Volumetric assessment of secondary alveolar bone grafting using cone beam computed tomography.
OBJECTIVE
To assess the radiographic outcome of secondary alveolar bone grafting in individuals with nonsyndromic unilateral or bilateral cleft lip and palate using cone beam computed tomography.


METHODS
This prospective study was conducted at the University of California at San Francisco Center for Craniofacial Anomalies on 21 consecutive nonsyndromic complete cleft lip and palate individuals between 8 and 12 years of age who required alveolar bone grafting. Seventeen unilateral and four bilateral cleft lip and palate individuals had preoperative and postoperative cone beam computed tomography scans that were analyzed using Amira 3.1.1 software.


RESULTS
The average volume of the preoperative alveolar cleft defect in unilateral cleft lip and palate was 0.61 cm(3), and the combined average volume of the right and left alveolar cleft defects in bilateral cleft lip and palate was 0.82 cm(3). The average percentage bone fill in both unilateral cleft lip and palate and bilateral cleft lip and palate was 84%. The outcome of alveolar bone grafting was assessed in relation to (1) type of cleft, (2) size of preoperative cleft defect, (3) presence or absence of lateral incisor, (4) root development stage of the maxillary canine on the cleft side, (5) timing, and (6) surgeon. None of these parameters significantly influenced the radiographic outcome of alveolar bone grafting.


CONCLUSIONS
Secondary alveolar bone grafting of the cleft defect in our center was successful, based on radiographic outcome using cone beam computed tomography scans. Volume rendering using cone beam computed tomography and Amira software is a reproducible and practical method to assess the preoperative alveolar cleft volume and the adequacy of bone fill postoperatively.
Oberoi
Snehlata
S
Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California at San Francisco, 94143, USA. sneha.oberoi@ucsf.edu
Chigurupati
Radhika
R
Gill
Pawandeep
P
Hoffman
William Y
WY
Vargervik
Karin
K
D000539:Alveolar Process / Q000000981:diagnostic imaging*; D000543:Alveoloplasty / Q000379:methods*; D000848:Anodontia / Q000000981:diagnostic imaging; D016025:Bone Transplantation / Q000000981:diagnostic imaging*; D002648:Child; D002971:Cleft Lip / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery; D002972:Cleft Palate / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery; D054893:Cone-Beam Computed Tomography; D003481:Cuspid / Q000254:growth & development; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007180:Incisor / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D009805:Odontogenesis / Q000502:physiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012984:Software; D013997:Time Factors; D014092:Tooth Root / Q000254:growth & development; D016896:Treatment Outcome