ALVEOLAR CLEFT BONE-GRAFTS - RESULTS AND IMPRECISIONS OF THE DENTAL RADIOGRAPH

Alveolar cleft bone grafts customarily have been evaluated by one-dime nsional dental radiographic measurements. Based on the dental radiogra ph, remarkable successes with just a single bone graft have been repor ted in the literature. At the Montreal Children's Hospital, the experi ence with 101 alveolar bone grafts in 62 cleft lip and palate patients was retrospectively reviewed to determine (1) the precision of dental radiographs at evaluating the clinical outcome, (2) the effect of den tal maturation on alveolar bone grafts, and (3) the effect of augmenta tion bone grafts. The dental radiograph significantly overestimated th e number of clefts that could be managed orthodontically (p < 0.01, Mc Nemar's test) and thus poorly prognosticated the ability to achieve bo ny obliteration of the alveolar cleft and orthodontic closure of the d ental gap. Bone grafts performed during the preeruptive canine dentiti on yielded significantly better results (p < 0.05, chi-squared test).W ith each subsequent augmentation bone-graft procedure performed, there existed a trend toward improved dental arch stability and radiographi c and clinical outcomes.