Early versus late alveolar bone grafting in unilateral cleft lip and palate: Dental arch relationships in pre-adolescent patients

Abstract

Objective: To evaluate the dental arch relationship in preadolescent children with complete unilateral cleft lip and palate after early secondary alveolar bone grafting (E-ABG) by comparing to late bone grafting (L-ABG).

Material and methods: Two raters blindly assessed the dental arch relationship with the modified Huddart-Bodenham (HB) Index for 2 groups: E-ABG group (36 children, mean age 9.6 years) and L-ABG group (56 children, mean age 11.1 years). The groups differed with respect to age at which alveolar bone grafting was performed: between 1.4 and 4.1 years (mean 2.2 years, E-ABG group) and after 8 years (L-ABG group). T-test was run to compare scores between 2 groups. Regression analysis was carried out to evaluate gender, age at cleft repair, age at ABG, and age at assessment with the HB index.

Results: The overall HB scores were -6.77 and -4.25 in the E-ABG and L-ABG groups, respectively (p = 0.025). Regression analysis showed that only the age at cleft repair influenced the HB scores.

Conclusion: ABG carried out between 2 and 4 years of age does not seem to negatively affect the dental arch relationship at the age of 10 years in comparison to L-ABG.

Keywords: Alveolar bone grafting; Cleft lip; Cleft palate; Dental arch relationship; One-stage repair.