Canine eruption into grafted alveolar clefts: A retrospective study

Abstract

Background: The contemporary treatment of cleft lip and palate involves a sequence of surgical procedures and orthodontic management. Alveolar bone grafting (ABG) is usually undertaken after orthodontic expansion of the maxillary segments between the ages of eight and 12 years. Two of the important goals of alveolar bone grafting are the provision of bony support for the eruption of the canine and the closure of residual oro-nasal fistulae. The purpose of this study was to retrospectively evaluate the root development and eruption of the canine following ABG. Methods: Group 1: radiographic and clinical records of a sample of 19 cleft patients who underwent alveolar bone grafting procedures, performed between 1996 and 1999 were reviewed. Group 2: a random sample of 15 cleft patients attending for routine dental review were clinically examined. The age of patient, degree of root development and eruption status of the canine, and presence of oronasal fistulae pre and post alveolar bone grafting were evaluated. Results: Most cleft canines had continued root development and descended in the alveolus towards eruption following ABG. Four canine teeth (8 per cent) were impacted and required surgical exposure and orthodontic treatment following failure of eruption. Closure of anterior oro-nasal fistulae at the time of grafting was maintained post-operatively. Conclusions: This study demonstrated that canine root development and eruption continued satisfactorily through grafted alveolar clefts in most cases and closure of anterior oro-nasal fistulae was achieved in all cases.

Alveolar Bone Formation in Patients with Unilateral and Bilateral Cleft Lip and Palate after Early Secondary Gingivoalveoloplasty: Long-Term Results

“…Interestingly, permanent canine retention was recorded in 15.5 percent of the sample and a surgical exposure of the canines was recorded in 4.4 percent of the sample (Table 3). Our percentage of retention seems higher than that reported after secondary bone grafting by other authors (e.g., 10 percent, 32 8 percent, 33 35 ), we believe the early closure of the alveolus compared with the timing of bone grafting might cause the reduction of the alveolar bone space at the cleft area, as suggested by Berkowitz et al 11 This partial reduction of the alveolar space might therefore be responsible for the higher percentage of canine retention. Over 70 percent of the patients had an orthodontic expansion of some extent.…”

Orthodontie Treatment Results following Grafting Autologous Mandibular Bone to the Alveolar Cleft in Patients with a Complete Unilateral Cleft

“…The timing of the operation is based on radiographic images of the unerupted cuspid adjacent to the cleft, whereby the root has to be 50% to 75% formed (el Deeb et al, 1989;da Silva Filho et al, 2000;Hogan et al, 2003;Gereltzul et al, 2005;Matsui et al, 2005).…”

Alveolar Cleft Reconstruction Using Chin Bone and Autogenous Tooth Bone Graft Material: Reports of 5 Cases

“…Case #4 also used AutoBT as grafting material in reconstructing alveolar cleft defects to guide the normal eruption of maxillary right canine. Studies have demonstrated that restoring alveolar cleft from the crest of the alveolus to the base of the nose early in the developmental stage of maxillary canine promotes normal eruption through the grafted area [12][13][14] . Although the recommended time in alveolar bone grafting is controversial, secondary bone grafting in mixed dentition is normally done between the ages of 9 and 11 when the canine root is one-fourth to two-thirds developed 13) .…”