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doi: 10.1597/06-054
The Cleft Palate-Craniofacial Journal: Vol. 44, No. 3, pp. 286–291.

Factors Influencing Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients: Prospective Analysis Using CT Image Analyzer
Tomomichi Ozawa, D.D.S., Ph.D.
Susumu Omura, D.D.S., Ph.D.
Eiji Fukuyama, D.D.S., Ph.D.
Yoshiro Matsui, D.D.S., Ph.D.
Katuyuki Torikai, M.D., Ph.D.
Kiyohide Fujita, D.D.S., Ph.D.

Dr. Ozawa is affiliated with the Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. Dr. Omura is affiliated with the Department of Oral and Maxillofacial Surgery and Orthodontics, Yokohama City University Medical Center, Yokohama, Japan. Dr. Fukuyama is affiliated with the Orthodontic Science Department of Orofacial Development and Function, Division of Oral Health Sciences Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. Dr. Matsui is affiliated with the Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. Dr. Torikai is Head of the Department of Plastic Surgery, Yokohama City University, Yokohama, Japan. Dr. Fujita is Head of the Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan

Submitted March 2006; Accepted June 2006.

Objective: To examine the effect of migration of the germ of the lateral incisor into the bone for eruption factors on bone bridge resorption.

Methods: Twenty-five subjects who underwent secondary alveolar bone graft were enrolled. The volume of the alveolar bone grafts immediately after the operation (V1), bone bridge formation 6 months postoperatively (V2), and tooth (teeth) migration into the bone bridge (Vt) were measured using a computed tomography (CT) image analyzer. Based upon these measurements, the following points were examined: (1) the correlation between the tooth-occupied ratio (Rt = Vt/V2 × 100) and the ratio of bone bridge resorption (Rv = (V1 − V2)/ V1 × 100); and (2) comparison of the tooth-occupied ratio (Rt) and the ratio of bone bridge resorption (Rv) between the groups with and without the germ of the lateral incisor.

Results: A significant negative correlation was found between Rv and Rt (p < .001). Comparison of Rv and Rt between the groups with and without a germ of the lateral incisor revealed that both indices were significantly higher in the former group than the latter one (p < .05).

Conclusion: In cleft lip and palate patients with a germ of the lateral incisor, it is beneficial to carry out secondary bone grafting to the alveolar cleft at the age of 5 to 7 years, preceding eruption of the canine, in order to form a good bone bridge that will facilitate eruption of the lateral incisor and subsequent normal dentition and occlusion.

KEY WORDS:bone bridge, cleft lip and palate, secondary alveolar bone grafting

© 2007, The American Cleft Palate-Craniofacial Association