Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate: A 20-Year Follow-up.

OBJECTIVE: To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height.

DESIGN: Observational follow-up study.

SETTING: Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden.

PATIENTS: 40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate.

INTERVENTIONS: Clinical examination, CBCT, and occlusal radiographs.

MAIN OUTCOME MEASUREMENTS: Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up.

RESULTS: The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total ( P = .045) and by subgroup with dental restoration ( P = .0078). This was positively correlated with the gingival bleeding index (GBI) ( r = 0.51, P = .0008) and presence of dental restorations in the cleft area ( r = 0.45, P = .0170). There was no difference in the Bergland index generated from scoring the alveolar bone height on occlusal radiographs as with the equivalent index on CBCT.

CONCLUSION: Patients rehabilitated with complex dental restoration seems to be at higher risk for progression of bone loss in the cleft area. Supportive periodontal therapy should be implemented after complex dental restorations in cleft patients. Conventional occlusal radiographs provide an adequate image for evaluating postoperative bone height in clinical follow-up.