Evaluation of graft uptake from the iliac crest in secondary alveolar bone grafting: Bergland's criteria revisited.

Back ground: The secondary alveolar grafting is an integral part in the management of alveolar cleft defect. Particulate cancellous bone and marrow (PCBM) graft obtained from iliac crest are considered as the gold standard.

Aim: Aim of the study was to evaluate the graft uptake clinically and radiologically using the Bergland's radiographic scale.

Material and methods: A longitudinal descriptive study was conducted on twenty patients of unilateral CLP in the age group of 6-13 years, presenting with residual/secondary alveolar cleft defect with unerupted maxillary lateral incisor/canine adjacent to the defect. Autologous PCBM graft obtained from iliac crest was used in all cases. Post operative clinical and radiological evaluation was carried out using the Bergland's radiographic scale at intervals of 1 week, 1 month and 6 months.

Data collection and result: Clinical evaluation consisted of assessment for infection, exposure of graft, rejection of graft, wound dehiscence and status of oronasal communication. A four-point Bergland's radiographic scale was used to compare the interdental height of the bone graft with unaffected side and categorized from grade I to IV. After six months, 6 cases were graded as grade I, 11 cases as grade II and 2 cases were grade III. Only one case deteriorated to grade IV which is considered as failure.

Summary and conclusion: Satisfactory results were obtained in 95% cases. Bergland's radiographic assessment scale is a valuable, easily available and inexpensive diagnostic tool to assess the condition of the grafted bone in SABG.