title: Increase in age is associated with worse outcomes in alveolar bone grafting in patients with bilateral complete cleft palate.
abstract: This prospective study aimed at evaluating the surgical outcomes of alveolar bone grafting (ABG) in subjects with bilateral cleft lip and palate treated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil, by means of cone-beam computed tomography. Twenty-five patients with bilateral complete cleft lip and palate, resulting in 50 clefts, were analyzed. Subjects were divided into 2 groups according to the dentition status at the time of surgery: (1) SABG group: subjects with mixed dentition operated on before or immediately after eruption of the permanent canine (10-13 years); (2) TABG group: subjects with permanent dentition (15-23 years). Cone-beam computed tomography analysis was performed in the buccal, intermediate, and palatal views, 2 and 6 to 12 months postoperatively. In the SABG group, 96% of the grafts were classified as successful, and no failure cases were observed. In the TABG group, successful cases decreased to 65%, and failures were seen in 27% of the cleft sites. In both postoperative periods, significantly better outcomes (lower mean scores) were observed for the SABG group in all the cone-beam computed tomography views (P < 0.05). Results show that the timing of surgery is an important factor in determining the outcomes of ABG in patients with bilateral cleft lip and palate, with increasing age being associated with the worse outcomes.
authors.affiliation: From the *Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies; †Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies; ‡Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies; and §Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
authors.forename: Adriana Maria
authors.initials: AM
authors.lastname: Calvo
authors.forename: Ivy Kiemle
authors.initials: IK
authors.lastname: Trindade-Suedam
authors.forename: Omar Gabriel
authors.initials: OG
authors.lastname: da Silva Filho
authors.forename: Roberta Martineli
authors.initials: RM
authors.lastname: Carvalho
authors.forename: Renato André
authors.initials: RA
authors.lastname: de Souza Faco
authors.forename: Terumi Okada
authors.initials: TO
authors.lastname: Ozawa
authors.forename: Flávia
authors.initials: F
authors.lastname: Cintra
authors.forename: Alceu Sergio
authors.initials: AS
authors.lastname: Trindade
authors.forename: Inge Elly Kiemle
authors.initials: IE
authors.lastname: Trindade
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D064728:Alveolar Bone Grafting / Q000009:adverse effects*; D000539:Alveolar Process / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D001938:Brazil; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult