Long-term Radiographic and Periodontal Evaluations of the Bone-grafted Alveolar Cleft Region in Young Adults Born with a UCLP

Overview

Journal Eur J Orthod

Publisher Oxford University Press

Specialty Dentistry

Date 2023 Nov 13

PMID 37955939

Authors

Mathias Lemberger

Petra Peterson

Anna Andlin Sobocki

Hedieh Setayesh

Agneta Karsten

Affiliations

Soon will be listed here.

Abstract

Background: Studies addressing the periodontal health of the teeth surrounding the bone-grafted cleft in patients born with unilateral cleft lip and palate disagree on whether periodontal health is compromised.

Objectives: To determine periodontal health differences between the cleft and the non-cleft sides nearly a decade after secondary alveolar bone grafting.

Methods: This prospective, controlled (split-mouth design) study comprised an intraoral apical radiographic and a periodontal examination of 40 consecutive patients from one centre (n = 26 males) who had undergone bone grafting at mean age of 10.2 years (±1.6). Probing pocket depth, gingival index, gingival recession, and radiographic bone support were assessed.

Results: No significant difference occurred in probing pocket depth between teeth at cleft and non-cleft sites (OR 1.8, P = .488). Gingival recession was present at 6.6% of all examined sites on the cleft side and at 1.7% on the non-cleft side (OR 17.3, P < .001). Gingival recession occurred most often on the buccal and disto-buccal surfaces of the central incisor on the cleft side. The gingival index was significantly higher on the cleft side (OR 8.0, P < .001). The Bergland index was I or II in most patients (87%).

Limitations: Recruitment of eligible patients was lengthy.

Conclusion: The teeth on the cleft side had high levels of gingival inflammation. Few pathological gingival pockets, however, were found. Shallow gingival recessions frequently occurred around the central incisor on the cleft side. Teeth in the bone-grafted cleft region generally had good bone support.

Citing Articles

Characterization and functional prediction of the dental plaque microbiome in patients with alveolar clefts.

Zhang Y, Zhi Q, Shi J, Jin Z, Zhou Z, Chen Z Front Cell Infect Microbiol. 2024; 14:1361206.

PMID: 38800834 PMC: 11119321. DOI: 10.3389/fcimb.2024.1361206.

References

Kalaaji A, Lilja J, Friede H, Elander A . Bone grafting in the mixed and permanent dentition in cleft lip and palatepatients: long-term results and the role of the surgeon's experience. J Craniomaxillofac Surg. 1996; 24(1):29-35. DOI: 10.1016/s1010-5182(96)80074-6. View

Loe H, SILNESS J . PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. Acta Odontol Scand. 1963; 21:533-51. DOI: 10.3109/00016356309011240. View

Russell K, McLeod C . Canine eruption in patients with complete cleft lip and palate. Cleft Palate Craniofac J. 2008; 45(1):73-80. DOI: 10.1597/07-049.1. View

Boyne P, Sands N . Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg. 1972; 30(2):87-92. View

BERGLAND O, Semb G, Abyholm F . Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment. Cleft Palate J. 1986; 23(3):175-205. View

Williams A, Bearn D, Mildinhall S, Murphy T, Sell D, Shaw W . Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory Group (CSAG) Study. Part 2: dentofacial outcomes and patient satisfaction. Cleft Palate Craniofac J. 2001; 38(1):24-9. DOI: 10.1597/1545-1569_2001_038_0024_clapci_2.0.co_2. View

Lundberg J, Levring Jaghagen E, Sjostrom M . Outcome after secondary alveolar bone grafting among patients with cleft lip and palate at 16 years of age: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021; 132(3):281-287. DOI: 10.1016/j.oooo.2021.04.057. View

Mendoza M, Molina F, Azzolini C, Ysunza Rivera A . Minimal incision palatopharyngoplasty. A preliminary report. Scand J Plast Reconstr Surg Hand Surg. 1994; 28(3):199-205. DOI: 10.3109/02844319409015981. View

Matic D, Power S . Evaluating the success of gingivoperiosteoplasty versus secondary bone grafting in patients with unilateral clefts. Plast Reconstr Surg. 2008; 121(4):1343-1353. DOI: 10.1097/01.prs.0000304604.89450.ae. View

10.

Quirynen M, Dewinter G, Avontroodt P, Heidbuchel K, Verdonck A, Carels C . A split-mouth study on periodontal and microbial parameters in children with complete unilateral cleft lip and palate. J Clin Periodontol. 2003; 30(1):49-56. DOI: 10.1034/j.1600-051x.2003.300108.x. View

11.

Coelho Lorenzoni D, Janson G, Bastos J, Carvalho R, Bastos Jr J, Lauris R . Evaluation of secondary alveolar bone grafting outcomes performed after canine eruption in complete unilateral cleft lip and palate. Clin Oral Investig. 2016; 21(1):267-273. DOI: 10.1007/s00784-016-1786-3. View

12.

Fahradyan A, Tsuha M, Wolfswinkel E, Mitchell K, Hammoudeh J, Magee 3rd W . Optimal Timing of Secondary Alveolar Bone Grafting: A Literature Review. J Oral Maxillofac Surg. 2018; 77(4):843-849. DOI: 10.1016/j.joms.2018.11.019. View

13.

Jia Y, Fu M, Ma L . Long-term outcome of secondary alveolar bone grafting in patients with various types of cleft. Br J Oral Maxillofac Surg. 2005; 44(4):308-12. DOI: 10.1016/j.bjoms.2005.07.003. View

14.

Andlin-Sobocki A, Eliasson L, Paulin G . Periodontal evaluation of teeth in bone grafted regions in patients with unilateral cleft lip and cleft palate. Am J Orthod Dentofacial Orthop. 1995; 107(2):144-52. DOI: 10.1016/s0889-5406(95)70129-x. View

15.

Jabbari F, Wiklander L, Reiser E, Thor A, Hakelius M, Nowinski D . Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate: A 20-Year Follow-up. Cleft Palate Craniofac J. 2018; 55(2):173-179. DOI: 10.1177/1055665617726999. View

16.

Karsten A, Larson M, Larson O . Dental occlusion after Veau-Wardill-Kilner versus minimal incision technique repair of isolated clefts of the hard and soft palate. Cleft Palate Craniofac J. 2003; 40(5):504-10. DOI: 10.1597/1545-1569_2003_040_0504_doavvm_2.0.co_2. View

17.

Williams A, Johnson N, Singer S, Southall P, Mildinhall S, Semb G . Outcomes of cleft care in Western Australia: a pilot study. Aust Dent J. 2001; 46(1):32-6. DOI: 10.1111/j.1834-7819.2001.tb00271.x. View

18.

Kindelan J, Roberts-Harry D . A 5-year post-operative review of secondary alveolar bone grafting in the Yorkshire region. Br J Orthod. 1999; 26(3):211-7. DOI: 10.1093/ortho/26.3.211. View

19.

Newlands L . Secondary alveolar bone grafting in cleft lip and palate patients. Br J Oral Maxillofac Surg. 2000; 38(5):488-91. DOI: 10.1054/bjom.2000.0300. View

20.

Dewinter G, Quirynen M, Heidbuchel K, Verdonck A, Willems G, Carels C . Dental abnormalities, bone graft quality, and periodontal conditions in patients with unilateral cleft lip and palate at different phases of orthodontic treatment. Cleft Palate Craniofac J. 2003; 40(4):343-50. DOI: 10.1597/1545-1569_2003_040_0343_dabgqa_2.0.co_2. View