title: Radiographic determination of the position of the maxillary lateral incisor in the cleft alveolus and parameters for assessing its habilitation prospects.
abstract: OBJECTIVE
  Develop patient selection criteria and guidelines for the diagnostic work-up for early secondary alveolar bone graft designed to accommodate a lateral incisor in the cleft.
  
  
  METHODS
  A literature review with clinical examples.
  
  
  METHODS
  For the majority of cleft lip and palate (CLP) patients, the timing of the secondary alveolar bone graft procedure is devised to accommodate the eruption of the maxillary canine. However, when the lateral incisor is present in the cleft area, a decision may be made to perform early grafting in order to salvage an additional tooth. Appropriate case selection for this intervention is the key for successful dental habilitation in the cleft area.
  
  
  CONCLUSIONS
  Attempts to maintain the lateral incisor are recommended only if the tooth contributes to the comprehensive orthodontic and restorative patient care and when the presence of a lateral incisor with adequate size, shape, and proper position may be demonstrated. For optimal decision making, the position, form, and periodontal ligament support of the lateral incisor should be assessed. Evaluation of these parameters is based chiefly on radiographic imaging. Occlusal projections and traditional tomography may augment the information available from periapical and panoramic radiographs. However, each of these has benefits and drawbacks that require consideration.
authors.affiliation: Department of Dental Medicine, Children's Hospital and Regional Medical Center, Seattle, Washington, USA.
authors.forename: D
authors.initials: D
authors.lastname: Shashua
authors.forename: M L
authors.initials: ML
authors.lastname: Omnell
mesh_terms: D000539:Alveolar Process / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008437:Maxilla / Q000000981:diagnostic imaging*; D018579:Patient Selection; D010513:Periodontal Ligament / Q000000981:diagnostic imaging; D011859:Radiography; D013997:Time Factors; D014078:Tooth Eruption; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000503:physiopathology