Clinical and Radiographical Evaluation of the Periodontal Condition of Teeth Adjacent to Alveolar Clefts After Secondary Alveolar Grafting

Abstract

Cleft lip and palate (CLP) is the most common orofacial congenital malformation found amongst live births.CLP has been recognized as a major source of disability that prevent people from realizing their potential and contributing fully to society.People who have a CLP experience feeding, swallowing, cosmetic, speech and hearing, as well as poor dental health. They are also at increased risk for the development of carious lesions and periodontal disease. The elimination of the residual alveolar clefts by secondary alveolar bone grafting (SABG) plays an important role in the dental rehabilitation of patients with cleft lip and palate. Conventional computed tomography (CT) scans have been used to assess outcome of ABG, and the development of 3D assessment of bone volume using computerized tomographic technology and 3D computer models may assist in a more precise radiographic evaluation. The aim of this study is to clinically evaluate the periodontal condition of teeth adjacent to alveolar clefts before and six months after secondary alveolar cleft grafting. And to radiographically evaluate the thickness and level of alveolar bone around those teeth using cone beam computed tomography. In this study, fifteen patients requiring alveolar bone grafting were selected from the patients attending the Cleft Care Center affiliated to the Department of Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, with age ranging from 8 to 16 years. All the patients were evaluated clinically andtheir cone beam computed tomography (CBCT) scans were analyzed pre-surgically and six months post-surgically. Test teeth were designated as those immediately adjacent to the unilateral alveolar cleft, with contralateral teeth on the non-cleft side serving as controls.For all teeth to be examined, PI, GI, CPI and tooth mobility were recorded preoperatively and postoperatively.Morphology of the alveolar bone surrounding the teeth adjacent to the alveolar cleft and the control teeth on the contralateral side were assessed by using cone beam computed tomography before and 6 months after secondary alveolar cleft grafting. The results of this study revealed that teeth near the cleft had higher PI, GI, CPI and tooth mobility scores when compared with the teeth in the non-cleft side pre-surgically and post-surgically. But the scores of the cleft side and the non-cleft side improved after the SABG surgery. Although the pre-surgical radiographic examination revealed that there is no significant difference between the teeth in the cleft side and those in the non-cleft side, the alveolar bone support of the teeth in the cleft side was non significantly improved after the SABG surgery.