Effect of Alveolar Bone Grafting in the Mixed Dentition on Maxillary Growth in Complete Unilateral Cleft Lip and Palate Patients

Abstract

Objective: This study was conducted to evaluate the effects on facial growth of alveolar bone grafting in the mixed dentition for patients with UCLP. Design: Retrospective cephalometric study. Setting: Craniofacial Treatment and Research Centre, The Hospital for Sick Children, Toronto, Ontario, Canada. Patients: The 58 patients participating in the study had a history of complete unilateral cleft lip and palate, all of which were repaired by the same plastic surgeon. Interventions: Twenty-one patients received an iliac-crest alveolar bone graft at a mean age of 10.3 years, while 37 did not receive an alveolar bone graft. Lateral cephalometric radiographs were obtained on all patients at two different times: at a mean age of 9.4 years (prior to bone grafting in the grafted group) and at a mean age of 15.2 years. Main Outcome Measures: All radiographs were traced and digitized by the same person, using cephalometric computer software. Superimposition and cephalometric analysis was undertaken to investigate the differences between the two groups in the 5.6-year experimental period. A two-way analysis of covariance was used for evaluation of the statistical significance of the results. Results: No statistically significant differences were found in 14 of the 15 cephalometric measurements performed. Harvold's maxillary unit length was statistically significantly shorter in the grafted group, although a lack of correlation with angular measurements and inherent problems with this specific measurement raise doubts in this finding. Conclusion: Mixed dentition bone grafting does not affect subsequent vertical and A-P development of the maxilla in complete unilateral cleft lip and palate patients during the first several postoperative years.