Cleft Size and Success of Secondary Alveolar Bone Grafting—A Systematic Review

Abstract

Objective This study aimed to review all research evidence of presurgical cleft size and related factors to success of secondary alveolar bone grafting (SABG). Design and Setting The systematic review searched the OVID-Medline®, PubMed®, Embase®, and Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2020. Two reviewers independently selected potential abstracts for full review. Disagreeements were resolved by consensus. The first author extracted data and assessed the risk of bias using Risk of Bias in Non-randomized studies—of Interventions tool. Patients and Interventions Patients with non-syndromic clefts who received SABG were selected. Presurgical cleft size/volume and treatment results must be available. Main Outcome Measures Level of the grafted bone, achievement of orthodontic tooth movement into the grafted area, need for re-operation. Results From 962 abstracts, 23 publications were included. Mean cleft width was 6.80 ± 1.98 mm, cleft area 20–240 mm2, and mean volume 0.89 ± 0.33 cm3. No definite conclusion was achieved on whether a narrow or wide cleft showed better treatment outcomes, but other potentially related factors were good oral hygiene and eruptive force of the maxillary canines. Lack of a standard definition of cleft size, a small sample size, varying outcome parameters, and moderate-to-high risk of bias contributed to the summary. A meta-analysis could not be performed because of the heterogeneity. Conclusion Due to insufficient evidence, cleft width/volume could not be specified leading to more successful SABG. Care of patients could be improved in both research by following rigorous methodology, and practice by clear communication.

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate

“…There was an increasing trend in their numbers with time. The maximum number of published articles were from the year 2021 (n = 29) [ 28 , 46 , 47 , 48 , 55 , 61 , 62 , 63 , 64 , 65 , 69 , 76 , 81 , 82 , 99 , 100 , 101 , 102 , 111 , 128 , 129 , 130 , 142 , 143 , 145 , 148 , 153 , 154 , 161 ]. It was observed that only three studies performed before 2010 could qualify during the two-stage scrutiny [ 72 , 112 , 113 ].…”

“…It was observed that only three studies performed before 2010 could qualify during the two-stage scrutiny [ 72 , 112 , 113 ]. Among the journals, the highest number of papers (n = 30) was published in the Cleft Palate Craniofacial Journal (CPCJ) [ 21 , 35 , 46 , 47 , 48 , 49 , 63 , 65 , 66 , 76 , 86 , 92 , 94 , 100 , 101 , 115 , 116 , 121 , 123 , 125 , 128 , 137 , 140 , 142 , 146 , 150 , 152 , 155 , 161 , 162 ] followed by The Cochrane Library (n = 8) [ 9 , 16 , 68 , 88 , 92 , 93 , 100 , 106 ] and the International Journal of Oral and Maxillofacial Surgery (n = 7) [ 31 , 72 , 89 , 93 , 106 , 110 , 135 ]. There was diversity among the journals of different specialties that had published the SRs related to CLP ( Supplementary Material S4 ).…”

Volumetric Analysis of Unilateral Alveolar Bone Defect Using Modified Subtraction in Older Chinese Patients

“…To the best of our knowledge, up till now, most studies only addressed the issue of bacterial contamination of an operated site using different bone materials, but no study addressed the question of bacterial contamination of a BS package after its initial opening. 7,9,10 The results showed no bacterial growth for both alloplastic and xenograft BSs when the original package was opened for 15 minutes (an appropriate time for the material to be used in a clinical environment), resealed, and then left to age in dry conditions for up to 1 week under dry conditions.…”

“…7 It has been recognized that the osteogenesis rate in older patients is lower than in younger patients; however, it remains controversial whether cleft size is the most critical influencing factor associated with bone graft failure in these patients. [8][9][10] Some experts speculate that the high rate of bone graft failure is related to a larger defect volume or width in older patients. 11,12 Conversely, Reddy et al 13 and Jabbari et al 14 found presurgical cleft size is of no significance.…”

Hiệu Quả Ước Lượng Thể Tích Khe Hở Xương Ổ Răng Bằng Phần Mềm Mimics Dựa Trên Dữ Liệu Hình Ảnh Cắt Lớp Điện Toán Chùm Tia Hình Nón

“…Theo nghiên cứu này, thể tích thiếu hổng xương trung bình ở bệnh nhân KHXOR một bên xấp xỉ 0,903 ± 0,222cm 3 . Kết quả này tương đồng với các nghiên cứu trước đây (Bảng 5) và là giá trị tham khảo cho lượng xương vùng cho cần thu thập cho PTGXOR ở các cơ sở còn giới hạn về khảo sát hình ảnh 3D tiền phẫu thuật [7], [4].…”