A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate (original) (raw)
Related papers
The Angle Orthodontist, 2015
; assess the bone support of the teeth adjacent to a cleft using cone-beam computed tomography (CBCT). Materials and Methods: The CBCT scans of 31 patients with unilateral cleft lip and palate (UCLP) were assessed. The data for teeth neighboring the cleft were compared with those of contralateral noncleft teeth. For each tooth analyzed, the distance between the cementoenamel junction (CEJ) and the bone crest (AC) at the buccal side was measured as was the thickness of the buccal bone level at 0, 1, 2, and 4 mm. Results: The bone thicknesses of the central teeth at the cleft region at the crest and 2 mm apically were statistically significantly thinner than that of the central incisor at a noncleft region. The CEJ-AC distance for central teeth at the cleft region was higher than that for central teeth in a noncleft region. Conclusions: Subjects with UCLP showed reduced bone support at teeth neighboring the cleft compared with controls. This may cause some problems during orthodontic treatment. (Angle Orthod. 2014;87:000-000.)
Assessment of the alveolar bone support of patients with unilateral cleft lip and palate
ABSTRACT ; Objective: To assess the bone support of the teeth adjacent to a cleft using cone-beam computed tomography (CBCT). Materials and Methods: The CBCT scans of 31 patients with unilateral cleft lip and palate (UCLP) were assessed. The data for teeth neighboring the cleft were compared with those of contralateral noncleft teeth. For each tooth analyzed, the distance between the cementoenamel junction (CEJ) and the bone crest (AC) at the buccal side was measured as was the thickness of the buccal bone level at 0, 1, 2, and 4 mm. Results: The bone thicknesses of the central teeth at the cleft region at the crest and 2 mm apically were statistically significantly thinner than that of the central incisor at a noncleft region. The CEJAC distance for central teeth at the cleft region was higher than that for central teeth in a noncleft region. Conclusions: Subjects with UCLP showed reduced bone support at teeth neighboring the cleft compared with controls. This may cause some problems during orthodontic treatment. (Angle Orthod. 2014;87:000–000.)
The Cleft Palate-Craniofacial Journal, 2012
Objectives: To verify the thickness and level of alveolar bone around the teeth adjacent to the cleft by means of cone beam computed tomography (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 (five boys and five girls) 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 iCAT Xoran System. The distance between the alveolar bone crest and the cement-enamel 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: In patients with BCLP in the mixed dentition, teeth adjacent to the alveolar cleft are covered by a thin alveolar bone plate. However, the level of alveolar bone crest around these teeth seems to be normal, and no bone dehiscence was identified at this age.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2018
The purpose of this study was to quantitatively assess dentoalveolar and skeletal compensations in patients with untreated unilateral cleft lip and palate (UCLP). We hypothesized that there are significant skeletal and dental adaptations in UCLP cases compared to a comparison maxillary crossbite group. A convenience retrospective sample of 30 patients with UCLP and a comparison group of 30 patients with unilateral posterior crossbite without CLP. Cone-beam computed tomography scans (CBCTs) were used to evaluate dental and skeletal compensations. In addition, alveolar bone thickness was measured at 2-mm increments in mesiodistal and faciolingual cross-sectional views along the long axis of the central incisors. Alveolar bone height was measured, and the percentage of root length supported by bone was calculated. Compensations for unilateral cleft lip and palate were restricted to the cleft site and adjacent structures. Dental compensations include alteration in the position of cleft-...
The Cleft Palate-Craniofacial Journal, 2018
Objective: The purpose of this study was to quantitatively assess dentoalveolar and skeletal compensations in patients with untreated unilateral cleft lip and palate (UCLP). We hypothesized that there are significant skeletal and dental adaptations in UCLP cases compared to a comparison maxillary crossbite group. Design: A convenience retrospective sample of 30 patients with UCLP and a comparison group of 30 patients with unilateral posterior crossbite without CLP. Cone-beam computed tomography scans (CBCTs) were used to evaluate dental and skeletal compensations. In addition, alveolar bone thickness was measured at 2-mm increments in mesiodistal and faciolingual crosssectional views along the long axis of the central incisors. Alveolar bone height was measured, and the percentage of root length supported by bone was calculated. Results: Compensations for unilateral cleft lip and palate were restricted to the cleft site and adjacent structures. Dental compensations include alteration in the position of cleft-adjacent maxillary incisors and maxillary canines. No gross skeletal compensations were found. Alveolar support of cleft adjacent incisors was similar to controls except for measurements in the most coronal and apical regions. The cleft group contralateral incisors exhibited buttressing effects and had significantly higher alveolar thickness in the coronal half of the tooth. There was less (5%) alveolar coverage of the cleft-facing aspect of the central incisor root than all other incisors. Conclusion: The bone adaptation to the presence of a cleft was localized in the vicinity of the cleft, and adaptations in the mandible were not apparent.
Egyptian Dental Journal, 2019
Objective: The purpose of this study was to investigate maxillofacial morphology using CBCT with the ultimate goal of finding whether differences existed in a two suggested subtypes of nonsyndromic bilateral cleft lip and palate (BCLP) patients. Design: This retrospective study included CBCT data of 22 BCLP patients with mean age of 9.6 years. The patients were divided initially according to premaxillary characteristics into two groups and this classification was further confirmed by measurement of sella-nasion-point A angle (SNA), Group (P): This represent BCLP characterized by well-developed (P) prominent pre-maxilla and SNA >80±2, Group(R): This represent BCLP characterized by ill-developed (R) rudimentary pre-maxilla and SNA < 80±2. The relation between maxilla and mandible measured by point A-nasion-B point angle (ANB), angle of septal deviation (ASD) and anterior upper facial height (AUFH) were assessed using On-demand 3D software and was compared among the two groups. Results: Patients within group P showed significantly higher ANB (P value ≤ 0.001). Patients within group R showed significantly higher ASD angle (P value ≤ 0.05), while AUFH showed insignificant difference between the two groups (P value ≥ 0.05). Conclusions: Maxillofacial morphology measurements assessed in this study support that difference exist between the two investigated subtypes of non-syndromic BCLP.
Maxillary Dental Development in Complete Unilateral Alveolar Clefts
The Cleft Palate-Craniofacial Journal, 1998
This study was conducted to determine whether development of individual maxillary teeth in subjects with complete unilateral alveolar clefts was significantly different from that found in unaffected children. Design: Retrospective, mixed longitudinal. Setting: Craniofacial Center, university based. Materials and Methods: A sample of 179 panoramic radiographs obtained during the mixed dentition from 79 subjects (47 males, 32 females) with complete alveolar clefts was analyzed. After visual evaluation of root development of the permanent maxillary teeth from radiographs, a score from 0 to 5 was assigned utilizing a predefined scoring system. Statistical analyses were performed between the cleft and unaffected reference groups available in the literature. Results: The cleft side dentition was found to be significantly delayed in development relative to the noncleft side (p Ͻ .05). Compared to the reference group, the cleft side lateral incisor demonstrated a mean difference in development of 1.59 years followed by the canine (1.39 years), the central incisor (0.96 years), the first premolar (0.94), and the second premolar (0.78). Conclusion: Teeth directly adjacent to the cleft site were shown to be the most delayed. The lateral incisors and canines were observed to be the most variable when compared to their corresponding antimeres. The information obtained from this study may assist the orthodontist in selecting the appropriate time to initiate orthodontic treatment in order to prepare the permanent dentition prior to alveolar bone grafting.
Open Journal of Stomatology, 2013
The purpose of this study was to assess the alveolar defect volume in unilateral cleft lip and palate (UCLP) subjects using computed tomography (CT) and a free software program to evaluate the intra-and interrater measurements, and to compare the cleft volume between age and affected side. The sample of this retrospective study consisted of 20 UCLP individuals, 12 boys and 8 girls, mean age 10.3 ± 2.4 years at the beginning of orthodontic treatment. All subjects required alveolar bone grafting. CT scans of the cleft area were obtained prior to secondary bone grafting, and were analyzed using Image J. software program. The cleft volume was calculated based on axial crosssectional CT images by two raters (orthodontist and radiologist) and by the same rater (orthodontist) at two different moments. Linear mixed model, Bland-Altman, Pearson's and intraclass correlation coefficient (ICC) were used. The mean cleft volume was 7.53 ± 1.55 mm³. The intra-and inter-rater measurements were reproducible (ICC = 0.976 and 0.963, respectively) with no significant difference between them. There were no statistically significant differences in the cleft volume related to age or cleft location. The assessment of cleft volume in UCLP using CT images and a free software program was a reproducible method. There was no significant relation between alveolar defect volume and age or cleft location.
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2018
To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height. Observational follow-up study. Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden. 40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate. Clinical examination, CBCT, and occlusal radiographs. Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up. The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total ( P = .045) and by subgroup with dental restoration ( P = .0078). This was positively correlated with the gingival bleeding index (GBI) ( r = 0.51, P = .0008) and presence of dental restorations in the cleft area ( r = 0.45, P = .017...
Plastic and Reconstructive Surgery, 2016
rimary closure of the alveolar cleft has been described by many authors with many different approaches: bone grafts, 1,2 periosteal pedicled flaps, 3 free periosteal flaps, 4,5 or mucoperiosteal flaps. 6 Primary gingivoperiosteoplasty was suggested by Millard in 1980 and consisted of a covering of the alveolar cleft with local mucoperiosteal flaps, performed together with lip adhesion at the age of 3 months. 7 Delaire postponed the alveolar closure at the age of 18 to 24 months, when the closure of the hard palate was also performed, 8 thus naming the procedure early secondary gingivoalveoloplasty. Both Millard and Delaire's protocol applied a presurgical orthopedic treatment to position the alveolar ridges close to one another. Since 1988, early secondary gingivoalveoloplasty was introduced in our surgical protocol and performed at 18 to 36 months, during the stage of hard palate repair, whereas lip, nose, and Disclosure: The present study was not supported by any company, institute, or organization that has profit-obtaining purposes. None of the authors has a financial interest in any of the products or devices mentioned in this article.