Alveolar Bone Grafting for Patients with Unilateral Complete Alveolar and Palatal Clefts Improves the Bony Structure of the Nose

2009 ◽  
Vol 46 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Tomohisa Nagasao ◽  
Hisao Ogata ◽  
Junpei Miyamoto ◽  
Hua Jiang ◽  
Tsuyoshi Kaneko ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Morphological Changes ◽  
Control Group ◽  
Tomographic Images ◽  
Bony Structure ◽  
Nasal Bones ◽  
External Nose ◽  
Alveolar Bone Grafting ◽  
Frontal Process

Objective: This is a retrospective study regarding the effect of alveolar bone grafting (ABG) on morphological changes in the bony structure of the nose in alveolar and palatal cleft patients. Methods: Sixty-five randomly selected adults were included in the present study. Of the 65 subjects, 21 had no congenital anomaly and were designated as the control group (n  =  21; mean age 22.4 ± 4.3 years). Forty-four had unilateral complete clefts of the alveolus and palate on the left side. The patients with clefts were further divided into two subgroups based on presence or absence of ABG in their histories. These groups were termed the ABG(+) group (n  =  24; mean age 20.3 ± 2.5 years) and the ABG(−) group (n  =  20; mean age 32 ± 4.5 years), respectively. An anatomical structure that constitutes the bony component of the nose was defined. This structure, composed of the nasal bones and part of the frontal process of the maxilla, was termed the BSEN (bony structure of the external nose). The symmetry of the BSEN was assessed quantitatively by performing morphological measurements on computerized tomographic images of each patient's skull, and these measurements were compared among the control, ABG(+), and ABG(−) groups. Results: The BSEN presented more symmetric features in the ABG(+) group patients than in the ABG(−) group patients. Conclusion: ABG improves symmetry of the BSEN. This finding justifies ABG in terms of cosmetic improvement of the external nose in patients with unilateral complete alveolar and palatal clefts.

Reduced Need for Alveolar Bone Grafting by Presurgical Orthopedics and Primary Gingivoperiosteoplasty

1998 ◽  
Vol 35 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Pedro E. Santiago ◽  
Barry H. Grayson ◽  
Court B. Cutting ◽  
Mark P. Gianoutsos ◽  
Lawrence E. Brecht ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Primary Study ◽  
Control Group ◽  
Dental Ct ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Presurgical Orthopedics

Objective The purpose of this study was to evaluate if narrowing and approximation of the alveolar cleft through presurgical alveolar molding followed by gingivoperiosteoplasty (GPP) at the time of lip repair reduces the need for a bone-grafting procedure. Design This was a retrospective blind study of patients with unilateral or bilateral alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon. Alveolar bone formation was assessed prior to the eruption of the maxillary lateral incisor or canine by clinical examination, panoramic and periapical radiographs, and/or a dental CT scan. The criterion for bone grafting was inadequate bone stock to permit the eruption and maintenance of the permanent dentition. Setting This study was performed at the Institute of Reconstructive Plastic Surgery by the members of the Cleft Palate Team. Patients All patients with unilateral (n = 16) or bilateral (n = 2) alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon from 1985 to 1988 were studied. The control population consisted of all alveolar cleft patients (n = 14) who did not undergo alveolar modeling or GPP during the same time period. Interventions Presurgical alveolar modeling was performed with an intraoral acrylic molding plate. This plate was modified on a weekly basis to align the alveolar segments and close the alveolar gap. The surgical intervention consisted of a modified Millard GPP. Main outcome Measures The primary study outcome measure was the elimination of the need for a secondary bone graft in patients who underwent presurgical alveolar molding and GPP. Results Of the 20 sites in the 18 patients who underwent GPP, 12 sites did not require an alveolar bone graft. Of the 8 sites requiring a bone graft, 4 presented minimal bony defects. All 14 patients in the control group required bone grafts. Conclusions In this series of 20 alveolar cleft sites treated with presurgical orthopedics and GPP, 60% did not need a secondary alveolar bone graft in the mixed dentition.

Secondary (Intermediate) Alveolar Bone Grafting

1993 ◽  
Vol 20 (4) ◽  
pp. 691-705 ◽  
Author(s):  
Mimis Cohen ◽  
John W. Polley ◽  
Alvaro A. Figueroa
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Alveolar Bone Grafting

Mind the Gap: Alveolar Bone Graft Revision in the Era of Computed Tomography

2021 ◽  
pp. 105566562110026
Author(s):  
Ema Zubovic ◽  
Gary B. Skolnick ◽  
Abdullah M. Said ◽  
Richard J. Nissen ◽  
Alison K. Snyder-Warwick ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Tertiary Care ◽  
Radiographic Examination ◽  
Graft Take ◽  
Alveolar Bone Grafting ◽  
Ct Evaluation

Objective: To determine the rate of revision alveolar bone grafting (ABG) in patients with cleft lip and palate (CLP) before and after the introduction of postoperative computed tomography (CT). Design: Retrospective case–control study analyzing the incidence of revision ABG in patients with and without postoperative CT scans for graft success evaluation. Setting: Academic tertiary care pediatric hospital. Patients: Eighty-seven patients with CLP or cleft lip and alveolus treated with autologous iliac crest bone grafting for alveolar clefts over a 10-year period (January 2009 to March 2019) with minimum 6-month follow-up. Fifty patients had postoperative CT evaluation; 37 did not. Interventions: Postoperative CT to determine ABG success, versus standard clinical examination and 2-dimensional radiographs. Main Outcome Measures: Requirement for revision ABG, defined as failure of the original graft by clinical or radiographic examination. Results: Fifty-eight percent of patients underwent a postoperative CT scan at median interval of 10 months after surgery. Patients with postoperative CT evaluation had a 44% rate of revision ABG (22/50) for inadequate graft take, compared to 5% (2/37) in patients without postoperative CT ( P < .001; 95% CT, 31%-58% in the CT group, 1%-16% in the non-CT group). Conclusions: Computed tomography evaluation after ABG is associated with a significantly increased revision rate for inadequate graft take. The presence of a secondary palatal fistula at the time of original ABG is not associated with revision requirement. Lack of standardized dental and orthodontic records complicates the study of ABG outcomes and presents an area for systems-based improvement.

Challenges of alveolar bone grafting in bilateral cleft patients

2019 ◽  
Vol 48 ◽  
pp. 15
Author(s):  
A.L. Ivanov ◽  
N.V. Starikova ◽  
V.A. Gorbonosov ◽  
N.V. Udalova
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Alveolar Bone Grafting

Long Term Effects of the Latham Presurgical Maxillary Orthopedic Appliance, Including Effects on Tooth Growth

2000 ◽  
Vol 8 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Michel C Samson ◽  
Donald H Lalonde ◽  
Donald Fitzpatrick ◽  
Gerald L Sparkes
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Consistent Difference ◽  
Long Term Effects ◽  
Beneficial Effects ◽  
Alar Base ◽  
Alveolar Bone Grafting ◽  
Base Elevation

Reported beneficial effects of presurgical maxillary orthopedics in cleft lip include reduction of the cleft width, alignment of the maxillary segments, elevation of the alar base on the cleft side, diminished need for alveolar bone grafting and lip closure without tension. Possible adverse effects of presurgical maxillary orthopedics include tooth root damage and inability of periosteoplasty to make bone over the cleft. A series of wide cleft lip patients (n=15) treated with the Latham appliance at the time of lip closure were retrospectively compared with a similar group treated without the Latham appliance. The Latham appliance group (seven unilateral clefts, eight bilateral clefts; mean follow-up 9.5 years; range four to 18 years) was treated between the years 1980 and 1994. None of the 15 patients treated with the appliance had any tooth loss or damage attributable to the pins, and bone formation in the alveolar cleft was observed radiographically in all 13 of the patients who had a periosteoplasty at the time of lip repair, possibly obviating the need for secondary bone grafting. Five of these Latham group patients demonstrated clinical and radiographic evidence of tooth eruption into the periosteoplasty-formed bone. There was no consistent difference in the level of nasal alar base elevation in the two groups.

Early Alveolar Bone Grafting Is Associated with Lower Regraft Rates and Improvements in Long-Term Psychosocial Outcomes

2021 ◽  
Vol 149 (1) ◽  
pp. 60e-67e ◽  
Author(s):  
Allison C. Hu ◽  
Nirbhay S. Jain ◽  
Candace H. Chan ◽  
Sri Harshini Malapati ◽  
Brian N. Dang ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Psychosocial Outcomes ◽  
Alveolar Bone Grafting
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