Minimally Invasive Alveolar Bone Grafting in Cleft Patients: Impact of Age-Related Outcomes and Complications

The objective of this study is to describe outcomes of alveolar bone grafting (ABG) and to determine if there is a significant association between age groups and the need for different levels of ABG (tertiary, quaternary). This retrospective study evaluated the outcomes of ABG in 147 nonsyndromic unilateral and bilateral cleft lip and palate patients at a single craniofacial hospital. Patients were divided into 3 age groups: <7 years, 7 to 12 years, and >12 years. A minimally invasive closed technique using cylinder bone extractors was employed. To evaluate the radiographic bone graft using the Chelsea scale, the position of bone tissue relative to teeth adjacent to the cleft was analyzed through radiographic images visualized by 2 cleft orthodontists. The results showed that children aged 7 to 12 years constituted 49.1% of all cases, whereas those <7 years and >12 years accounted for 7.8% and 31.1%, respectively. Bilateral complete clefts exhibited the highest complication rate at 29%, followed by left complete clefts (22.4%) and right complete clefts (12.1%). A statistically significant difference was found in the need for tertiary/quaternary ABG among age groups (Chelsea B, D, E, and F), with a high prevalence in patients >12 years (44.23%) compared to those aged 7 to 12 years (21%) ( P  < 0.05). In conclusion, considering a broader age range of 9 to 12 years during graft planning can accommodate the variability in developmental stages. This approach may reduce the risk of graft failure by enabling timely interventions that align with the individual's specific developmental timeline, tailored to our individual scenarios.