scholarly journals Enxerto Ósseo na Fenda Lábio-Palatina: Experiência de um Hospital de Referência Português

2016 ◽  
Vol 29 (3) ◽  
pp. 210 ◽  
Author(s):  
Ana Isabel Costa ◽  
Hélder Morgado ◽  
Carlos Mariz ◽  
José Manuel Estevão-Costa
Keyword(s):  
Bone Grafting ◽  
Alveolar Bone ◽  
Donor Site ◽  
Type I ◽  
Type Ii ◽  
Orofacial Clefts ◽  
Type Iii ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

<p><strong>Introduction:</strong> Orofacial clefts are the most frequent craniofacial birth defects. In the presence of bone defect, the secondary alveolar bone grafting is the correction method most commonly accepted by clinicians. This study evaluates the result of this technique in a tertiary hospital.<br /><strong>Material and Methods:</strong> Analysis of the secondary alveolar bone grafting performed between 2007 and 2014, with inclusion of cases in which the iliac crest was the donor site for the graft and the clinical and imaging information was complete. The success of the intervention was assessed radiographically using the Bergland scale (type I-IV) and correlated to variables associated with pathology and/or surgical correction.<br /><strong>Results:</strong> Of the 32 secondary alveolar bone grafting performed, 29 met the inclusion criteria: 13 cases (44.8%) corresponded to complete unilateral pre-foramen clefts; four (13.8%) to complete bilateral pre-foramen clefts; eight (27.6%) to transforamen unilateral clefts and four (13.8%) to bilateral transforamen clefts. According to the scale of Bergland (applied with a mean follow-up of 8 ± 5 months) six were classified as type I, 15 as type II, five as type III and three as type IV. No association was found between the effectiveness of the surgery and the type of orofacial clefts, the presence of the incisor and the canine eruption phase. Five patients were re-operated (three of type II and two of type III at baseline).<br /><strong>Discussion:</strong> In this series, the secondary alveolar bone grafting was effective in most patients (72% type I &amp; II) regardless of the type of orofacial clefts. The relatively high proportion of failures (10.3%) and subsequent need for re-intervention (17%) justify long-term follow up and the continuation of this study. <br /><strong>Conclusion:</strong> It is important to highlight the multidisciplinary involvement in order to identify previously the ideal timing for each intervention and to optimize results.</p>

Evaluation of Alveolar Bone Grafting: A Survey of ACPA Teams

2005 ◽  
Vol 42 (1) ◽  
pp. 99-101 ◽  
Author(s):  
Ananth S. Murthy ◽  
James A. Lehman
Keyword(s):  
North America ◽  
Cleft Palate ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Alveolar Bone ◽  
Donor Site ◽  
X Rays ◽  
Alveolar Bone Grafting ◽  
Missing Tooth

Objective To evaluate the management of alveolar clefts by cleft palate and craniofacial teams in North America. Design An anonymous survey was mailed to 240 American Cleft Palate– Craniofacial Association teams across North America regarding alveolar bone grafting. The questionnaire included multiple questions about each team's approach to alveolar bone grafting and options for the missing tooth. Results Consensus was achieved in three areas: 90% of centers performed secondary alveolar bone grafting, 78% performed grafting between ages 6 and 9 years, and iliac crest donor site was the most popular site (83%). There was no consensus with respect to dental criteria for the timing of grafting, follow-up x-rays, or the use of a grading system for evaluating results. In addition, there was no consensus on the management of the missing tooth. Conclusion There is wide acceptance of secondary bone grafting and there is a consensus for the age of grafting (6 to 9 years) and donor site (iliac crest). The disturbing finding was the lack of postoperative x-ray evaluation of the results. With so much variability in management, the use of a routine, standardized scale to measure postoperative results would allow for better outcome studies in alveolar bone grafting.

Effect of Cuspid Positioning in the Cleft at the Time of Secondary Alveolar Bone Grafting on Eventual Graft Success

1996 ◽  
Vol 33 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Ross E. Long ◽  
Michele Paterno ◽  
Britt Vinson
Keyword(s):  
Root Length ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Graft Outcome ◽  
Crown Length ◽  
Alveolar Bone Grafting ◽  
Graft Success ◽  
The Relationship ◽  
Secondary Alveolar Bone Grafting

This investigation was to determine the relationship between the success of secondary alveolar bone grafting and the position of the permanent cuspid relative to the cleft at the time of grafting. In this retrospective study utilizing periapical radiographs taken on cleft patients to evaluate bone grafting results, the subjects were patients treated at the Lancaster Cleft Palate Clinic, a private institution specializing in the care of cleft patients. Sixty-seven patients (20 BCLP; 47 UCLP) were selected for this study based on availability of quality radiographs and a minimum of 6-month post-surgical follow-up. All patients underwent alveolar bone grafting (mean age, 10 years 7 months). Presurgical radiographs were taken within 3 months of the operation. Post-surgical radiographs were taken to evaluate the outcome of grafting (mean follow-up, 2 years 10 months). Radiographs were traced and digitized on a total of 86 cleft sites. Presurgically, a ratio was used to determine the amount of cuspid crown emerged through the alveolus into the cleft site relative to the anatomic cuspid-crown length. Post-surgically, ratios of bone support for the teeth mesial and distal to the cleft were established by dividing the amount of root covered by bone by the anatomic root length. Ratios expressing the height of alveolar crest relative to the cementoenamel junction (CEJ) of adjacent teeth and amount of alveolar notching relative to the mesial tooth root length were also evaluated. Linear regressions of each of the five ratios of graft outcome on the cuspid-eruption ratio were done. No significant correlations could be found between final graft success and the amount of cuspid crown exposed in the cleft at the time of grafting. Cuspid position could not be shown to be a significant factor in determining graft success.

Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 173-179
Author(s):  
Fatemeh Jabbari ◽  
Laila Wiklander ◽  
Erika Reiser ◽  
Andreas Thor ◽  
Malin Hakelius ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Dental Restoration ◽  
Dental Restorations ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting ◽  
Bone Height

Objective: To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height. Design: Observational follow-up study. Setting: Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden. Patients: 40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate. Interventions: Clinical examination, CBCT, and occlusal radiographs. Main Outcome Measurements: Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up. Results: The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total ( P = .045) and by subgroup with dental restoration ( P = .0078). This was positively correlated with the gingival bleeding index (GBI) ( r = 0.51, P = .0008) and presence of dental restorations in the cleft area ( r = 0.45, P = .0170). There was no difference in the Bergland index generated from scoring the alveolar bone height on occlusal radiographs as with the equivalent index on CBCT. Conclusion: Patients rehabilitated with complex dental restoration seems to be at higher risk for progression of bone loss in the cleft area. Supportive periodontal therapy should be implemented after complex dental restorations in cleft patients. Conventional occlusal radiographs provide an adequate image for evaluating postoperative bone height in clinical follow-up.

Clinical Study on Eruption of Permanent Canines after Secondary Alveolar Bone Grafting

2005 ◽  
Vol 42 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Keiko Matsui ◽  
Seishi Echigo ◽  
Satoshi Kimizuka ◽  
Masato Takahashi ◽  
Masatoshi Chiba
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Surgical Exposure ◽  
Alveolar Bone Grafting ◽  
Nasal Side ◽  
Cleft Lip Palate ◽  
Lost To Follow Up ◽  
Secondary Alveolar Bone Grafting

Objective Eruption of cleft-associated permanent canines was studied in 190 patients with unilateral cleft lip/palate and whose permanent canines had not erupted at the time of alveolar bone grafting. In 162 of these patients, width of bone defect was compared between patients who underwent surgical exposure of canines and those whose canines erupted naturally. Results Cleft-associated canines naturally erupted after bone grafting in 150 patients (78.9%) and required surgical exposure in 36 patients (18.9%). Cleft-associated canines had not yet erupted in two patients. Two patients were lost to follow-up. Nasal-side bone defects were significantly wider in patients who underwent surgical exposure of cleft-associated permanent canines than in those whose cleft-associated permanent canines erupted naturally. Conclusions The present results suggest that nasal-side cleft width is related to the need for surgical exposure of permanent canines in children with cleft lip/palate.

Sign in / Sign up

Export Citation Format

Share Document