Influence of bone-anchored maxillary protraction on secondary alveolar bone graft status in unilateral complete cleft lip and palate

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 158; no. 5; pp. 731 - 737
• Main Authors: Stangherlin Gomes, Oscar, Carvalho, Roberta Martinelli, Faco, Renato, Yatabe, Marilia, Ozawa, Terumi Okada, De Clerck, Hugo, Timmerman, Hilde, Garib, Daniela
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2020
• Subjects: Alveolar Bone Grafting; Child; Cleft Lip - diagnostic imaging; Cleft Lip - surgery; Cleft Palate - diagnostic imaging; Cleft Palate - surgery; Dentistry; Humans; Maxilla - diagnostic imaging; Maxilla - surgery
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2019.10.021

Our objective was to evaluate the effects of bone-anchored maxillary protraction (BAMP) on the status of the secondary alveolar bone graft in patients with unilateral complete cleft lip and palate (UCLP). The experimental group (EG) comprised 26 patients with UCLP, mean age of 11.9 years, submitted to secondary alveolar bone grafting (SABG) with recombinant bone morphogenetic protein, and BAMP therapy, using miniplate-borne Class III intermaxillary elastics. Cone beam computed tomography (CBCT) examinations were taken 6 months after SABG and before BAMP (T1) and after 18 months of BAMP therapy (T2). The control group (CG) was composed of 24 patients with UCLP submitted only to SABG with recombinant bone morphogenetic protein or autogenous bone from iliac crest without BAMP therapy, matched by initial age and sex with the EG. In the CG, CBCT examinations were performed 6 months (T1) and 12 months (T2) after SABG surgery. CBCT axial sections were analyzed using Garib scores in both time points. Intra- and intergroup comparisons were performed using Wilcoxon and Mann-Whitney tests, respectively (P <0.05). No intergroup differences were found at T1 and T2. The EG showed significant improvement of graft status from T1 to T2 at the cervical and middle levels of the alveolar cleft. No significant interphase differences were found for graft scores in the CG. Despite loads of intermaxillary elastics applied to the maxilla, no harm to the grafted alveolar bone was observed after BAMP therapy in patients with UCLP. •Alveolar bone grafts of UCLP patients were evaluated using CBCT before and after BAMP.•The graft was evaluated in 3 different sites longitudinally.•No harm on the grafted alveolar bone was observed after BAMP therapy.