Change in grafted secondary alveolar bone in patients with UCLP and UCLA. A three-dimensional computed tomography study

Angle Orthod. 2008 Jul;78(4):631-40. doi: 10.2319/0003-3219(2008)078[0631:CIGSAB]2.0.CO;2.

Abstract

Objective: To evaluate changes in the grafted bone after secondary alveolar bone graft (ABG) with iliac bone using 3-dimensional computed tomography (3D-CT).

Materials and methods: The sample consisted of 10 patients with unilateral cleft lip and palate (UCLP) and 5 patients with unilateral cleft lip and alveolus (UCLA) (mean age = 10 years). 3D-CT data (Sensation 10, Siemens, Munchen, Germany), which was obtained 1 month before (T0), 3 months after (T1), and 12 months (T2) after ABG, were used to measure the height, labiolingual thickness (LLT), and volume of the grafted bone using V-Works 4.0 program (Cybermed Inc, Seoul, Korea). All of the UCLA patients showed the lingual process in the cleft area at T0, but the UCLP did not.

Results: During T1-T2, there was a significant decrease in height of the upper part of the grafted bone; however, volumes of both the upper and lower parts were decreased. Unilateral cleft type and presence of ULI in the cleft area did not affect the change in height and volume of the grafted bone. The resorption amount (RA) was significantly larger in the lower part than in the upper part, while the resorption rate (RR) exhibited an opposite result. In addition, there was significantly more RA in the labial side in UCLA than UCLP (P < .05). There was no correlation between the initial cleft width and changes in height, LLT, and volume of the grafted bone.

Conclusion: Overpacking and/or excessive condensation of the grafted bone is not necessary in UCLA with the lingual process because of the greater chance of resorption on the labial side of the grafted bone.

MeSH terms

  • Alveolar Process / abnormalities
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / surgery
  • Alveoloplasty / adverse effects*
  • Alveoloplasty / methods
  • Bone Density
  • Bone Resorption / etiology*
  • Bone Transplantation / adverse effects*
  • Bone Transplantation / methods
  • Child
  • Cleft Lip / surgery
  • Cleft Palate / surgery*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Linear Models
  • Male
  • Prospective Studies
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / instrumentation
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Vertical Dimension