Prognostic Factors for Alveolar Bone Grafting in Patients with Alveolar Cleft

Objective: Alveolar bone grafting （ABG） is a common effective therapy to improve the alveolar arch form and induce permanent tooth eruption in a patient with alveolar cleft. However, several studies have reported cases in which the grafted bone was absorbed earlier after surgery. We conducted the present study to investigate the outcomes of ABG in our hospital and to identify factors associated with a poor prognosis in order to improve the prognosis for further ABG. <br>Methods: Fifty-seven patients （65 clefts）, who underwent ABG in the Department of Oral and Maxillofacial Surgery, Dokkyo Medical University Hospital during the 13-year period from April 2008 to March 2020, were included in the present study. The survey items included cleft type, gender, age at grafting, distance of cleft, infection after grafting, wound rupture, lack of lateral incisors and canine tooth eruption in the cleft. The characteristics of the poor bone formation group （re-grafting group） were extracted and compared with those of the good bone formation group. <br>Result: Of the total of 65 clefts, 5 （7.7％） clefts, which included 4 cleft lip and palate and 1 cleft lip and alveolus, were the poor bone formation group. In the comparison between the good and poor bone formation groups, the incidence rates of wound rupture, and lack of lateral incisors in the cleft were significantly higher in the poor bone formation group. Furthermore, the mean distance of the cleft was significantly larger in the poor bone formation group. <br>Discussion: Orthodontists and oral surgeons should cooperate closely to obtain a good outcome of ABG. The operation should be performed at the recommended appropriate age （canine tooth eruption period）, and special care for wound rupture and postoperative infection control is important. Furthermore, it is important to conserve the lateral incisors in the cleft wherever possible and to avoid excessive expansion of the cleft.