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. 2024 May;61(5):791-800.
doi: 10.1177/10556656221143945. Epub 2023 Feb 7.

Comparison of Alveolar Bone Grafting Outcomes using CBCT in Individuals with UCLP Based on the Presurgical Orthodontic Treatment Methods

Jaemin Ko  1 , Samantha Rustia  2 , Lateefa Alkharafi  3 , Rumpa Ganguly  4 , Stephen L-K Yen  1 , Snehlata Oberoi  3
Affiliations

Comparison of Alveolar Bone Grafting Outcomes using CBCT in Individuals with UCLP Based on the Presurgical Orthodontic Treatment Methods

Jaemin Ko et al. Cleft Palate Craniofac J. 2024 May.

Abstract

Objective: The purpose is to evaluate outcomes of alveolar bone grafting based on the pre-grafting orthodontic preparation methods.

Design: Retrospective analysis of individuals with unilateral cleft lip and palate.

Subjects and settings: 28 individuals with non-syndromic UCLP from two craniofacial centers, 14 individuals each from XXXX and XXXX.

Interventions: The alignment group underwent maxillary expansion with incisors alignment while the non-alignment group underwent only maxillary expansion for presurgical orthodontic preparation.

Methods: Initial and post-surgical CBCT scans were compared to observe changes in angulation of the incisor adjacent to the cleft site, alveolar bony root coverage, and bone graft outcomes.

Results: In the alignment group, the buccolingual rotation decreased by 32.35 degrees (p = .0002), the anteroposterior inclination increased by 14.01 degrees (p = .0004), and the mesiodistal angulation decreased by 17.88 degrees (p = .0001). Alveolar bony coverage did not change after bone graft in both groups, and no difference was observed between the groups. Chelsea scale showed satisfactory bone graft outcome (category A, C) in 12 cases (85.71%) in the alignment group and 11 cases (78.51%) in the non-alignment group. The volumetric measurement showed the alignment group had better bone fill of 69.85% versus 51.45% in the non-alignment group (p = .0495).

Conclusions: Alveolar bony coverage on the tooth adjacent to cleft sites did not change with alveolar bone grafting surgery in either of the alignment and non-alignment group. Presurgical orthodontic alignment does not induce root exposure nor poorer bone grafting outcome.

Keywords: bone grafting; bone regeneration; computerized tomography; orthodontics; tooth movement.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Orientation of the occlusal plane.
Figure 2.
Figure 2.
Measurement of angulation of the tooth adjacent to cleft site: A, buccolingual rotation at T1; B, buccolingual rotation at T2; C, anteroposterior inclination at T1; D, anteroposterior inclination at T2; E, mesiodistal tipping at T1; F, mesiodistal tipping at T2.
Figure 3.
Figure 3.
Measurement of alveolar root coverage: A, apex; B, alveolar crest; C, cementoenamel junction.
Figure 4.
Figure 4.
Measurement of graft fill: A, axial slice at T1; B, axial slice at the same position at T2; C, superimposed axial slices of T1 and T2; D, measurement of defect area at T1; E, measurement of graft filling area using outline drawn in figure D.
See this image and copyright information in PMC

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