An Evaluation of Alveolar Bone Grafting in the UK and Ireland

To determine the main factors influencing the timing of alveolar bone grafting among cleft teams in the UK and Ireland, to assess the types of radiographs used to evaluate bone grafting sites pre- and postoperatively and the views of the profession on orthodontic expansion prior to grafting.

An online survey consisting of 24 questions was compiled and emailed to 53 orthodontists and surgeons in all 12 Cleft Hub Units in the UK and Ireland.

All units in the UK and Ireland responded with 51 responses, 39 complete and 12 partial responses, obtained from cleft surgeons and orthodontists. The majority of units are using dental criteria (75%) as a guide to timing alveolar bone grafting. Most units take a postoperative radiograph at 6 months but the view being taken varied. When asked if four cases were ready for grafting based on their radiographs, there was clear agreement by a significant majority for 3 cases but for 1 only a minimal majority (61%). The most common donor site chosen for the graft is the Iliac crest (92.9%). There was excellent agreement for 2 cases asking when to use expansion but poor agreement for one, 55% saying they would expand and 45% saying no.

Overall there is good agreement among cleft teams in the UK and Ireland about management of alveolar bone grafting; however, a clearer consensus on preoperative orthodontic expansion may be needed.