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Muhammad Asim
However, all surgical and grafting procedures can cause growth alterations with bone dysplasias that are more severe when the procedure is performed early.
Canine position and its eruption stage at the time of bone grafting.
The success of bone grafts decreases if the procedure is performed after canine eruption on the cleft side.
The Role of the therapy protocol and the orthodontic role, which
have not been explored in the literature.
Authors analyzed the records of 446 complete cleft lip and palate
patients of the regional hospital.
Inclusion criteria
Congenital complete cleft lip and palate. Treatment with the protocol of the regional hospital of vicenza and
Performance of the alveolar bone graft by the same surgeon Digital occlusal x-rays exposed with a standardized radiologic
necessary.
Based on the results, the patients were divided into the following
groups:
Minor cleft: type I, score 1 or 0.5, on both teeth adjacent to the cleft. Moderate cleft: types II and III, score 0.5, on both teeth adjacent to
the cleft.
Severe cleft: type IV, score 0, on both teeth adjacent to the cleft.
Kendall coefficient of concordance: To compare Bergland scale with the Witherow-derived scale.
The patients were divided into those who were 10 years or younger
The success rate at T1 was 70.41% (95% CI). The success rate at T2 was 91.84% (95% CI).
The correlation between cleft palate severity and success rate at T2 was not statistically significant (P=0.64).
The Kendall coefficient of concordance was 0.99 for both the Bergland and the Witherow-derived scales, indicating that these scales were comparable.
patient's sex or age and the success of the alveolar bone graft at T2
(P=0.08 and=0.94, respectively).
Teeth lost adjacent to the cleft at T2 did not correlate with cleft
cleft area.
Success rates were 70.41% (95% CI) at T1 and 91.84% (95% CI) at
T2.
In this study, the average age at bone grafting was 10.25 years, with
In this study, Cleft severity was not statistically correlated with the
rate of surgical success at T2. Therefore, minor, moderate, and severe clefts appear to have the same long-term stability.
Bone levels between site 1 (mesial side of the cleft) and site 2
(distal side of the cleft). In this study, site 2 had a higher bone level than site 1.
Both authors suggested that, unlike the apex of the distal tooth, the
apex of the mesial tooth was not always covered by bone. In this
situation, the clinician should not use orthodontic force to prevent root resorption.
cleft patients:
Arch development with previous orthopedic expansion. Creation of space for canine eruption with orthodontic therapy.
Periodontal health of the canine with respect to the root during the
graft surgery.
Patients with alveolar clefts have a 20-fold increased risk for Canine
However, Canine impaction do not affect the bone height after the
bone graft.
In this study, 65.31% (95% CI) of the patients had lateral incisor
agenesis.
The high rate of dental anomalies on the cleft side might be due to a
Only 3 patients (6.12%) had lost teeth adjacent to the cleft side at
T2. Two patients had peg-shaped lateral incisors, and 1 patient had
microdontic supernumerary teeth instead of a lateral incisor; these were extracted during the graft surgery.
This finding concurs with the findings of Long et al, Tooth loss adjacent to the cleft at T2 did not correlate with cleft severity or type of cleft at T0.
There was no significant correlation between age or sex and the long-term stability of the bone graft.
There was also no significant association between cleft severity (minor, moderate, severe) at T0 and the success of the alveolar graft at T2, or between the type of cleft (unilateral or bilateral) and the stability of the alveolar graft.
There is no significant correlation between lateral incisor agenesis on the cleft side and the long-term success of bone grafts.
If expansion is carried out after bone grafting, fistulae can appear, leading to an additional surgical procedure.
stability.
The grafted side must be restored with functioning prosthetic teeth (implants) as soon as possible to prevent bone loss.
The success rate of bone grafts at T2 was 91.84, suggesting a high percentage of success with this therapy protocol.
Cleft severity was not statistically correlated with success at T2, demonstrating the protocols efficacy and its ability to repair clefts of varying severity.
The concordance rate between the Bergland and the Witherowderived scales was 87.07% , indicating that this is a simple and