Periodontal Assessment Of Complete BCLP Patients: CBCT Evaluation

Objectives: The aim of this study was to verify the thickness and level of alveolar bone around the teeth adjacent to the clefts by means of CBCT in patients with complete bilateral cleft lip and palate prior to bone graft surgery and orthodontic intervention. Method: The sample comprised 10 patients with complete bilateral cleft lip and palate (5 males and 5 females) in the mixed dentition. The mean age was 9.5 years and all subjects showed a G3 interarch relationship according to the Bauru index. The thickness of alveolar bone surrounding the maxillary incisors and the maxillary canines was measured in CBCT axial section using the software i-CAT Xoran System. The distance between the alveolar bone crest and the cementoenamel junction (CEJ) was measured in cross sections. Results: The tomography images showed a thin alveolar bone plate around teeth adjacent to clefts. No bone dehiscence was observed in teeth adjacent to clefts during the mixed dentition. A slight increase in the distance between the alveolar bone crest and the CEJ was observed in the mesial and lingual aspects of canines adjacent to cleft. Conclusion: Despite the presence of the clefts, generally the teeth adjacent to the cleft present a good periodontal bone support during the stage of mixed dentition. Buccal and mesiodistal orthodontic movement as well as rotational movements of maxillary anterior teeth before alveolar bone graft should be avoided or carefully conducted in these patients.