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Open Access 01-02-2020 | Cleft Lip and Palate | Original Article

Incidence of complications in secondary alveolar bone grafting of bilateral clefts with premaxillary osteotomy: a retrospective cohort study

Authors: Gerhard K. P. Bittermann, Robert J. J. van Es, Adrianus P. de Ruiter, Michael H. Frank, Arnold J. N. Bittermann, Aebele B. Mink van der Molen, Ron Koole, Antoine J. W. P. Rosenberg

Published in: Clinical Oral Investigations | Issue 2/2020

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.

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Title: Incidence of complications in secondary alveolar bone grafting of bilateral clefts with premaxillary osteotomy: a retrospective cohort study
Authors: Gerhard K. P. Bittermann
Robert J. J. van Es
Adrianus P. de Ruiter
Michael H. Frank
Arnold J. N. Bittermann
Aebele B. Mink van der Molen
Ron Koole
Antoine J. W. P. Rosenberg
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Cleft Lip and Palate
Cleft Lip and Palate
Cleft Lip and Palate
Cleft Lip and Palate
Cleft Lip and Palate
Published in: Clinical Oral Investigations / Issue 2/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02977-y

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Incidence of complications in secondary alveolar bone grafting of bilateral clefts with premaxillary osteotomy: a retrospective cohort study

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical relevance

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