Evaluation of Cleft Adjacent Canine Eruption in Patients With Alveolar Cleft Treated With Early Secondary Alveolar Bone Grafting.

Abstract

ObjectiveEvaluate cleft adjacent canine eruption in patients who underwent early secondary alveolar bone grafting (ABG).DesignRetrospective cohort study.SettingNorth-American cleft center.SubjectsA total of 121 children with nonsyndromic cleft lip and alveolus or cleft lip and palate (unilateral or bilateral).MethodsPatients consecutively treated with early or later secondary ABG during a 10-year period were evaluated. The primary outcome identified the status of cleft adjacent canine eruption through the grafted site. Secondary outcomes included need for regrafting, need for pregraft expansion and status of the cleft lateral incisor. Categorical variables were compared with Pearson's chi-square test and Fisher's exact test, and P < .05 was considered statistically significant.ResultsA total of 152 ABG (125 early and 27 later ABG) were performed in 121 patients. The age at time of ABG differed significantly between the 2 groups with a mean age of 73.5 ± 5.0 months for the early ABG group versus 113.4 ± 32.0 months for the later ABG group (P < .001). None of the patients required pregraft expansion. The cleft diagnosis distribution was similar (P = .686). The overall need for regrafting was 1.3% and did not differ between the groups (1.6% vs 0%; P = .675). The cleft adjacent canine spontaneously erupted in 84.0% for early ABG versus 70.4% for later ABG group. Close to twice as many canines required surgical exposure (9.6% vs 18.5%) or extraction (6.4% vs 11.1%) in the later ABG group, but this difference was not statistically significant (P = .183).ConclusionsEarly secondary ABG, without pregraft expansion, does not compromise the eruption of the cleft adjacent canine compared to later secondary ABG.