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- Title
Incidence of complications in secondary alveolar bone grafting of bilateral clefts with premaxillary osteotomy: a retrospective cohort study.
- Authors
Bittermann, Gerhard K. P.; van Es, Robert J. J.; de Ruiter, Adrianus P.; Frank, Michael H.; Bittermann, Arnold J. N.; van der Molen, Aebele B. Mink; Koole, Ron; Rosenberg, Antoine J. W. P.
- Abstract
Objective: To evaluate factors affecting incidence of complications after secondary alveolar bone grafting with premaxillary osteotomy (SABG + PO) in children with complete bilateral cleft of lip and palate (BCLP). Materials and methods: Data were collected from children with BCLP treated with SABG + PO from 2004 to 2014 at our institute. Preoperative parameters included age, donor site, race, gingival health, bone quality around cleft-related teeth, premaxilla position, graft timing, presence of canines in the cleft, and presence of deciduous teeth around the cleft area. Logistic regression and the chi-squared test were used to assess correlations and the incidence of complications. Results: In the 64 patients, a significant correlation was found between complication rate and timing of bone grafting with respect to early versus late SABG + PO (p = 0.041), age > 12 years (p = 0.011; odds ratio (OR) 5.9; 95% confidence interval (CI) 1.49–23.93), malposition of the premaxilla (p = 0.042; OR 3.3; 95% CI 1.04–10.13), and preoperative bone quality around cleft-related teeth (p = 0.005; OR 5.3; 95% CI 1.6–17.2). Conclusions: The timing of SABG + PO is essential, as early SABG + PO is associated with fewer complications. A malpositioned premaxilla and poor bone quality around cleft-related teeth are associated with more complications. Therefore, preoperative orthodontic repositioning of the malpositioned premaxilla before SABG + PO should be considered. Clinical relevance: Analysis of treatment protocols and complications for BCLP patients underscores that proper timing of SABG + PO and correct premaxilla repositioning help reduce complications.
- Subjects
BONE grafting; DECIDUOUS teeth; OSTEOTOMY; PALATE surgery; CLEFT lip; CLEFT palate; GINGIVAL recession; TOOTH loss
- Publication
Clinical Oral Investigations, 2020, Vol 24, Issue 2, p915
- ISSN
1432-6981
- Publication type
Article
- DOI
10.1007/s00784-019-02977-y