Author:
Preston Kathryn,Chen Lucia,Brennan Tyler,Sheller Barbara
Abstract
ABSTRACT
Objectives
To describe pre– and post–alveolar bone graft (ABG) practice protocols of orthodontists associated with American Cleft Palate-Craniofacial Association–approved cleft and cleft/craniofacial teams.
Materials and Methods
Electronic survey responses from team orthodontists were evaluated regarding pre-ABG orthodontic treatment type(s), timing of post-ABG imaging and post-ABG orthodontic treatment, and craniofacial orthodontic fellowship training status of the team orthodontists. A P value of <.05 was considered significant.
Results
Of 31 responding orthodontists, 54.8% had fellowship training and 45.2% did not. Pre-ABG orthodontic preparation ranged from solely maxillary expansion for alveolar segment alignment (35.5%) to a combination of maxillary expansion for both alveolar segment alignment and posterior crossbite correction, anterior tooth alignment, and anterior crossbite correction (19.4%). Most captured post-ABG radiographs prior to orthodontic tooth movement (90.3%). Orthodontists began treatment at least 6 months (35.5%), 2–4 months (32.3%), or 4–6 months (29%) post-ABG. No significant differences were found when comparing fellowship subgroups. In addition, 47.1% of fellowship-trained orthodontists deferred post-ABG orthodontic treatment to at least 6 months post-operatively, vs 21.4% of non–fellowship trained orthodontists (P = .14).
Conclusions
A large variation in approaches is evident in pre-ABG orthodontic treatment types and timing of post-ABG treatment. Post-operative imaging is pursued by most orthodontists to assess graft status prior to initiating orthodontic treatment. Additional clinical research is needed to support providers in their decision-making with regard to evidence-based approaches.
Publisher
The Angle Orthodontist (EH Angle Education & Research Foundation)
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