Abstract
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 inter-rater 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 cross-sectional 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.
Highlights
Secondary bone grafting is considered the gold standard for repairing the cleft region [1]
The sample of this retrospective study using multi-slice spiral computed tomography (CT) scans consisted of twenty patients with unilateral cleft lip and palate (UCLP) seeking care in the Cleft Lip and Palate Rehabilitation Center (CERLAP) at Pontifical Catholic University of Rio Grande do Sul (PUCRS)
The intra- and inter-rater measurements were reproduceble (ICC = 0.976 and 0.963, respectively) and comparesons showed a strong association with no significant difference among measurements (Figure 1)
Summary
Secondary bone grafting is considered the gold standard for repairing the cleft region [1]. Secondary bone grafting enhances the dental alveolus for eruption and periodontal support of the teeth adjacent to the cleft, usually the canine and the lateral incisor [2,6,7]. This allows, through orthodontic treatment, the closing of the residual space, and in many cases it does not require rehabilitation with prosthesis or implants. The alveolar bone graft bridges the cleft defect with bone, providing an alar base support and allowing closure of the communication between the oral and nasal cavities [5,8,9]
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