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.

Scandcleft trial of primary surgery for unilateral cleft lip and palate: Craniofacial cephalometrics at 8 years

2020 ◽  
Author(s):  
Annelise Küseler ◽  
Arja Heliövaara ◽  
Kirsten Mølsted ◽  
Agneta Marcusson ◽  
Agneta Karsten ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Controlled Trial ◽  
Craniofacial Morphology ◽  
Primary Surgery ◽  
Growth Studies ◽  
Alveolar Bone Grafting ◽  
Lateral Cephalograms

Summary Background The Scandcleft trial is a randomized controlled trial that includes children with unilateral cleft lip and palate where registrations are standardized and therefore provides the opportunity to describe craniofacial characteristics in a very large sample of patients. Objectives The aim of this study was to describe craniofacial growth and morphology in a large study sample of 8-year-old children with unilateral cleft lip and palate (UCLP); before orthodontic treatment and before secondary alveolar bone grafting; and to compare the cephalometric values with age-matched non-cleft children from previous growth studies to identify the differences between untreated cleft- and non-cleft children. Materials There are 429 eight-year-old UCLP patients in the Scandcleft study group. A total of 408 lateral cephalograms with a mean age of 8.1 years were analysed. Cephalometric analyses were performed digitally. The results from three previously published growth studies on non-cleft children were used for comparison. Results Cephalometric analyses showed a large variation in craniofacial morphology among the UCLP group. In general, they present with significant maxillary retrusion and reduced intermaxillary relationships compared to the age-matched non-cleft children. In addition, the vertical jaw relationship was decreased, mainly due to decreased maxillary inclination. The upper and lower incisors were retroclined. It can be expected that these differences will increase in significance as the children age. Conclusion Results from this study provide proposed norms for the young UCLP before any orthodontic treatment and can be valuable for the clinician in future treatment planning. Trial registration ISRCTN29932826.

Cephalometric Comparison of Craniofacial Morphology between Primary Bone Grafted and Nongrafted Complete Unilateral Cleft Lip and Palate Adults

1996 ◽  
Vol 33 (5) ◽  
pp. 429-435 ◽  
Author(s):  
Akira Suzuki ◽  
Keiya Goto ◽  
Norifumi Nakamura ◽  
Yasuo Honda ◽  
Masamichi Ohishi ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bone Grafts ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Craniofacial Growth ◽  
Anterior Maxilla ◽  
Lateral Cephalograms ◽  
Primary Bone

The effect of primary bone grafts on craniofacial growth was evaluated in adult patients with complete unilateral cleft lip and palate (UCLP).The subjects were 18 UCLP patients with primary bone grafts and a control group of 36 UCLP patients without bone grafts. The former received primary transplantation of autogenous rib bone simultaneously with primary cheiloplasty by the same surgeon between 1963 and 1969. Frontal and lateral cephalograms taken after 16 years of age were traced. Skeletal landmarks were Identified on them, and their x,y-coordinates were digitized. The effects of gender and/or primary bone graft on the craniofacial morphology were tested by ANOVA using 21 angles, 8 breadths, 13 distances, and 2 ratios. Nasal cavity breadth was wider in the primary bone grafted group. However, the anterior maxilla in that group was more upward and retruded than that in the nongrafted group. The primary bone grafted group was divided into two subgroups based on the overjet of the incisors: group N = normal overjet; group C = anterior cross-bite. There was no difference in the maxilla between groups N and C. However, the mandible in group C was more anterior and superior than in group N. In conclusion, primary bone graft may impede maxillary horizontal and vertical growth to a certain degree, and severe anterior cross-bite in primary bone grafted subjects may be brought about by mandibular closure.

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

Sella Turcica Bridging and Tooth Agenesis in Children With Unilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562098464
Author(s):  
Gregory S. Antonarakis ◽  
Luis Huanca Ghislanzoni ◽  
David M. Fisher
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Multinomial Logistic Regression ◽  
Sella Turcica ◽  
Lateral Incisor ◽  
Maximum Height ◽  
Dental Anomalies ◽  
Alveolar Bone Grafting ◽  
Lateral Cephalograms

Aim: To investigate differences in sella turcica size and bridging in children with unilateral cleft lip and palate (UCLP) with or without concomitant dental anomalies. Patients and Methods: A cross-sectional study was carried out looking at 56 children with nonsyndromic UCLP. Lateral cephalograms, taken before alveolar bone grafting, were used to assess sella turcica height, width, area, and bridging. Panoramic radiographs were used to evaluate the presence of dental anomalies in the cleft area including agenesis, supernumerary, and peg-shaped lateral incisors. Differences between sella turcica measurements in the presence or absence of dental anomalies were assessed using t tests. Differences between the prevalence of dental anomalies and sella turcica bridging were assessed using χ2 and Fisher exact tests. Multinomial logistic regression was used to investigate potential associations between sella measurements and dental anomalies. Results: Twenty-six of the 56 children presented with agenesis of the cleft-side lateral incisor, while 7 had a supernumerary, and 19 had a peg-shaped lateral incisor. With regard to sella turcica bridging, 27 children had no calcification, 25 partial and 4 complete calcification. Children with agenesis of the cleft-side lateral incisor showed a shorter sella maximum height ( P = .010) and a smaller area ( P = .019). When looking at sella turcica bridging, 100% of children with complete calcification showed agenesis of the cleft-side lateral incisor, compared with 52% and 33% of children with partial calcification and no calcification, respectively ( P = .034). Conclusions: Children with UCLP and sella turcica bridging are more likely to present with agenesis of the cleft-side maxillary lateral incisor.

Comparison of Facial Morphology in Two Populations with Complete Unilateral Cleft Lip and Palate from Two Different Centers

2006 ◽  
Vol 43 (4) ◽  
pp. 471-476 ◽  
Author(s):  
John Daskalogiannakis ◽  
Gabriëlle E. H. M. Dijkman ◽  
Anne Marie Kuijpers-Jagtman ◽  
R. Bruce Ross
Keyword(s):  
Repeated Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Craniofacial Morphology ◽  
Facial Morphology ◽  
History Of ◽  
Sick Children ◽  
Genetically Determined ◽  
Two Populations

Objective To identify differences in craniofacial morphology of two populations with a history of complete unilateral cleft lip and palate (UCLP) treated under different protocols. Design Retrospective longitudinal cohort study. Setting Cleft Center of the University of Nijmegen, The Netherlands, and the Cleft Lip and Palate Program, The Hospital for Sick Children, Toronto, Canada. Subjects Nineteen patients (16 male, 3 female) from Nijmegen and 19 patients (16 male, 3 female) from Toronto. Each patient was matched for sex and age with a patient from the other group. The mean ages at which lateral cephalometric radiographs were available for the Nijmegen group were 5.5, 9.9, and 18.3 years, while for the Toronto group these were available at mean ages of 5.3, 10.1, and 18.3 years, respectively. Eighteen patients from the Nijmegen group received an alveolar bone graft at a mean age of 9.5 years (range 8.2 to 13.5 years). None of the patients from Toronto received bone grafts. Main Outcome Measures Eighteen cephalometric variables per radiograph were calculated at each time registration, using Dentofacial Planner cephalometric software. Statistical evaluation was performed with repeated-measures analysis of variance. Results No differences were seen in the maxillary measurements. The patients in the Toronto group had significantly larger mandibles at all three time registrations. Conclusions The Nijmegen and Toronto protocols resulted in similar maxillary projections in patients with UCLP. Comparison of data from other studies supports the contention that the larger profile convexity of the Nijmegen group is a reflection of a genetically determined smaller mandibular size in the Dutch population.

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