Outcomes of secondary alveolar bone grafts in cleft patients
Aim The aim of this retrospective study was to determine the outcomes of secondary alveolar bone grafts (SABG) in cleft patients treated at the Wits Dental Hospital at the Charlotte Maxeke Johannesburg Academic Hospital. Objectives To record the demographic data of patients who had secondary alveolar bone grafts, and to assess the outcomes of SABG by evaluating clinical variables and the quantity of bone post SABG. Methods Records of 19 patients with a total of 23 clefts were examined to evaluate the amount of bone at the cleft site following secondary alveolar bone graft. Socio-demographic information was collected as well as the clinical variables of the type of graft used, canine eruption, keratinised tissue around teeth close to the cleft, and closure or persistence of any oronasal fistula. The amount of bone at the graft site was measured on CBCT images using the Chelsea scale. Comparisons of Chelsea scale scores and CBCT findings were carried out. SPSS ® 24 was used to analyse the data. All statistical tests were conducted at 5% significance level. Results Most (52%) patients were male, with 57% having left unilateral cleft. The majority of them received autogenous bone grafts from the chin. Most (65.2%) of the patients showed good clinical outcomes, whilst showing evidence of bone resorption in and around the graft site on CBCT images. Fifteen of the patients were considered to have partial alveolar graft resorption. Conclusion In the majority of patients, 3D CBCT images revealed bone resorption in areas that 2D images gave an impression of presence of bone. However, the majority of patients indicated good clinical outcomes despite the poor radiological findings.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Dentistry in the branch of Maxillofacial and Oral Surgery 31 May 2018.