Bone Formation in Unilateral Cleft Lip and Palate Patients after Early Secondary Gingivoalveoloplasty and Bone Graft: Long-Term Study.

BACKGROUND

The aim of this study was to conduct a comparative analysis, using computed tomographic scans, of ossification patterns in unilateral cleft lip and palate patients who underwent early secondary gingivoalveoloplasty (esGAP) versus those who underwent traditional alveolar bone grafting harvested from the iliac crest (IC).

METHODS

Computed tomographic scans of 22 consecutively treated patients with esGAP were compared with those of 21 patients treated with bone grafting from the IC. Inclusion criteria were nonsyndromic unilateral cleft lip and palate patients in permanent dentition. Two parameters were considered: the alveolar thickness, measured at 3 levels, and the nasoalveolar height. All measurements were normalized and ratios of the affected versus nonaffected sides were provided as in addition to the statistical comparison between the 2 groups' ossification outcomes.

RESULTS

In the esGAP sample, nasoalveolar height was categorized as ideal and good in 86.36% and in 13.64% of the cases, and no mediocre or insufficient ossification was detected; whereas in the bone grafting sample, 38.10% had ideal and good ossification, 14.29% had mediocre ossification, and 9.52% had insufficient ossification. As regards the alveolar thickness, when we consider the average of 3 levels, the esGAP sample was ideal and good in 57.57% and in 30.30% of the cases; for the IC sample, the alveolar thickness was ideal and good 41.27% and in 25.40% of the cases, respectively. The analysis detected a statistically significant difference in the ossification outcomes in the 2 samples.

CONCLUSION

The esGAP yields superior ossification grades in comparison to IC bone grafting.

CLINICAL RELEVANCE STATEMENT: In unilateral cleft lip and palate patients, esGAP seems to allow for a higher grade of ossification compared to IC bone grafting.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.