Alveolar Bone Grafting Success In Clefts – A 5 Year Study

Objectives: (1) Determine radiographic success of secondary alveolar bone grafting in cleft patients in the Craniofacial Center at the University of North Carolina at Chapel Hill from 2012-01-01 to 2016-12-31. (2) Investigate factors contributing to radiographic success of secondary alveolar bone grafting in cleft patients.
Methods: Cleft patients receiving an alveolar bone graft (ABG) between 2012-01-01 and 2016-12-31 were identified by a specific medical code. The medical records were examined and patient demographics, cleft type, and cleft site were recorded. Pre-ABG and post-ABG panoramic radiographs were imported into PowerPoint. Two calibrated examiners blinded to patient demographics and surgical procedures examined the radiographs for presence/absence of the permanent lateral incisor and supernumerary teeth, permanent canine development, angulation and height from the occlusal plane, and ABG success using the Kindelan Index. Descriptive statistics, Fisher exact test, and logistic regression were used to analyze the data.
Results: 127 (59 male, 68 female) cleft patients were identified with an age range of 6-23 years (mean 10 years, 6 months). 83 were unilateral clefts (left-sided 54, right-sided 29) and 44 were bilateral clefts. 51 patients (40.2%) were excluded due to either repeat ABG or insufficient radiographic information. Of the included patients, 99 cleft sites were examined. Permanent lateral incisor presence contributed to ABG success (P<0.05). In addition, the height of the canine also contributed to ABG success with permanent canines in the failure group closer to the occlusal plane by 12% as compared to the success group (P<0.05). No other factors were found to influence ABG success.
Conclusions: This retrospective study provides valuable insight into factors that can predict ABG success in cleft patients. Presence of the permanent lateral incisor contributes to graft success. Additionally, the canine height from the occlusal plane may also contribute to success.