[Bone transplantation in cleft palate patients. A retrospective study]

Area of Science:

• Oral and Maxillofacial Surgery
• Pediatric Dentistry
• Orthodontics

Background:

• Residual alveolar clefts affect bone height, impacting canine eruption and overall dental arch development.
• Alveolar bone grafting is a critical procedure in managing cleft deformities.
• The optimal timing for alveolar bone grafting remains a subject of clinical investigation.

Purpose of the Study:

• To evaluate the impact of alveolar bone grafting timing on bone height in patients with residual alveolar clefts.
• To assess the spontaneous eruption rate of unerupted canines following alveolar bone grafting.

Main Methods:

• A retrospective study of 45 patients (31 unilateral, 14 bilateral clefts) undergoing 59 iliac crest bone grafts.
• Patients were divided into two groups: grafting before canine eruption (Group A) and after canine eruption (Group B).
• Alveolar bone height was assessed using occlusal radiographs; follow-up averaged 5.7 years.

Main Results:

• Alveolar bone height was significantly greater in patients grafted before canine eruption (Group A) compared to those grafted after (Group B).
• No significant difference in outcomes was observed between unilateral and bilateral clefts.
• Spontaneous eruption occurred in 68.4% (26 out of 38) of canines that had not erupted at the time of grafting.

Conclusions:

• Performing alveolar bone grafting prior to the eruption of the homolateral canine yields superior bone height results.
• The timing of bone grafting does not appear to influence outcomes differently for unilateral versus bilateral alveolar clefts.
• Alveolar bone grafting before canine eruption facilitates spontaneous canine eruption in a majority of cases.