Alveolar Bone Defect and Secondary Bone Grafting Outcome in Cleft Lip/Palate Patients

Background: Current evidence on factors influencing the outcome of Secondary Alveolar Bone Grafting (SABG) in cleft lip/palate patients is ambiguous and further deliberations are required to provide solid proof on prognostic criteria. Objectives: The objectives of this study were to determine the changes brought about by SABG in cleft depth and alveolar bone support of teeth in the vicinity of the cleft and to elucidate their prognostic value in surgical outcomes. Materials & methods: A prospective study was designed for 17 consecutive cleft lip and palate patients who underwent secondary alveolar bone grafting with anterior iliac crest graft at the AIMS Cleft Lip and Palate Clinic, Amrita Institute of Medical Sciences, Kochi. Maxillary occlusal radiographs taken at two time periods (T1preoperative within 1month, T2-post-operative, after 6 months) were assessed for medial and lateral bone support of the teeth adjacent to cleft as well as for reduction in alveolar notching. The changes between the two were statistically analyzed using paired t-test and correlation computed with Pearson correlation coefficient. Results: Statistically and clinically significant improvements were achieved by the SABG procedure in terms of bone support and cleft depth. Pre surgical medial alveolar bone support and medial alveolar crest defect were found to have a positive impact on post surgical values. Conclusion: Significant increase in bone support achieved for cleft adjacent teeth and elimination/reduction of alveolar notching proves the beneficial role of SABG in cleft management protocol.