A New Scale to Assess Radiographic Success of Secondary Alveolar Bone Grafts

Abstract

Objectives: To propose a new scale for evaluating the position of the bone graft within the cleft and assess its inter- and intraobserver reliability. Design: Sixty-six patients (70 cleft sites) over a 14-year period were assessed, 90% of patients retrospectively and 10% prospectively. The radiographs were reviewed by two clinicians in controlled conditions twice, with 1 week between assessments. Both clinicians were blind to patient identity. Outcome measures: A new scale subdividing the position of the bone into one of six categories was used. The radiographs were also assessed using the Bergland scale. Results: Using the Bergland scale, 62.9% of the cleft sites were type I, 21.4% type II, 4.3% type III, and 5.7% type IV. It was not possible to assess 5.7% of the clefts with this scale because the canine was unerupted. Using the Chelsea alveolar bone graft scale, 58% were category A, 20% B, 7% C, 3% D, 3% E, and 9% F. Conclusions: The above scale can be used to determine accurately the position of bone within the cleft site. It can be used in the mixed dentition prior to eruption of the canine. It demonstrated moderate to substantial inter- and intraobserver reliability and offers several advantages, compared with other scales.

Ultrasound Evaluation of Primary Alveolar Grafting in Cleft Lip/Palate Treatment: Development of a Novel Sonographic Grading System

“…The ultrasound evaluation scale was designed to be comparable to previously described rating scales for alveolar bone graft success. This scale includes similar measurements of success, such as percentage of bony infill and the position of bone bridges, used in the Bergland, Kindelan, and Chelsea radiographic scales (Bergland et al, 1986; Kindelan et al, 1997; Witherow et al, 2002). The scores on the ultrasound scale were compared to existing scales in limited patients with dental radiographs.…”

Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate

“…Considering the benefit of tooth eruption, the current trend is to perform surgery at the age of mixed dentition [9,[21][22][23]. Dental age is our main consideration for determining the timing of surgery.…”

Secondary Alveolar Bone Grafting (CLEFTSiS) 2007–2010

“…The success of alveolar bone grafting can be determined using a number of other clinical and radiographic measures (Bergland et al, 1986a; Long et al, 1995; Witherow et al, 2002). However, these indices are designed to be used once the permanent maxillary canine has erupted, often a significant time after the initial graft.…”