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Doucet K, Shaheen E, Danneels M, Dormaar T, Verdonck A, Willems G, Politis C, Jacobs R, Cadenas de Llano-Pérula M. Three-dimensional evaluation of secondary alveolar bone grafting in patients with unilateral cleft lip and palate: A 2-3 year post-operative follow-up. Orthod Craniofac Res 2024; 27 Suppl 1:100-108. [PMID: 38299981 DOI: 10.1111/ocr.12763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES The present study aims to quantitatively assess secondary alveolar bone graft (SABG) resorption in unilateral cleft lip, alveolus and palate (UCLAP) patients in a 2-3 year longitudinal follow-up setting by using a validated 3D protocol. Furthermore, the potential relation of SABG resorption with maxillary canine position and a number of patient-related factors was investigated. METHODS UCLAP patients who underwent SABG and had good quality CBCT images at the following timepoints were included in the study: pre-operative (T0), immediate (T1), 6 months (T2) and either 1-2 years (T3) or 2-3 years (T4) post-operative. The final bone grafted region was defined on the T1 scans and refined in the registered T0 scans. The bone graft after resorption was determined by applying threshold-based segmentation on the registered T2, T3 or T4 scans within the segmented bone graft volume. The position of the canines was determined at every timepoint at the cleft and non-cleft side. RESULTS Forty-five UCLAP patients (mean age 9.0 ± 1.3 years) were included. In the first 6 months after SABG, 43.6% bone resorption was recorded. 2-3 years post-operative, 56% bone resorption was found if the maxillary canine was not yet erupted and 42.7% if it erupted through the graft. The vertical position of the canines was significantly higher on the cleft side at T3. CONCLUSIONS The present study reports significant SABG resorption over time. However, no correlation was found between SABG resorption and canine position, nor between other patient-related factors.
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Affiliation(s)
- Kaat Doucet
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Margaux Danneels
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Titiaan Dormaar
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Weismann C, Lehmann M, Aretxabaleta M, Koos B, Schulz MC. Maxillary canine position of patients with non-syndromic craniofacial disorder: a retrospective evaluation of panoramic radiographs. Head Face Med 2023; 19:44. [PMID: 37814280 PMCID: PMC10561517 DOI: 10.1186/s13005-023-00390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/29/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The study evaluates the position and displacement tendency of unerupted maxillary canines in orthodontic patients with non-syndromic craniofacial disorders (CD) compared to a control (C) group. METHODS Canine position and displacement tendency were evaluated using panoramic radiographs (PAN) examined with parameters such as sector classification (sectors 1-5) and inclination angles (α and β). The displacement tendency was defined as the positioning of the tip in sectors 1 or 2, as well as its combination with increased angles (α > 30° and β > 39°). In addition, the correlation of the tooth position and agenesis, cleft side, and sex was assessed. RESULTS A total of 116 pre-treatment PAN, divided into the CD group (n = 50; mean age 8.32 ± 2.27 years) and the C group (n = 66; mean age 10.80 ± 2.82 years), were evaluated in this study. The sector classification showed no displacement tendency in both groups. Inclination angles α/β showed a statistically significant higher displacement tendency (p = 0.01) of the CD group (n = 5) on the right side, compared to healthy subjects (n = 1). Male CD patients had a statistically significant higher displacement tendency on the right side (p = 0.03). A statistically significant correlation between cleft and non-cleft-side (p = 0.03) was found. CONCLUSION Patients with CD showed a statistically significant higher displacement tendency of the maxillary canine affected by the cleft side. The inclination angle was found to be the better predictor compared to the sector classification which should be considered in the orthodontic treatment planning.
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Affiliation(s)
- C. Weismann
- Department of Orthodontics, University Hospital Tübingen, Osianderstr, 2-8, 72076 Tübingen, Germany
| | - M. Lehmann
- Department of Orthodontics, University Hospital Tübingen, Osianderstr, 2-8, 72076 Tübingen, Germany
| | - M. Aretxabaleta
- Department of Orthodontics, University Hospital Tübingen, Osianderstr, 2-8, 72076 Tübingen, Germany
| | - B. Koos
- Department of Orthodontics, University Hospital Tübingen, Osianderstr, 2-8, 72076 Tübingen, Germany
| | - M. C. Schulz
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Osianderstr, 2-8, 72076 Tübingen, Germany
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Kumar N, Daigavane P. Kumar and Daigavane's Impacted Maxillary Canine Grading System: A New Classification System For Treatment of Cleft Lip and Palate. Cureus 2022; 14:e29586. [DOI: 10.7759/cureus.29586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/25/2022] [Indexed: 11/05/2022] Open
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Hong H, Yang IH, Choi JY, Lee JH, Chung JH, Kim S, Baek SH. Does absence of maxillary lateral incisor affect the status of maxillary canine before and after secondary alveolar bone grafting in patients with unilateral alveolar cleft? Angle Orthod 2022; 92:683-690. [PMCID: PMC9374357 DOI: 10.2319/102221-788.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/01/2022] [Indexed: 07/29/2023] Open
Abstract
Objectives To investigate whether absence of maxillary lateral incisor (MXLI) would affect the status of maxillary canine (MXC) before and after secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP). Materials and Methods 47 male patients with UCLA and UCLP, whose Bergland indices were type I or II after SABG, were divided into the MXLI-absence (n = 26) and MXLI-presence groups (n = 21). Using panoramic radiographs, the position, angulation, and development status of MXC on the cleft side, and the cleft width before SABG (T1) were evaluated. After full eruption of the permanent dentition (T2), the root length, root shape, and frequency of forced eruption of MXC on the cleft side were investigated. Then, statistical analysis was performed. Results Compared to the MXLI-presence group, the MXLI-absence group showed higher frequencies of mesial angulation of MXC at T1 (criteria: >25°; 46.2% vs 14.3%, P < .05) and dilaceration of MXC at T2 (26.9% vs 4.8%, P < .001). MXC on the cleft side showed positive correlations between horizontal position at T1 and forced eruption at T2, and between vertical position and mesial angulation at T1 and dilaceration at T2 (all P < .01). Conclusions In patients with UCLA and UCLP whose SABG outcome was successful, absence of MXLI on the cleft side increased only the frequencies of mesial angulation of MXC at T1 and dilaceration of MXC at T2, not frequency of forced eruption at T2.
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Caceres Manfio AS, Suri S, Dupuis A, Stevens K. Eruption path of permanent maxillary canines after secondary alveolar bone graft in patients with nonsyndromic complete unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop 2022; 161:e416-e428. [DOI: 10.1016/j.ajodo.2021.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/01/2022]
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Antonarakis GS, Ghislanzoni LH, Fisher DM. Sella Turcica Bridging and Tooth Agenesis in Children With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 58:1382-1388. [PMID: 33375837 DOI: 10.1177/1055665620984649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIM To investigate differences in sella turcica size and bridging in children with unilateral cleft lip and palate (UCLP) with or without concomitant dental anomalies. PATIENTS AND METHODS A cross-sectional study was carried out looking at 56 children with nonsyndromic UCLP. Lateral cephalograms, taken before alveolar bone grafting, were used to assess sella turcica height, width, area, and bridging. Panoramic radiographs were used to evaluate the presence of dental anomalies in the cleft area including agenesis, supernumerary, and peg-shaped lateral incisors. Differences between sella turcica measurements in the presence or absence of dental anomalies were assessed using t tests. Differences between the prevalence of dental anomalies and sella turcica bridging were assessed using χ2 and Fisher exact tests. Multinomial logistic regression was used to investigate potential associations between sella measurements and dental anomalies. RESULTS Twenty-six of the 56 children presented with agenesis of the cleft-side lateral incisor, while 7 had a supernumerary, and 19 had a peg-shaped lateral incisor. With regard to sella turcica bridging, 27 children had no calcification, 25 partial and 4 complete calcification. Children with agenesis of the cleft-side lateral incisor showed a shorter sella maximum height (P = .010) and a smaller area (P = .019). When looking at sella turcica bridging, 100% of children with complete calcification showed agenesis of the cleft-side lateral incisor, compared with 52% and 33% of children with partial calcification and no calcification, respectively (P = .034). CONCLUSIONS Children with UCLP and sella turcica bridging are more likely to present with agenesis of the cleft-side maxillary lateral incisor.
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Affiliation(s)
- Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Luis Huanca Ghislanzoni
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - David M Fisher
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Vandersluis YR, Fisher DM, Stevens K, Tompson BD, Lou W, Suri S. Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine. Am J Orthod Dentofacial Orthop 2020; 157:668-679. [PMID: 32354440 DOI: 10.1016/j.ajodo.2019.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION For patients with complete unilateral cleft lip and palate (CUCLP), secondary alveolar bone grafting (SABG) can be performed before or after the emergence of the cleft side permanent canine (pre-CE and post-CE, respectively). The controversy regarding dental outcomes related to the timing of SABG remains unsettled. The objective of this study was to evaluate dental survival and specific dental outcomes of cleft-adjacent teeth in children with CUCLP who received either pre-CE or post-CE SABG. METHODS The permanent maxillary canines and the central and lateral incisors of 21 pre-CE and 23 post-CE SABG subjects with nonsyndromic CUCLP and all cleft-related surgeries performed by the same surgeon were analyzed retrospectively. Intraoral radiographs and clinical chart notes were collected at age 7 years, at the time of the SABG, and approximately 4 years after the grafting. Dental survival, spontaneous canine eruption, planned prosthetic replacement, root development, and root resorption were analyzed. RESULTS Dental outcomes on the noncleft side were better than those on the cleft side. On the cleft side, dental survival of the cleft-adjacent teeth was not significantly different between the pre-CE and post-CE SABG groups (P >0.05). Most teeth completed root development after grafting, and the cleft side canine root development in the pre-CE SABG group appeared to accelerate after SABG. Trends showed that the pre-CE SABG group suffered less root resorption (16.28%; post-CE: 22.73%; P >0.05) and received fewer planned prosthetic replacements (14.29%; post-CE: 26.01%; P >0.05) but required a greater number of canine exposures (33.33%; post-CE: 4.55%; P = 0.02). CONCLUSIONS Pre-CE SABG showed better dental outcomes in patients with CUCLP, with fewer adverse dental outcomes than post-CE SABG.
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Affiliation(s)
| | - David M Fisher
- Department of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Kyle Stevens
- Department of Dentistry, Division of Orthodontics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bryan D Tompson
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Division of Orthodontics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sunjay Suri
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Division of Orthodontics, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Rizell S, Alhakim Z, Mark H, Naoumova J. Predictive factors for canine position in patients with unilateral cleft lip and palate. Eur J Orthod 2020; 43:367-373. [PMID: 32459854 DOI: 10.1093/ejo/cjaa034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The aims were to compare cleft and non-cleft canine position, to find predictive factors for canine position and to assess surgically exposed canines. MATERIALS/METHODS One hundred forty-eight individuals, born 1978-2005, with total unilateral cleft lip and palate (including Simonart's band <5 mm) treated in Gothenburg, were included. Canine angulation as well as vertical and horizontal position were assessed on panoramic radiographs (PAN) taken at the age of 10. Plausible predictive factors were registered from PAN, cast models and medical records. Data on spontaneous eruption or surgical exposure were available for 88 patients. Cleft- and non-cleft side was compared using paired t-test and Fisher's exact test. Multiple stepwise regression analysis and logistic regression analysis were used to detect possible predictors for cleft canine position. RESULTS The cleft canine angulation was 29.3 ± 13.1 degrees (mean ± standard deviation) versus 7.6 ± 8.2 degrees on the non-cleft side (p < 0.001). Cleft canines were higher positioned and located closer to the midline compared to non-cleft canines (p < 0.001). Age for both hard palate closure and bone grafting, cleft lateral agenesis as well as transposition were associated with canine position. Cleft canines that required surgical exposure (28%) had an increased angulation and were higher positioned than spontaneously erupted canines (p < 0.001). LIMITATIONS The shortcomings were the retrospective design and incomplete assessment of the buccal-palatal canine position on 2D images. CONCLUSIONS/IMPLICATIONS With increased age for bone grafting, decreased age for hard palate closure and transposition, an association with abnormal canine position was found. A rigorous monitoring of cleft canine eruption is, therefore, advocated.
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Affiliation(s)
- Sara Rizell
- Clinic of Orthodontics, Public Dental Service, Region Västra Götaland, Gothenburg
| | - Zahra Alhakim
- Clinic of Orthodontics, Public Dental Service, Region Västra Götaland, Gothenburg
| | - Hans Mark
- Department of Plastic Surgery, Sahlgrenska University Hospital and Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Julia Naoumova
- Clinic of Orthodontics, Public Dental Service, Region Västra Götaland, Gothenburg
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A review of emerging bone tissue engineering via PEG conjugated biodegradable amphiphilic copolymers. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 97:1021-1035. [PMID: 30678893 DOI: 10.1016/j.msec.2019.01.057] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/26/2018] [Accepted: 01/12/2019] [Indexed: 01/19/2023]
Abstract
Defects in bones can be caused by a plethora of reasons, such as trauma or illness, and in many cases, it poses challenges to the current treatment approaches for bone repair. With increasing demand of bone bioengineering in tissue transplant, there is a need to source for sustainable solutions to induce bone regeneration. Polymeric biomaterials have been identified as a promising approach due to its excellent biocompatibility and controllable biodegradability. Specifically, poly(ethylene glycol) (PEG) is one of the most commonly investigated polymer for use in bio-related application due to its bioinertness and versatility. Furthermore, the hydrophilic nature enables it to be incorporated with hydrophobic but biodegradable polymers like, polylactide (PLA) and polycaprolactone (PCL), to create an amphiphilic polymer. This article reviews the recent synthetic strategies available for the construction of PEG conjugated polymeric system, analysis of PEG influence on the material properties, and provides an overview of its application in bone engineering.
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