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Timing of Alveolar Bone Grafting Determines Different Outcomes in Patients With Unilateral Cleft Palate

Trindade-Suedam, Ivy Kiemle DDS, PhD*†; da Silva Filho, Omar Gabriel DDS, MS; Carvalho, Roberta Martinelli DDS, MS; de Souza Faco, Renato André DDS, MS; Calvo, Adriana Maria DDS, PhD; Ozawa, Terumi Okada DDS, PhD; Trindade, Alceu Sergio Jr DDS, PhD*†; Trindade, Inge Elly Kiemle MS, PhD*†

doi: 10.1097/SCS.0b013e3182519ab5
Original Articles

The objective of the current study was to assess the outcome of the alveolar bone grafting (ABG) in patients with cleft palate. Thirty-one patients with complete unilateral cleft lip and palate were prospectively divided into 2 groups according to the timing of surgery: (1) secondary ABG (SABG), undertaken during mixed dentition (n = 16); and (2) tertiary ABG (TABG), undertaken during permanent dentition (n = 15). Septum height was assessed using cone beam computed tomography in 3 views (buccal, intermediate, palatal) and classified according to the modified Bergland Index, which scores the results into 5 types according to the height of the neoformed bone septum (excellent: septum with a normal height; good: septum with minor deficiency; regular: marginal defect of >25% of the root length; bad: bone deficiency on the nasal aspect; and failure). In the SABG group, 6 to 12 months postoperatively, 75% of the patients were classified as having excellent/good conditions and 25% as having regular/bad conditions. No patients were observed as having failure conditions. In the TABG group, 53% of the patients were classified as having excellent/good, 21% were classified as having regular/bad conditions, and 26% were classified as having failure conditions. Significantly better outcomes were observed for the SABG group when compared with the TABG group. In conclusion, the age at which ABG is performed is a factor that impacts on the surgical outcome. Specifically, increasing age is associated with worse outcomes.

From the *Bauru School of Dentistry and †Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil.

Received December 14, 2011.

Accepted for publication February 21, 2012.

Address correspondence and reprint requests to Ivy Kiemle Trindade-Suedam, DDS, PhD, Rua Sílvio Marchione, 3-20, Bauru-SP, CEP 17012-900, Bauru, Brazil; E-mail address:

Financial support was provided by CAPES (PRODOC).

The authors report no conflicts of interest.

© 2012 Mutaz B. Habal, MD