OBJECTIVE: Secondary bone grafting plays an important role in the dental rehabilitation of patients with clefts of the lip, alveolus, and palate. A major complication of this surgical technique is resorption of the grafted bone transplant. Conventional two-dimensional radiographs are often inconclusive and do not demonstrate the true deficit. The main objective of this study was to evaluate the amount and exact location of bone loss on the basis of three-dimensional models over a period of 3 years. DESIGN: Twenty-four patients with unilateral cleft palate were included in this prospective study. Axial computed tomography scans of all patients were taken immediately preoperatively, and 1, 2, and 3 years postoperatively. Volumetric analysis was performed on three-dimensional models of the cleft defects and the bone bridges using three-dimensional computed tomography. INTERVENTIONS: All patients were treated by secondary alveolar bone grafting prior to eruption of the permanent canine. RESULTS: Extensive bone resorption was found in the bucco-palatal dimension of the alveolar portion of the transplant. The success rate of secondary bone grafting was high in cases of rapid orthodontic gap closures. The mean bone loss in the first year after surgery was 49.5%. The transplants remained almost constant in the following 2 years. CONCLUSIONS: Radiographic scales based on orthopantomography only evaluate the vertical dimension of the transplants. This study, however, showed that bone resorption in the transversal dimension is clearly underestimated with conventional two-dimensional radiographs.
OBJECTIVE: Secondary bone grafting plays an important role in the dental rehabilitation of patients with clefts of the lip, alveolus, and palate. A major complication of this surgical technique is resorption of the grafted bone transplant. Conventional two-dimensional radiographs are often inconclusive and do not demonstrate the true deficit. The main objective of this study was to evaluate the amount and exact location of bone loss on the basis of three-dimensional models over a period of 3 years. DESIGN: Twenty-four patients with unilateral cleft palate were included in this prospective study. Axial computed tomography scans of all patients were taken immediately preoperatively, and 1, 2, and 3 years postoperatively. Volumetric analysis was performed on three-dimensional models of the cleft defects and the bone bridges using three-dimensional computed tomography. INTERVENTIONS: All patients were treated by secondary alveolar bone grafting prior to eruption of the permanent canine. RESULTS: Extensive bone resorption was found in the bucco-palatal dimension of the alveolar portion of the transplant. The success rate of secondary bone grafting was high in cases of rapid orthodontic gap closures. The mean bone loss in the first year after surgery was 49.5%. The transplants remained almost constant in the following 2 years. CONCLUSIONS: Radiographic scales based on orthopantomography only evaluate the vertical dimension of the transplants. This study, however, showed that bone resorption in the transversal dimension is clearly underestimated with conventional two-dimensional radiographs.
Authors: Nard G Janssen; Willem L J Weijs; Ronald Koole; Antoine J W P Rosenberg; Gert J Meijer Journal: Clin Oral Investig Date: 2013-02-22 Impact factor: 3.573
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Authors: Peter J Revington; Clare McNamara; Shumaila Mukarram; Esther Perera; Hemendranath V Shah; Scott A Deacon Journal: Ann R Coll Surg Engl Date: 2010-07-02 Impact factor: 1.891
Authors: Diego Coelho Lorenzoni; Guilherme Janson; Juliana Cunha Bastos; Roberta Martinelli Carvalho; José Carlos Bastos; Rita de Cássia Moura Carvalho Lauris; José Fernando Castanha Henriques; Terumi Okada Ozawa Journal: Clin Oral Investig Date: 2016-03-15 Impact factor: 3.573
Authors: Gabriella Lopes de Rezende Barbosa; Jeyhan S Wood; Luiz A Pimenta; Solange Maria de Almeida; Donald A Tyndall Journal: Dentomaxillofac Radiol Date: 2015-12-09 Impact factor: 2.419