THREE-DIMENSIONAL ASSESSMENT OF ALVEOLAR BONE GRAFT IN CLEFT PALATE PAT I E N T S B Y M E A N S O F C O N E B E A M COMPUTED TOMOGRAPHY: PRELIMINARY RESULTS

Trindade-Suedam IK1, Tabanez AP2, Lima TF*3, Carvalho RM4, Calvo AM5, Ozawa TO6.
1. DDS, MSc, PhD, Assistant Professor, Department of Biological Sciences, Bauru School of Dentistry and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of So Paulo, Bauru, SP, Brazil. 2.DDS. Former undergraduate student, Bauru School of Dentistry University of So Paulo. 3. DDS Graduate student, POSTGRADUATE PROGRAM IN REHABILITATION SCIENCES University of So Paulo. 4 DDS, MSc, Oral and Maxillofacial Surgeon, of the Dental Division of the Hospital for Rehabilitation of Craniofacial Anomalies, University of So Paulo, Bauru, SP, Brazil. 5. Post-doctoral researcher, Hospital for Rehabilitation of Craniofacial Anomalies, University of So Paulo, Bauru, SP, Brazil. 6 DDS, MSc, Orthodontist of the Dental Division of the Hospital for Rehabilitation of Craniofacial Anomalies, University of So Paulo, Bauru, SP, Brazil.

thiagofreirelima@gmail.com

Introduction
Alveolar bone grafting (ABG), which is ideally performed during the mixed dentition and before the permanent canine eruption, using autogenous bone, is considered the gold standard procedure for the treatment of the alveolar clefts. This study aimed to prospectively assess the outcomes of ABG performed in patients with complete unilateral cleft lip and palate, during the mixed dentition, before and after canine eruption, by means of cone beam computed tomography (CBCT).

Material And Methods

! Fourteen subjects ! 2 groups: ! BC (n=7): before canine eruption ! AC (n=7): after canine eruption. ! CBCT images were obtained 2 (PO2m) and 6 to 12 months (PO6-12m) postoperatively. !I mages were reformatted in 3D for volume assessment.

! Area of interest:
Non-Affected Side Piriform Aperture Neoformed Piriform Aperture

ECJ

ECJ

Picture 1 Ilustration of the Area of Interest in the CBCT software.

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Results

Pictures 2,3,4 and 5 The surgical sequence of the ABG procedure in unilateral cleft lip and palate.

The average bone volume (xd) (mm3), in the BC group, in PO2m and PO6-12m, and the average percentage of bone resorption in PO6-12 were, respectively, 716 241and 658 348 (8%). In the AC group values corresponded to 764301 and 599243 (20%).
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PRE

PO2

PO6-12

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Picture 6 - Dentalslice (Bioparts) software was used to assess the volume of the cleft lip and palate defect, the graft volume after 2 and after 6-12 months postoperatively Table 1 BC Group Results Patients BC Group 1 2 3 4 5 6 7 Aver. Volume(mm3) Standar Deviation () PO2 993 1052 513 543 790 693 431 716241 PO6-12 961 1062 491 338 1021 502 230 658348

Picture 7 Rx Control at PO12m.

Table 2 AC Group Results Patients AC Group 1 2 3 4 5 6 7 Aver. Volume(mm3) Standar Deviation () PO2 719 659 806 1007 776 211 1167 764301 * PO6-12 689 637 553 799 516 127 869 599243 *

Conclusions

* P < 0.05; periods sharing the same symbol show significant difference

In both groups, results were successful. Bone resorption over time was considered to be physiological in the BC group. However, resorption in the AC group was significantly higher, probably because the absence of the stimuli caused by the canine eruption.