Three-Dimensional Evaluation of Secondary Alveolar Bone Grafting in Patients With Bilateral Cleft Lip and/or Palate:...

To quantify secondary alveolar bone graft (SABG) resorption and the position of permanent upper canines in 3D in patients with bilateral cleft lip and/or palate (BCL/P).

Patients with BCL/P were prospectively included. CBCT scans were taken pre-operative (T0), at approximately 6 weeks (T1), 6 months (T2), 1-2 years (T3) and > 2 years post-operative (T4). Volumetric assessment of the bone grafts was performed across the time points to calculate the resorption rate. The position of the canines was assessed on the CBCT scans at all time points, determining angulation towards the midline and horizontal and vertical position, which were compared with the non-cleft side of a previously published unilateral cleft lip and/or palate (UCL/P) cohort.

16 patients with BCL/P were included in the study. At T2, 43.8% of the graft volume was resorbed. In patients whose canines had not erupted yet by T3, mean resorption was 51.5% at T3 and 58.9% at T4. For erupted canines at T3, resorption rates were 55.7% at T3 and 87.4% at T4. No significant difference in resorption rates was observed in comparison with those observed in patients with UCL/P, previously reported by Doucet et al. The canines tend to move more towards the midline; however, vertical movement towards the occlusal plane was similar.

Significant rates of SABG resorption were found in this BCL/P cohort. The vertical movement of the upper canine towards the occlusal plane was similar to that of the control group, confirming that SABG facilitates successful canine eruption.