Alveolar cleft repair: A 30-year follow-up

Area of Science:

• Craniofacial surgery
• Pediatric dentistry
• Orthodontics

Background:

• Secondary alveolar bone grafting (SABG) is crucial for cleft lip and palate (CLP) management.
• Long-term outcomes of SABG beyond ten years are not well-documented.

Purpose of the Study:

• To conduct a 30-year longitudinal evaluation of SABG outcomes in complete unilateral non-syndromic CLP.
• To identify clinical, radiological, and patient-reported predictors of surgical success.

Main Methods:

• Retrospective cohort analysis of 32 patients who underwent SABG (1990-1994).
• Clinical assessment (DMFT index), radiological assessment (Cone Beam CT, Suomalainen Index), and patient-reported outcomes (CLEFT-Q).
• Uni- and multivariate regression analyses for outcome predictors.

Main Results:

• 56.3% achieved satisfactory radiological outcomes (Suomalainen Index ≥12) after 30 years.
• Autologous grafting, good oral health (low DMFT), and orthodontic compliance were associated with favorable outcomes.
• Oral health and orthodontic treatment were independent predictors in multivariate analysis.

Conclusions:

• SABG offers durable clinical and radiological benefits for over three decades.
• Optimal outcomes depend on orthodontic management and sustained oral health.
• Successful grafts correlate with improved patient satisfaction and psychosocial well-being.