Abstract
To evaluate the outcome of secondary alveolar bone grafting (SABG) in patients with cleft lip and palate at 16 years of age and to identify predictors associated with surgical failure. This retrospective follow-up included 91 patients with 100 cleft palates treated with SABG at a mean age of 9.2 years. The possible predictors for surgical failure analyzed were sex, dental development stadium, type of cleft, side, tooth erupting into the graft, cortical boundary, presence of a lateral incisor, extraction, preoperative expansion, oral hygiene, retention device, and age. The outcome variable for surgical success was Bergland score I and II. Surgical outcome was analyzed at 16 years of age based on intraoral radiographs, according to the Bergland index. Statistical analyses included estimation of odds ratios for predictor variables. The post-SABG success rate was 91% (Bergland score I and II) with a mean follow-up of 7.2 years. Surgical failure was significantly associated with poor oral hygiene. This study revealed a high success rate (91%) at a mean of 7.2 years post-SABG. Poor oral hygiene significantly increased the risk of surgical failure. This suggests that increased perioperative measures to maintain good oral health could reduce surgical failure.
Highlights
Erupted, canine and premolars under eruption/all teeth erupted), type of cleft, cleft side, erupting tooth into the grafted cleft, reoperation, cortical boundary, aplasia of the lateral incisor, tooth extraction during surgery, preoperative orthodontic treatment, oral hygiene, retention device, and patient age at surgery
Poor oral hygiene was identified as a predictor for surgical failure (OR = 11.39; 95% confidence interval [CI], 2.53-51.33; P = .002)
The intraobserver agreement was good to very good (k = 0.754-0.928), and the interobserver agreement was good (k = 0.754). In this retrospective follow-up after secondary alveolar bone grafting (SABG), we found a success rate of 91%, as determined by the Bergland index score I or II. This result corresponds with earlier studies of both unilateral and bilateral alveolar bone clefts showing success rates varying between 73% and 98%
Summary
To evaluate the outcome of secondary alveolar bone grafting (SABG) in patients with cleft lip and palate at 16 years of age and to identify predictors associated with surgical failure. Secondary alveolar bone grafting (SABG) was first described by Boyne and Sands in 1972 and has since become the standard surgical protocol for alveolar bone reconstruction.[1] This bone grafting procedure is performed with the aim of constructing a homogeneous alveolar arch and stabilizing the maxillary arch, providing support for tooth eruption, eliminating oronasal fistulas, and improving the aesthetic result.[2,3,4] The age at which SABG is performed depends on the eruption status of the canine or lateral incisor[5] but is generally between 7 and 11 years. (CLP) and to identify possible predictor variables that affected the surgical outcome at 16 years of age
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