Evaluation of maxillary central incisors on the noncleft and cleft sides in patients with unilateral cleft lip and palate—Part 1: Relationship between root length and orthodontic tooth movement

Maeda‐Iino, Aya; Marutani, Kanako; Furukawa, Minami; Nakagawa, Shoko; Kwon, Sangho; Kibe, Toshiro; Tezuka, Masahiro; Nakamura, Norifumi; Miyawaki, Shouichi

doi:10.2319/031317-188.1

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…There was evidence that orthodontic tooth movement stimulates bone apposition, it was not necessary for the bone thickness to be at least the root width of the adjacent teeth [ 38 ], and bone resorption in the most inferior 1/4 level was acceptable [ 20 ]. Furthermore, in 5 patients, it was found that root length of the central incisor at the cleft side was less than 9 mm due to higher probability of malformation [ 39 ], thus bone bridge assessment at the level of 9 mm was compared with the root diameter measured 0.5 mm beneath the apex, though the scores at this level were all above 2, but they might face higher risk of root resorption in the orthodontic treatment after SABG procedure.…”

Section: Discussionmentioning

confidence: 99%

Correlation between alveolar cleft morphology and the outcome of secondary alveolar bone grafting for unilateral cleft lip and palate

Huang

2022

BMC Oral Health

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Background Secondary alveolar bone grafting (SABG) is an integral part of the treatment for cleft lip and alveolus and cleft lip and palate. However, the outcome of SABG was not satisfactory as expected, factors that affecting the outcome were still controversial. The aims of this study were to summarize a new method for the classification of alveolar cleft morphology in patients with unilateral cleft lip and alveolus or unilateral cleft lip and palate, to evaluate the correlation between the morphology and SABG outcomes, to identify factors that might predict the outcomes. Methods The characteristics of the cleft morphologies of 120 patients who underwent SABG were observed using the preoperative Cone-Beam Computed Tomography (CBCT) images. 52 patients who had CBCT scans performed at least 6 months after SABG were included for the evaluation of outcomes. Both categorical and continuous evaluation methods were measured. Correlations between cleft morphology and SABG outcomes were assessed using the Pearson correlation coefficient in SPSS 27.0.0. Results A new method for the classification of cleft morphology was summarized:type I, prism type (labial defect size ≥ palatal defect size; nasal defect size ≥ occlusal defect size); type II, prism’ type (labial defect ≥ palatal defect; nasal defect < occlusal defect); type III, inverted prism type (palatal defect ≥ labial defect); type IV, funnel type (presented as a significantly narrow defect area in the middle towards the vertical dimension); and type V, undefinable (extremely irregular morphology can’t be defined as any of the above types). Categorical evaluation showed 8 failure, 11 poor, 12 moderate, and 21 good results, while the average bone filling rate was 59.24 ± 30.68%. There was a significant correlation between the cleft morphology and categorical/continuous evaluation outcome (p < 0.05). Conclusion The new method for the classification of alveolar cleft morphology summarized in this study was comprehensive and convenient for clinical application. Both categorical and continuous methods should be used for radiographic assessments in patients undergoing SABG. The chances of a successful procedure might be better when the patient has type I or IV morphology, in which the shape is like a funnel in the relatively palatal or occlusal area towards the vertical dimension. A relatively great amount of bone resorption was observed in most patients. Trial registration Chinese clinical trial registry; registration number: ChiCTR2100054438.

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Section: Discussionmentioning

confidence: 99%

Correlation between alveolar cleft morphology and the outcome of secondary alveolar bone grafting for unilateral cleft lip and palate

Huang

2022

BMC Oral Health

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“…Besides, patients need orthodontic treatment before and after cleft repair surgery. Inappropriate forces to incisors may have negative effect on root length and ABS of tooth (Maeda et al, 2017; Yatabe et al, 2015). So they should be taken into consideration when treatment starts.…”

Section: Discussionmentioning

confidence: 99%

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

Huang

Chen

2020

The Cleft Palate-Craniofacial Journal

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Objectives: To evaluate the tooth lengths, crown to root ratios (CRRs), and alveolar bone support (ABS) around cleft-adjacent maxillary central incisors (U1s) in patients with unilateral cleft lip and alveolus (UCLA) and to investigate the relationships between CRR and ABS. Design: This is a retrospective study. Setting: Cleft Lip and Palate Care Center of Shanghai Ninth People’s Hospital, Shanghai, China. Patients: Fifty-eight Chinese patients with UCLA. Main Outcome Measure: Cone beam computed tomography data from 58 nonsyndromic patients with UCLA (36 males, 22 females; mean age = 12.65 ± 3.64 years) were evaluated. Crown length and root length, alveolar bone thickness (ABT), and the distances between the cementoenamel junction and alveolar bone crest on 4 surfaces of cleft-adjacent U1 were measured and compared with those of noncleft side in the same patients. Crown to root ratio and frequency of dehiscence were calculated and comparisons were also made between cleft and noncleft sides. Regression analysis was performed to explore the association between CRR and ABS. Results: The CRR of cleft-adjacent U1 and alveolar bone crest heights (ACHs) on the 4 surfaces were significantly greater than those of noncleft side ( P < .01). A 3 mm labial, all lingual, and apico-distal ABTs decreased on the cleft side ( P < .01). A positive correlation was found between lingual ACH and CRR ( R = 0.316, P < .05), between the 3 mm ( R = 0.417, P < .05) and 6 mm labial ( R = 0.448, P < .05) ABT and CRR. A negative correlation was found between the 3 mm and 6 mm labial ABTs and the root length. Conclusions: It can be suggested that the CRR is related to ACH and ABT. The lingual ACH, the 3 mm, and 6 mm labial ABTs tend to increase with the increasing CRR.

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“…Maeda-lino found that the root lengths of U1 were comparatively short on the cleft side in patients with UCLP treated with MPA before SABG. Thus, they concluded that orthodontic force exerted by the MPA before SABG might result in short dental roots [58].…”

Section: Management Of Maxillary Deficiency In Growing Cleft Patientsmentioning

confidence: 99%

Orthodontics in Relation with Alveolar Bone Grafting in CLP Patients

Uzel¹

2019

Current Approaches in Orthodontics

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Alveolar bone grafting is an essential step in the overall management of patients with cleft lip and palate (CLP). The numerous advantages of this procedure have been reported in the literature. Failure to rehabilitate the alveolar cleft may give rise to a variety of problems. Lack of investing alveolar bone often precludes the correction of anterior tooth irregularities and limits orthodontic treatment and/or prosthodontic rehabilitation. The success of the graft is multifactorial. The periodontal health of the surrounding graft tissues, the experience and ability of the surgeon, the timing of surgery, and orthodontic management of the cleft area before and after grafting are shown to be the most important factors in this issue. In this chapter, current orthodontic approaches in relation with alveolar bone grafting (ABG) in cleft patients will be discussed.

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Evaluation of maxillary central incisors on the noncleft and cleft sides in patients with unilateral cleft lip and palate—Part 1: Relationship between root length and orthodontic tooth movement

Cited by 4 publications

References 15 publications

Correlation between alveolar cleft morphology and the outcome of secondary alveolar bone grafting for unilateral cleft lip and palate

Correlation between alveolar cleft morphology and the outcome of secondary alveolar bone grafting for unilateral cleft lip and palate

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

Orthodontics in Relation with Alveolar Bone Grafting in CLP Patients

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