures ◽  
Alveolar Bone ◽  
Bone Grafts ◽  
Intraobserver Reliability ◽  
Mixed Dentition ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv

Objectives: To propose a new scale for evaluating the position of the bone graft within the cleft and assess its inter- and intraobserver reliability. Design: Sixty-six patients (70 cleft sites) over a 14-year period were assessed, 90% of patients retrospectively and 10% prospectively. The radiographs were reviewed by two clinicians in controlled conditions twice, with 1 week between assessments. Both clinicians were blind to patient identity. Outcome measures: A new scale subdividing the position of the bone into one of six categories was used. The radiographs were also assessed using the Bergland scale. Results: Using the Bergland scale, 62.9% of the cleft sites were type I, 21.4% type II, 4.3% type III, and 5.7% type IV. It was not possible to assess 5.7% of the clefts with this scale because the canine was unerupted. Using the Chelsea alveolar bone graft scale, 58% were category A, 20% B, 7% C, 3% D, 3% E, and 9% F. Conclusions: The above scale can be used to determine accurately the position of bone within the cleft site. It can be used in the mixed dentition prior to eruption of the canine. It demonstrated moderate to substantial inter- and intraobserver reliability and offers several advantages, compared with other scales.

Racial Disparities Affect Timing of Alveolar Bone Grafting for Patients With Cleft Lip and Palate: An Analysis of the 2012 Kids’ Inpatient Database

FACE ◽  
2021 ◽  
pp. 273250162110485
Author(s):  
Alfredo Cepeda ◽  
Mary T. Austin ◽  
Phuong D. Nguyen ◽  
John F. Teichgraeber ◽  
Matthew R. Greives
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Sociodemographic Factors ◽  
Alveolar Bone Grafting ◽  
Income Quartile ◽  
Inpatient Database

Objective: The timing of alveolar bone graft (ABG) for patients with cleft lip and palate is critical to the success of the operation. Sociodemographic factors have been implicated in delaying surgery for other diagnoses but their impact on patients undergoing ABG is unknown. The purpose of this study is to examine the association of sociodemographic factors on the age of patients undergoing ABG. Methods: The Kids’ Inpatient Database (KID) from 2012 was used to define a cohort of patients with cleft lip and/or palate between the ages of 5 and 14. Patients were selected using ICD-9 procedure codes for repair of oronasal fistula and bone graft. Gender, race, income quartile, hospital region, and type of insurance were used as independent variables. Time to ABG was then calculated as hazard ratios (HR) of having surgery using Cox regression models with 95% confidence intervals. Results: A cohort of 395 patients was identified. Median age at ABG was 9 ± 0.15 years. On univariate analysis, Non-Hispanic Black (NHB) patients underwent surgery later than Non-Hispanic White (NHW) patients (11.13 ± 0.44 years vs 9.67 ± 0.19 years, P = .0026). Patients in the higher 2 income quartiles were more likely to have an early surgery as compared to those in the lowest quartile (9.16 ± 0.43 and 9.32 ± 0.43 years vs 10.20 ± 0.33, P = .016 and 0.043 respectively). No factor was significant on multivariate analysis. Conclusions: Patients who are NHB are associated with delayed time to ABG as compared to NHW. Conversely, those in the upper income quartile by zip code underwent surgery at an earlier age. While this study identifies demographic factors associated with delay of ABG, more research is needed to understand the direct causal effects for this delay in surgery and its implication for future growth and need for orthognathic surgery.

Long-Term Stability of Alveolar Bone Graft in Cleft Lip and Palate Patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Arezoo Jahanbin ◽  
Elaheh Kamyabnezhad ◽  
Mohammad Ali Raisolsadat ◽  
Fahimeh Farzanegan ◽  
Erfan Bardideh
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Term Stability ◽  
Long Term Stability

scholarly journals Radiological evaluation of secondar y bone grafting results in patients with cleft lip and palate

2021 ◽  
Vol 3 (59) ◽  
pp. 51-55
Author(s):  
Silvia Railean ◽  
◽  
Egor Porosencov ◽  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Type I ◽  
Alveolar Ridge ◽  
Radiological Evaluation ◽  
Equal Distribution ◽  
Care Protocol

Introduction. Bone grafts are a necessary component of the care protocol for patients with cleft lip and palate (CLP). Radiological evaluation is an essential tool in evaluating the integration of the bone graft at the cleft area. Aim: Evaluation of the interdental height of the alveolar ridge in patients with CLP at the pre- and postoperative stages in order to assess the integration of bone graft in the cleft area. Material and methods: Cross-sectional clinical study, which included 34 patients with CLP; with equal distribution by gender, with an average age of 17.6±0.43 years. The study group underwent surgical treatment with bone grafting in the cleft region. The radiological evaluation was performed pre- and postoperatively (over 6 months), according to the scale of assessment proposed by Abyholm et al. Statistical evaluation of the data was performed by the Pearson correlation coefficient. Results: Overall, favorable postoperative results were observed. Initially, according to the radiological evaluation, the patients presented at the preoperative stage type III 29.4% (n = 10) and type IV - 70.6% (n = 24) of the interdental height of the alveolar ridge. Following bone grafting, it was recorded at 52.9% (n = 18) - type I, mainly in female patients (n = 11) and 47.1% (n = 16) - type II of the interdental height of the alveolar ridge , being predominantly registered in male patients (n = 10). Statistically significant differences between the sexes were not recorded (p = 0.132). The successful results obtained by secondary bone grafting in the cleft region allowed to continue the rehabilitation treatment of patients with CLP. Conclusion: Radiological evaluation of secondary bone grafting in the cleft area in terms of assessing the height of the alveolar ridge according to the scale of Abyholm et al. is a valuable diagnostic tool, readily available for assessing the condition of the grafted bone.

scholarly journals Eruption of Impacted Teeth in Cleft Lip and Palate Patients following Alveolar Bone Graft

2018 ◽  
Vol 19 (9) ◽  
pp. 1072-1075
Author(s):  
Matheus C Bandeca ◽  
Alvaro H Borges ◽  
Mateus R Tonetto ◽  
Suellen L Lima ◽  
Andreza MF Aranha ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Impacted Teeth

scholarly journals Effects of Different Timing of Alveolar Bone Graft on Craniofacial Morphology in Unilateral Cleft Lip and Palate

2019 ◽  
Vol 57 (1) ◽  
pp. 105-113 ◽  
Author(s):  
Andrzej Brudnicki ◽  
Ewa Sawicka ◽  
Renata Brudnicka ◽  
Piotr Stanisław Fudalej
Keyword(s):  
Bone Graft ◽  
Regression Models ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Primary Repair ◽  
Craniofacial Morphology ◽  
Retrospective Assessment ◽  
Lateral Cephalograms ◽  
Negative Effect

Objective: To evaluate the effect of the timing of secondary alveolar bone graft (SABG) on craniofacial morphology in patients with complete unilateral cleft lip and palate (UCLP). Design: Single-center retrospective assessment of consecutively treated nonsyndromic patients with complete UCLP. Participants: One hundred sixty-seven patients (108 males, 59 females) with complete UCLP in whom the cleft was repaired with 1-stage method at approximately 8 months of age. The age of 128 patients at SABG varied from 1.4 to 11.5 years (SABG group), while 39 patients still awaited SABG at the moment of cephalometric evaluation (no-SABG group). Methods: Craniofacial morphology was assessed on lateral cephalograms taken at 10 years of age (standard deviation = 0.8; range: 7.5-12.3) using linear and angular measurements. T tests and regression models were made to analyze data. Results: Regression models demonstrated that the effect of SABG on the craniofacial morphology was limited—cephalometric variables which were statistically significantly different between SABG and no-SABG groups showed no association with the timing of SABG when (1) age of primary repair of the cleft, (2) age of cephalometric evaluation, (3) cleft side, (4) gender, and (5) operator were controlled for. Only the length of the maxilla (Condylion-point A) was affected—1-year delay of SABG corresponded with an increase in Co-point A distance by 0.52 mm. However, adjusted R 2 of the model was 0.11. Conclusions: Our findings cautiously indicate that SABG performed before 8 years of age can have limited negative effect on craniofacial morphology. Nevertheless, our results should be confirmed by cleft centers practicing alternative surgical repairs of the cleft.

scholarly journals Time to Recovery of Feeding After Alveolar Bone Graft Is Associated With Postoperative Nausea and Vomiting Within 2 Hours in Children

2019 ◽  
Vol 13 ◽  
pp. 117955651985538
Author(s):  
Kaoru Yamashita ◽  
Toshiro Kibe ◽  
Sachi Ohno ◽  
Minako Uchino ◽  
Yurina Higa ◽  
...  
Keyword(s):  
Bone Graft ◽  
Postoperative Nausea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
School Age Children ◽  
Surgical Timing ◽  
Significant Difference

Objective: To examine the relationship between the method of anesthesia for alveolar bone graft surgery and postoperative nausea and vomiting (PONV) based on the difference in surgical timing and to assess factors related to the postoperative quality of life. Design: Retrospective observational study. Setting: Hospital. Participants: Patients with cleft lip and palate who underwent alveolar bone graft surgery under general anesthesia. The subjects were divided into two groups based on surgical timing: secondary bone graft (SBG) and late secondary bone graft (LSBG) groups. Main Outcome Measures: Relationship between time to recovery of feeding and the types of anesthesia, PONV, and postoperative pain period. Results: The mean patient age was 9.97 ± 1.33 years in the SBG group and 15.39 ± 0.31 years in the LSBG group. In the SBG group, patients who were administered fentanyl or remifentanil had significantly higher incidence of PONV than those who were not administered these drugs. In the SBG group, the time to recovery of feeding was significantly longer in patients experiencing PONV within 2 hours or that lasted for 24 hours than in those without PONV. In the LSBG group, there was no significant difference regarding any of the above factors. Conclusions: Our results suggest that the occurrence of PONV within 2 hours or lasting for 24 hours postoperatively in school-age children prolonged the time to recovery of feeding. This indicates that the time to recovery of feeding can be predicted based on the occurrence of PONV within the first 2 hours.

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