Evaluation of maxillary central incisors on the noncleft and cleft sides in patients with unilateral cleft lip and palate—Part 2: Relationship between root resorption, horizontal tooth movement, and quantity of grafted autogenous bone

Abstract

Objective: To evaluate the relationship between external apical root resorption (EARR) of the maxillary central incisors (U1), horizontal orthodontic tooth movement, and quantity of grafted bone in subjects with unilateral cleft lip and palate (UCLP) over an average duration of 8 years. Materials and Methods: Thirty subjects with UCLP were evaluated for EARR of U1 after edgewise treatment (T2). The teeth were classified as having no EARR, moderate EARR (combined into ''no/ moderate'' EARR), or severe EARR. Frontal cephalometric radiographs acquired at eruption of U1 (T0), less than 6 months before secondary alveolar bone grafting (T1), and T2 were evaluated to determine the horizontal inclination (U1-axis angle) and distance of the root apex from the median line (U1-root-VL distance). On the cleft side, the quantities of grafted bone at less than 12 months postsecondary bone grafting and at T2 were evaluated using the alveolar bone graft (ABG) scale. Results: Cleft-adjacent teeth exhibited more severe EARR than did teeth on the noncleft side. The cleft side exhibited greater changes in U1-axis angle and U1-root-VL distance between T0 and T2 than did the noncleft side. On the cleft side, the ABG score at T2 in the severe EARR group was significantly lower than that in the no/moderate EARR group. These measurements were correlated with EARR grade. Conclusions: Cleft-adjacent U1 exhibited more severe EARR than did the U1 on the noncleft side, which might be associated with orthodontic treatment-induced changes in horizontal inclination and root apex movement. On the cleft side, severity of EARR may be correlated with the success of

Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography

“…A recent study found that cleft-adjacent U1 exhibited more severe external root resorption after orthodontic treatment. 18 The risk of irreversible damage to the root and supporting tissues should also be conveyed to patients and their parents.…”

The Effect of Platelet-Rich Fibrin and Platelet-Rich Plasma in Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients: A Systematic Review

“…Among all three studies that used 2D quantitative assessment, only the study by Dhayashankara et al found that the PRF group had better bone height as compared to control group [11]. This positive outcome is explained by the ability of platelet-derived products to speed up bone formation and reduce bone resorption in alveolar cleft bone grafting [11,16,21]. However, this study compared the intervention and control group in a purely descriptive manner without any statistical inference analysis [11].…”

Relationship Between Crown to Root Ratio and Alveolar Bone Support in Patients With Unilateral Cleft Lip and Alveolus

“…Unilateral cleft lip and alveolus with or without cleft palate (UCLA ± CP) exhibits delayed or insufficient dental arch and tooth development on the cleft side compared with their noncleft side (Zhang et al, 2016). It has been documented that the development of bilateral teeth and arches, especially the anterior area, is asymmetrical: tooth eruption on the cleft side is delayed, abnormal tooth morphology and size (Zhang et al, 2016), and shorter roots are more frequently observed on the cleft side (Al-Jamal et al, 2010; Maeda-Iino et al, 2017).…”