Use of three-dimensional computed tomography to classify filling of alveolar bone grafting

Abstract

Several authors have proposed classifications to analyze the quality over time of secondary alveolar bone grafting. However, little discussion has been held to quantitatively measure the secondary bone grafting for correction of nasal deformity associated to cleft palate and lip. Twenty patients with unilateral alveolar cleft, who underwent secondary alveolar bone grafting, were studied with 3D computer tomography. The height between the inferior portion of the pyriform aperture and the incisal border of the unaffected side (height A) and the affected side (height B) was measured using a software Mirror. A percentage was then obtained dividing the height B by the height A and classified into grades I, II, and III if the value was greater than 67%, between 34% and 66%, or less than 33%. Age, time of followup, initial operation, and age of canine eruption were also recorded. All patients presented appropriate occlusion and function. Mean time of followup was 7 years, and mean initial age for operation was 10 years old. 16 patients were rated as grade I and 4 patients as grade II. No cases had grade III. We present a new grading system that can be used to assess the success of secondary bone grafting in patients who underwent alveolar cleft repair.

Figure 1

Classification based on pyriform aperture. Grade I: 67–100%; grade II: 34–66%; grade III: 0–33%.

Figure 2

Patient with grade I. (a) CT scan view; (b) occlusal view; (c) dental X-ray.

Figure 3

Patient with grade II. (a) CT scan view; (b) occlusal view; (c) dental X-ray.

Figure 4

Patient with grade II. (a) CT scan view; (b) occlusal view; (c) panorex demonstrating dental implant.