A new scale to assess radiographic success of secondary alveolar bone grafts.
OBJECTIVE
To propose a new scale for evaluating the position of the bone graft within the cleft and assess its inter- and intraobserver reliability.


METHODS
Sixty-six patients (70 cleft sites) over a 14-year period were assessed, 90% of patients retrospectively and 10% prospectively. The radiographs were reviewed by two clinicians in controlled conditions twice, with 1 week between assessments. Both clinicians were blind to patient identity.


METHODS
A new scale subdividing the position of the bone into one of six categories was used. The radiographs were also assessed using the Bergland scale.


RESULTS
Using the Bergland scale, 62.9% of the cleft sites were type I, 21.4% type II, 4.3% type III, and 5.7% type IV. It was not possible to assess 5.7% of the clefts with this scale because the canine was unerupted. Using the Chelsea alveolar bone graft scale, 58% were category A, 20% B, 7% C, 3% D, 3% E, and 9% F.


CONCLUSIONS
The above scale can be used to determine accurately the position of bone within the cleft site. It can be used in the mixed dentition prior to eruption of the canine. It demonstrated moderate to substantial inter- and intraobserver reliability and offers several advantages, compared with other scales.
Witherow
H
H
Chelsea and Westminster Cleft and Craniofacial Unit, London, England. helenwitherow@netscapeonline.co.uk
Cox
S
S
Jones
E
E
Carr
R
R
Waterhouse
N
N
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000000981:diagnostic imaging*; D000543:Alveoloplasty; D016025:Bone Transplantation / Q000145:classification / Q000000981:diagnostic imaging*; D002648:Child; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000601:surgery*; D003481:Cuspid / Q000000981:diagnostic imaging; D003818:Dentition, Mixed; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013223:Statistics as Topic; D019237:Tooth Cervix / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000000981:diagnostic imaging; D014097:Tooth, Unerupted / Q000000981:diagnostic imaging; D016896:Treatment Outcome