Abstract
Objectives: This study was to analyze factors that affect peri-implant bone loss around dental implants placed into alveolar cleft sites. Methods: Thirty-one patients with cleft lip and palate (total 46 implants) who underwent implant treatment following secondary bone graft to the alveolar cleft were included in this study. Evaluation at the peri-implant bone level was measured using standard X-ray images. Analysis of covariance was performed using the amount of periimplant bone loss as the objective variable and sex, cleft type, age at bone grafting of alveolar clefts, time since completion of implant treatment, type of implant, length of the implant, presence or absence of vestibuloplasty, and presence or absence of bone augmentation with simultaneous implant placement as the eight explanatory variables. Results: Of the eight explanatory variables, the factors that affected the amount of peri-implant bone resorption were sex, presence or absence of vestibuloplasty, and length of the implant. The amount of peri-implant bone resorption was greater in men than in women (p=0.004), and those that underwent vestibuloplasty also tended to have a greater amount of bone resorption (p=0.002). Conclusions: In implant treatment for alveolar cleft sites, a variety of factors that are not seen in non-cleft, individuals are intricately linked. Detailed analysis of factors that affect peri-implant bone loss is therefore needed in larger a subject sample in order to establish guidelines for implant treatment of alveolar cleft sites.
Highlights
Secondary bone grafting of alveolar cleft, in which permanent teeth adjacent to the cleft are encouraged to erupt or correctively displaced, is considered the most ideal method of occlusal reconstruction in cases of cleft lip and palate [1,2]
The utility of choosing implant treatment as a method that does not place a burden on the teeth adjacent to the alveolar cleft has been reported in cases where occlusal reconstruction is difficult with orthodontic treatment alone for reasons such as missing permanent teeth [3,4]
Survival of dental implants and peri-implant bone loss Osseointegration was achieved in all 31 cleft lip and palate patients
Summary
Secondary bone grafting of alveolar cleft, in which permanent teeth adjacent to the cleft are encouraged to erupt or correctively displaced, is considered the most ideal method of occlusal reconstruction in cases of cleft lip and palate [1,2]. The utility of choosing implant treatment as a method that does not place a burden on the teeth adjacent to the alveolar cleft has been reported in cases where occlusal reconstruction is difficult with orthodontic treatment alone for reasons such as missing permanent teeth [3,4]. Matsui et al [5] placed implants in bone bridges formed by secondary bone grafts to alveolar clefts and reported an implant survival rate of 98.6% in cleft lip and palate patients who underwent 5 years or more of follow-up. Wang et al [6] collected and analyzed clinical studies conducted to date and reported a 91.5% implant survival rate in alveolar cleft area over a 54.3-month follow-up period. There have been no reports analyzing the changes that occur at the peri-implant alveolar bone level in the bone bridge following secondary bone grafting, so the facts are unclear. Many factors that affect changes at the peri-implant bone level have been reported, including sex, age, site of implant placement, length and diameter of the implant, surface properties of the implant, and bone quality of the jawbone [8,9]
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