Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography

Abstract

Objectives: To evaluate alveolar bone support around cleft-adjacent maxillary central incisors (U1) in patients with unilateral cleft lip, alveolus and palate (UCLAP) in the late mixed dentition and to investigate the correlation between the alveolar bone thickness (ABT) and tooth inclination.

Materials and methods: Cone beam computed tomography scans of 45 subjects with UCLAP (29 boys, 16 girls; mean age = 10.74 ± 1.08 years) were assessed. The distance between the cementoenamel junction (CEJ) and alveolar bone crest (AC), and the ABTs at 3 mm, 6 mm, and the apex were measured on the labial, lingual and distal surfaces of U1. The cleft and normal sides were compared using a paired t-test and Pearson's χ² test. Pearson's correlation was used to explore the association between the ABT and tooth inclination of cleft-adjacent U1 in the labiolingual and mesiodistal dimensions.

Results: The CEJ-AC distances were significantly greater in cleft-adjacent U1 ( P < .01), with more bone height reduction observed labially and distally ( P < .001). The labial, lingual, and apico-distal ABTs were decreased on the cleft side ( P < .01). A positive correlation was found between the apico-labial ABT and the labiolingual inclination ( r = 0.568, P < .01).

Conclusions: Patients with UCLAP have reduced alveolar bone support around the cleft-adjacent U1, and the apico-labial ABT tends to decrease with increasing lingual tooth inclination; however, the correlation was weak.

Keywords: Alveolar bone; Cone beam computed tomography; Tooth inclination; Unilateral cleft lip, alveolus, and palate.

Figure 1.

Labiolingual inclination of a cleft-adjacent U1 determined by the long axis of U1 and the SN plane from a sagittal section.

Figure 2.

Mesiodistal inclination of a cleft-adjacent U1 determined by the long axis of U1 and the sagittal line from a coronal section.

Figure 3.

Alveolar bone support measurement. (A) Labial and lingual CEJ-AC distances from a sagittal section and the three ABT measurement planes (3 mm, 6 mm, and apex). (B) Distal CEJ-AC distance from a coronal section. Labial, lingual, and distal ABT measurements from axial sections at (C) 3 mm from the CEJ, (D) 6 mm from the CEJ, and (E) at the apex. Sa, axial section line; Sc, coronal section line; Ss, sagittal section line.