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Evaluation of alveolar bone grafting: a survey of ACPA teams
Ananth S Murthy1, James A Lehman
1Plastic Surgery, Summa Health System, Akron, Ohio, USA.
Objective:
To evaluate the management of alveolar clefts by cleft palate and craniofacial teams in North America.
Design:
An anonymous survey was mailed to 240 American Cleft Palate- Craniofacial Association teams across North America regarding alveolar bone grafting. The questionnaire included multiple questions about each team's approach to alveolar bone grafting and options for the missing tooth.
Results:
Consensus was achieved in three areas: 90% of centers performed secondary alveolar bone grafting, 78% performed grafting between ages 6 and 9 years, and iliac crest donor site was the most popular site (83%). There was no consensus with respect to dental criteria for the timing of grafting, follow-up x-rays, or the use of a grading system for evaluating results. In addition, there was no consensus on the management of the missing tooth.
Conclusion:
There is wide acceptance of secondary bone grafting and there is a consensus for the age of grafting (6 to 9 years) and donor site (iliac crest). The disturbing finding was the lack of postoperative x-ray evaluation of the results. With so much variability in management, the use of a routine, standardized scale to measure postoperative results would allow for better outcome studies in alveolar bone grafting.
