Rapid Maxillary Expansion after Alveolar Bone Grafting with rhBMP-2 in UCLP Evaluated by Means of CBCT

2017 ◽  
Vol 54 (4) ◽  
pp. 474-480
Author(s):  
Daniela Garib ◽  
Felicia Miranda ◽  
Renata Sathler ◽  
Anne Marie Kuijpers-Jagtman ◽  
Carlos Alberto Aiello
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Collagen Membrane ◽  
Craniofacial Anomalies ◽  
Maxillary Expansion ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting

Objective To demonstrate the feasibility of rapid maxillary expansion (RME) after alveolar bone grafting (ABG) in complete unilateral cleft lip, alveolus and palate (UCLP) without damage to the grafted area. Setting Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Department of Orthodontics. Patient A case report of a 10-year-old boy with a complete UCLP who was treated with RME after secondary ABG procedure. RME was performed 1.3 years after the bone grafting with rhBMP-2 in collagen membrane. Result Postexpansion cone-beam computed tomography (CBCT) axial and coronal sections demonstrated the opening of the midpalatal suture in the premaxilla without damages to the alveolar bone grafting region. Postretention CBCT images showed bone formation at the split midsuture of the premaxilla. Conclusion Rapid maxillary expansion performed after ABG with rH-BMP2 led to complete opening of the premaxillary midline suture without compromising the integrity of the grafted alveolar cleft.

Rapid Maxillary Expansion after Secondary Alveolar Bone Grafting in Patients with Alveolar Cleft

2009 ◽  
Vol 46 (3) ◽  
pp. 331-338 ◽  
Author(s):  
Omar Gabriel da Silva Filho ◽  
Elaine Boiani ◽  
Arlete de Oliveira Cavassan ◽  
Milton Santamaria
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Qualitative Evaluation ◽  
Rapid Maxillary Expansion ◽  
Dental Arch ◽  
Sample Population ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting ◽  
Before And After ◽  
Secondary Alveolar Bone Grafting

Objective: To test the hypothesis that it is possible to perform rapid maxillary expansion (RME) after alveolar bone grafting in patients with clefts of the lip and palate (CLP) without compromising the final result of the bone graft. Design: Occlusal and periapical radiographs of the grafted area of 17 unilateral and 11 bilateral patients with CLP (n  =  28) were obtained before and after RME. Setting and sample population: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo. Twenty-eighty patients with CLP who had undergone RME. Interventions: RME was performed in patients with CLP who had already undergone RME before secondary bone grafting but with relapse of the maxillary dental arch constriction, as well as in patients with CLP who had never undergone expansion before bone grafting. Outcome measure: Qualitative evaluation in occlusal and periapical radiographs after alveolar bone grafting. Results: Findings showed opening of the midpalatal suture in 42.8% of patients in this study. Regardless of the success rate of RME, the alveolar bone grafting was not affected when the procedures were inverted. Conclusion: The hypothesis was accepted. RME can be performed after secondary alveolar bone grafting without affecting it.

scholarly journals The effectiveness of mineralized plasmatic matrix in the closure of alveolar clefts with volumetric assessment

2021 ◽  
Vol 9 ◽  
pp. 1
Author(s):  
Padminii Ellapakurthi ◽  
Gotike Siva Prasad Reddy
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Platelet Rich Plasma ◽  
Cone Beam ◽  
Average Percentage ◽  
Alveolar Cleft ◽  
Volumetric Assessment ◽  
Alveolar Bone Grafting

Objectives: The purpose of this study is to assess the effectiveness of mineralized plasmatic matrix in the soft tissue closure of naso-alveolar fistula, to estimate the postoperative bone fill and volume of the graft placed in the alveolar cleft defect using cone-beam computed tomography (CBCT) at 3rd- month and 6th- month. Material and methods: 10 patients, in the age group of 15‑30 years were included in this study. They were diagnosed with unilateral cleft lip and alveolus defects with or without a cleft palate requiring late secondary alveolar bone grafting. Alveolar cleft defects were closed with mineralized plasmatic matrix (MPM), a combination of autogenous iliac bone graft and platelet rich plasma (PRP) and platelet rich fibrin (PRF). Results: The mean defect volume pre-operatively is 0.75 cm3 and at the end of 3rd-month postoperatively is 0.51 cm3 and at 6th-month postoperatively is 0.27 cm3. The average percentage of bone fill between preoperative (A) & 3th- month postoperatively (B) is 33.4% and between 3rd-month (B) and 6th-month post operatively (C) is 49.5%. Conclusions: Utilization of this new matrix (MPM), has shown to be effective in the closure of the cleft defect, oro-nasal fistula and also reduction in the volume of the residual cleft defect seen with sequential cone-beam computed tomography (CBCT) radiographs.

scholarly journals A novel method for alveolar bone grafting assessment in cleft lip and palate patients: cone-beam computed tomography evaluation

2020 ◽  
Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Bone Architecture ◽  
Cone Beam ◽  
Bone Morphology ◽  
Alveolar Bone Grafting

Abstract Objectives This retrospective cross-sectional study aimed to present a new method for secondary alveolar bone grafting (SABG) assessment and to qualitatively evaluate the SABG results in unilateral cleft lip and palate patients. Materials and methods Research was conducted according to the STROBE guidelines. The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography (CBCT) was performed at least 1 year after grafting. The experimental side was the cleft side, and the contralateral side without a congenital cleft was the control. Measurements were performed at four levels of the maxillary central incisors’ roots according to the new scale with scores from 0 to 3. The sum of the scores provided a general assessment of bone architecture. The Wilcoxon signed-rank test was used for intergroup comparisons, and a Kappa coefficient was used for reproducibility measurements. Results High individual variability was found, and the bone architecture was significantly worse on the cleft side than on the noncleft side. The results showed 28.57% failure, 33.33% poor, 19.05% moderate, and 19.05% good results from the surgical procedure. Kappa coefficients produced results from 0.92 to 1.00 for intra-rater and from 0.81 to 1.00 for inter-rater reproducibility. Conclusions CBCT provides detailed information about alveolar bone morphology. The new assessment method is useful at every treatment stage and provides excellent repeatability. SABG did not provide good bone morphology, in most cases. Clinical relevance This research presents a new universal alternative for the assessment of SABG by utilizing CBCT.

Alveolar Bone Grafting

2019 ◽  
pp. 95-98
Author(s):  
Raj M. Vyas ◽  
Gennaya L. Mattison
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Bone Grafting ◽  
Crucial Role ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting ◽  
Cleft Lip Repair

Alveolar bone grafting plays a crucial role in cleft reconstruction. When neonatal presurgical orthodontia is successful in aligning the cleft segments, alveolar reconstruction can be initiated as a gingivoperiosteoplasty during primary cleft lip repair. In children with cleft palate, alveolar bone grafting is usually done after transverse maxillary expansion with a palatal expander. Exact timing of bone grafting is controversial; most centers initiate orthodontic evaluation/expansion between ages 7 and 8 years (beginning of mixed dentition) with an aim to bone graft before age 10 in order to allow osteogenic incorporation prior to eruption of the permanent canine teeth.

Volumetric Assessment of Secondary Alveolar Bone Grafting Using Cone Beam Computed Tomography

2009 ◽  
Vol 46 (5) ◽  
pp. 503-511 ◽  
Author(s):  
Snehlata Oberoi ◽  
Radhika Chigurupati ◽  
Pawandeep Gill ◽  
William Y. Hoffman ◽  
Karin Vargervik
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Cone Beam ◽  
Alveolar Bone Grafting ◽  
Bilateral Cleft Lip ◽  
Secondary Alveolar Bone Grafting

Objective: To assess the radiographic outcome of secondary alveolar bone grafting in individuals with nonsyndromic unilateral or bilateral cleft lip and palate using cone beam computed tomography. Methods: This prospective study was conducted at the University of California at San Francisco Center for Craniofacial Anomalies on 21 consecutive nonsyndromic complete cleft lip and palate individuals between 8 and 12 years of age who required alveolar bone grafting. Seventeen unilateral and four bilateral cleft lip and palate individuals had preoperative and postoperative cone beam computed tomography scans that were analyzed using Amira 3.1.1 software. Results: The average volume of the preoperative alveolar cleft defect in unilateral cleft lip and palate was 0.61 cm3, and the combined average volume of the right and left alveolar cleft defects in bilateral cleft lip and palate was 0.82 cm3. The average percentage bone fill in both unilateral cleft lip and palate and bilateral cleft lip and palate was 84%. The outcome of alveolar bone grafting was assessed in relation to (1) type of cleft, (2) size of preoperative cleft defect, (3) presence or absence of lateral incisor, (4) root development stage of the maxillary canine on the cleft side, (5) timing, and (6) surgeon. None of these parameters significantly influenced the radiographic outcome of alveolar bone grafting. Conclusions: Secondary alveolar bone grafting of the cleft defect in our center was successful, based on radiographic outcome using cone beam computed tomography scans. Volume rendering using cone beam computed tomography and Amira software is a reproducible and practical method to assess the preoperative alveolar cleft volume and the adequacy of bone fill postoperatively.

The Presurgical Status of the Alveolar Cleft and Success of Secondary Bone Grafting

2000 ◽  
Vol 37 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Catherine Aurouze ◽  
Karlind T. Moller ◽  
Richard R. Bevis ◽  
Kelly Rehm ◽  
Joel Rudney
Keyword(s):  
Healthy Individual ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Alveolar Cleft ◽  
Satisfactory Outcome ◽  
Alveolar Bone Grafting ◽  
Study Population ◽  
Secondary Alveolar Bone Grafting

Objective The primary purpose of this study was to evaluate presurgical status of the alveolar cleft site and success of secondary alveolar bone grafting. Design Thirty patient records were retrospectively reviewed. Patients selected for inclusion had isolated cleft of at least the primary palate. Patients with additional anomalies were not selected. The study population consisted of 15 female sites and 16 male cleft sites. There were two bilateral cleft lip and palate (CLP) patients and 28 unilateral CLP patients. The age at the time of the secondary alveolar bone grafting ranged from 7 years to 14 years, 4 months. Setting The study was conducted at the Cleft Palate Clinic at the University of Minnesota, School of Dentistry. Method Presurgical radiographs taken at least 1 month prior to the secondary bone grafting and postsurgical radiographs taken at least 6 months after bone surgery were measured. Measurements included size of the cleft defect and bone support for distal and mesial teeth adjacent to the cleft. Evaluation of success was determined on the basis of postsurgical measurements of satisfactory, intermediate, and unsatisfactory outcomes. Results and Conclusion The size of the cleft defect was not correlated with the success rate of the secondary alveolar bone grafting. If the amount of distal bone support for the mesial tooth was the same as those in a periodontally healthy individual, a satisfactory outcome was 5.8 times more likely. If the amount of mesial bone support for the distal tooth was the same as those in a periodontally healthy individual, the satisfactory outcome was 3.8 times more likely. Although not a primary purpose of the study, it was found that in this study population, if the patient was female, a satisfactory outcome was 3.8 times more likely.

Alveolar bone grafting in the treatment of midline alveolar cleft and diastema in incomplete median cleft lip

2008 ◽  
Vol 37 (10) ◽  
pp. 886-891 ◽  
Author(s):  
H.-T. Liao ◽  
C.-H. Chen ◽  
L. Bergeron ◽  
E.W.-C. Ko ◽  
P.K.T. Chen ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Median Cleft
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