New Clinical Method for Alveolar Bone Graft Evaluation in Cleft Patients: A Pilot Study

Abstract

The objective of this analytical cross-sectional study was to develop and test a new clinical evaluation method, using two sets of clinical criteria: (1) probing depth for teeth at either side of the grafted region and (2) residual defect at the central faciolingual region of the alveolar bone graft site, for assessing alveolar bone graft outcomes in patients with cleft of the lip and palate. Thirteen patients, 8 to 13 years old, with cleft lip and palate who underwent alveolar bone graft at Srinagarind Hospital and Faculty of Dentistry of Khon Kaen University were recruited into the study to test the agreement between two sets of data: (1) clinical examination scores and an expert's clinical judgment, (2) clinical and radiographic examination scores (Bergland and Chelsea scales). Study results showed that between the two criteria used in the new clinical method, reliability of the first criterion was higher than that of the second, .66 to 1.00 and .59 to .65, respectively. The reliability test for radiographic evaluation showed that the Chelsea scale had higher agreement than the Bergland, .80 to 1.00 and .64 to .86, respectively. Sensitivity, specificity, and likelihood ratio of the three proposed methods could not be concluded statistically due to the small sample size. In conclusion, even though the study sample was small, the method offers useful prospects as a supplement, if not an alternative, to overcome identified deficiencies of the Bergland and Chelsea scales and computed tomography scans, which raise concerns about radiation hazards and costs.