Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb;145(2):391e-400e.
doi: 10.1097/PRS.0000000000006494.

A Review of 30 Years of Alveolar Bone Grafting in the Mixed Dentition Using a Standardized Protocol in Western Australia

Pierre Keribin  1 , Wendy Nicholls  1 , Mark Walters  1 , Albert Tan  1 , Melanie McAlpine  2   1 , David Gillett  1
Affiliations

A Review of 30 Years of Alveolar Bone Grafting in the Mixed Dentition Using a Standardized Protocol in Western Australia

Pierre Keribin et al. Plast Reconstr Surg. 2020 Feb.

Abstract

Background: Outcomes for a continuously applied alveolar bone grafting protocol, established in 1982, are reported and compared to previously published outcomes from the authors' unit and elsewhere.

Methods: A descriptive, retrospective cohort study of alveolar bone grafting outcomes at a tertiary referral cleft center was performed. Records of all alveolar bone grafts between 2002 and 2014 were reviewed (224 grafts). Three-year postoperative periapical radiographs were evaluated using the Bergland, Kindelan, and standardized way to assess graft scores by an external rater. Incomplete records, a syndromic diagnosis, or primary surgery performed elsewhere resulted in 123 grafts being excluded, leaving 101 grafts for assessment. The distribution of scores was compared to the authors' previous studies and international reports. The authors also tested for any impact on the outcome based on cleft type, laterality, timing for incisor or canine eruption, and surgeon experience.

Results: A total of 95.6 percent of applicable grafts (66 of 69) were considered "successful" by Bergland scores and 96 percent by Kindelan scores. Eighty-nine percent of grafts were "very good" based on standardized way to assess graft score. No significant differences were detected in outcomes based on timing, cleft type, or laterality. Surgeon experience had a significant impact (p < 0.05) on outcome for Bergland and Kindelan scores. Distribution of Bergland scores did not differ from the authors' earlier studies demonstrating consistent outcomes for over 30 years.

Conclusions: The Western Australian alveolar bone grafting protocol has consistently achieved a very high success rate (96 percent) for over 30 years despite multiple staff changes. These results compared well with best-reported outcomes from worldwide cleft centers. Surgeon training and experience were significant in achieving these outcomes.

Clinical question/level of evidence: Therapeutic, IV.

PubMed Disclaimer

Comment in

References

    1. Johanson B, Ohlsson A. Bone grafting and dental orthopaedics in primary and secondary cases of cleft lip and palate. Acta Chir Scand. 1961;122:112–124.
    1. Boyne PJ. Autogenous cancellous bone and marrow transplants. Clin Orthop Relat Res. 1970;73:199–209.
    1. Matthews D, Broomhead I, Grossmann W, Orth D, Goldin H. Early and late bone grafting in cases of cleft lip and palate. Br J Plast Surg. 1970;23:115–129.
    1. Boyne PJ, Sands NR. Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg. 1972;30:87–92.
    1. Abyholm FE, Bergland O, Semb G. Secondary bone grafting of alveolar clefts: A surgical/orthodontic treatment enabling a non-prosthodontic rehabilitation in cleft lip and palate patients. Scand J Plast Reconstr Surg. 1981;15:127–140.