A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate

Movahhedian, Najmeh; Vossoughi, Mehrdad; Hajati-Sisakht, Mahtab

doi:10.1177/1055665619874613

Cited by 4 publications

(3 citation statements)

References 33 publications

(74 reference statements)

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“…23 Teeth adjacent to cleft sites have less alveolar bony support. 28,31,32 Woods et al observed that the cleft facing surface of the root had 5.7% less bony coverage compared to the contralateral tooth. 28 Ercan et al also reported that the tooth adjacent to the cleft had reduced bony support on the buccal surface.…”

Section: Discussionmentioning

confidence: 99%

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

Rustia

Alkharafi

et al. 2023

The Cleft Palate Craniofacial Journal

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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.

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Section: Discussionmentioning

confidence: 99%

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

Rustia

Alkharafi

et al. 2023

The Cleft Palate Craniofacial Journal

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“…CBCT is able to portray thickness and height of the alveolar bone, particularly on the buccal and palatal sides. Conventional, 2D dental radiography cannot provide such information [ 16 ]. Furthermore, the previous studies have demonstrated how pre-surgical knowledge of the exact volume of bone graft needed can improve surgical results [ 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of cleft volume and evaluation of cleft’s impact on adjacent anatomical structures using CBCT imaging

Vicente,

Wiedel,

Becker

et al. 2024

Oral Radiol

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Objectives To determine pre-operative cleft volume and evaluate cleft´s impact on surrounding anatomical structures in children and adolescents with orofacial clefts using cone bean computed tomography (CBCT) imaging. Methods The present retrospective study retrieved CBCT examinations of 68 patients from a previous study. The examinations had been exposed either before (n = 53) or after (n = 15) alveolar bone grafting. Pre-operative volume of cleft was determined, and type and location were evaluated. Morphological changes on the adjacent anatomical structures, including the incisive foramen, the nasal septum and floor, and the inferior turbinate, were assessed. Results Mean bilateral cleft volume was 0.76 cm3, while mean unilateral cleft volume was 1.08 cm3; the difference was significant (p < 0.001). Variation in cleft volume, however, was large. The incisive foramen was not visible in the majority of cases with bilateral clefts (71%); the difference was significant (p = 0.001). In cases with unilateral clefts, the nasal septum in 87% was curved towards the cleft or graft side. Also, the mean size of the widest part of the inferior turbinate was 8.8 mm on the cleft or graft side and 10.4 mm on the non-cleft side. The difference was significant (p < 0.001). Conclusions When required, CBCT is a feasible method for quantitatively illustrating alveolar clefts and their impact on the morphological development of surrounding structures. Variation in cleft volume was large.

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“…The alveolar bone on the buccal and palatal sides of teeth anterior to the cleft is significantly thinner compared to teeth unaffected by a cleft [ 14 ]. The lack of alveolar bone results in poor periodontal support for teeth adjacent to the cleft margins, increasing the risk of early tooth loss.…”

Section: Introductionmentioning

confidence: 99%

Use of Individually Designed CAD/CAM Suprastructures for Dental Reconstruction in Patients with Cleft Lip and Palate

Mäntynen,

Laurila,

Strausz

et al. 2023

Dentistry Journal

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This patient series reports the outcomes of CAD/CAM prosthetic reconstructions in patients with cleft lip and palate (n = 9, aged 27 to 76) who have experienced significant failure with conventional restorative and fixed prosthodontic treatments. The objective of the protocol is to establish a functional and patient-friendly prosthetic structure for individuals with unilateral/bilateral cleft lip and palate (UCLP/BCLP) while minimising the requirement for specialised follow-up care in the cleft unit. The study data were obtained from a retrospective cohort at Helsinki University Hospital. Prosthetic reconstructions were performed using CAD/CAM bar structures by the Atlantis 2in1 system or Createch removable telescope structures, supported by four to eight maxillary dental implants. Out of the nine patients, seven experienced no complications. One prosthesis fracture occurred after 16 months due to a design error in the original framework, and one patient experienced failure of osseointegration in a dental fixture (specifically, one fixture out of the eight maxillary implants in this patient). In total, 56 implants were successfully placed. The maxillary dentition of elderly patients with cleft lip and palate often poses challenges due to periodontal and reconstructive issues. An implant-supported CAD/CAM bar with a removable telescope suprastructure offers an easily maintained and functional solution for dental rehabilitation.

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A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate

Cited by 4 publications

References 33 publications

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

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

Quantitative assessment of cleft volume and evaluation of cleft’s impact on adjacent anatomical structures using CBCT imaging

Use of Individually Designed CAD/CAM Suprastructures for Dental Reconstruction in Patients with Cleft Lip and Palate

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