American Journal of Orthodontics and Dentofacial Orthopedics
Original articleComparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine
Section snippets
Material and methods
The study design was a retrospective longitudinal assessment conducted at The Hospital for Sick Children in Toronto, Canada. Ethics approval was obtained before initiation. To minimize surgical variation, and for sample homogeneity, subjects were only included if they were born with CUCLP and had all cleft-related surgeries and SABG performed by the same experienced surgeon (D.M.F.). To reduce variation resulting from cleft type and severity, only patients with a diagnosis of CUCLP were
Results
Between the years of 2000 and 2017, a total of 350 patients with CLP had SABG procedures performed by the same surgeon (D.M.F.) at The Hospital for Sick Children, Toronto. To allow a minimum follow-up of 2 years after SABG, the final year of inclusion for SABG surgery was 2016. Between January 2009 and August 2016, 64 patients with CUCLP had all cleft-related surgeries (cheiloplasties and palatoplasties) in addition to SABG surgeries performed by the same surgeon (D.M.F.), which were important
Discussion
This study demonstrates that in our sample of patients with CUCLP, better dental outcomes are observed for pre-CE SABG compared with post-CE SABG, with fewer adverse outcomes. Since the magnitude of differences in dental outcomes was small between the groups, these findings are clinically significant because they indicate that even though pre-CE SABG is the preferred timing, post-CE SABG could still be performed without large impacts on dental outcomes if the timing was narrowly missed.
In
Conclusions
In this study, better dental outcomes were observed in the pre-CE SABG group than in the post-CE SABG group. Because of these findings, cleft teams should aim to integrate pre-CE SABG into their treatment protocols for CUCLP. However, because the magnitude of these dental differences was not large, if the pre-CE SABG timing is narrowly missed, post-CE SABG should still be undertaken.
Acknowledgments
We thank the Departments of Plastic Surgery and Dentistry at The Hospital for Sick Children for facilitating this study.
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Cited by (0)
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.
Preliminary data from this research were presented at the 70th Annual Session of the Canadian Association of Orthodontists, Vancouver, British Columbia, Canada (September 6-8, 2018), and at the 119th Annual Session of the American Association of Orthodontists, Los Angeles, Calif (May 3-7, 2019).