Secondary alveolar bone grafting (CLEFTSiS) 2000-2004

Area of Science:

• Cleft lip and palate surgery
• Oral and maxillofacial surgery
• Pediatric dentistry

Background:

• Previous UK studies reported a 58% success rate for alveolar bone grafting.
• Reorganization of Scottish cleft services aimed to improve patient outcomes.
• The national managed clinical network for Scottish cleft services (CLEFTSiS) conducts annual audits.

Purpose of the Study:

• To evaluate alveolar bone graft success rates following the reorganization of Scottish cleft services.
• To assess the accuracy of results reported in CLEFTSiS annual audits.
• To identify factors influencing alveolar bone graft outcomes.

Main Methods:

• Retrospective analysis of electronic radiographs from 115 patients undergoing alveolar bone grafting.
• Evaluation of radiographic success using the Kindelan Bone-Fill Index.
• Statistical analysis including weighted kappa and two-sample t-tests to assess reproducibility and influencing factors.

Main Results:

• Graft success rate was 76%, with 23% partial failures and 1% total failures.
• Intraobserver and interobserver reproducibility of radiographic assessment were high (kappa > 0.83).
• Presurgical maxillary expansion was associated with statistically significant better outcomes (p = .046).

Conclusions:

• Alveolar bone graft outcomes in Scotland have improved since previous reports.
• Presurgical maxillary expansion is a key factor in achieving successful alveolar bone grafts.
• CLEFTSiS audits provide accurate data for monitoring and improving cleft care.