Evaluation of success of alveolar cleft bone graft performed at 5 years versus 10 years of age

Background and purposeAlthough alveolar cleft bone grafting is the most widely accepted approach, controversies remain on the operative timing.MethodsA consecutive retrospective series of 28 patients who received alveolar bone grafting was examined and divided into 2 groups depending on the age at the time of bone graft. Group A (14 patients) was operated at a mean age of 5.2 years [range, 4–7] and Group B (14 patients) at a mean age of 10 years [range, 8.5–13].All the children were assessed clinically and by Cone Beam Computed Tomography (CBCT) before bone grafting and 6 months post-operatively. Cleft and bone graft dimensions, volumes were assessed using Osirix v.3.9.2. Residual bone graft coefficient (Bone Graft Volume on 6-months Postoperative CBCT/Alveolar Cleft Volume) was calculated. Complications, tooth movement or dental agenesis were also reported.ResultsThe sample was uniform within both groups, considering cleft forms, pre-surgical fistula rate and cleft volume. Residual bone graft coefficient reached 63.3% in Group A and 46.2% in Group B (p = 0.012). Results of residual bone graft are also influenced by tooth eruption through the graft (p = 0.007 in Group A and p = 0.02 in Group B).ConclusionsThis 3D analysis highlighted higher success of alveolar bone grafts when children are operated earlier around 5 years.Level of evidenceTherapeutic study. Level III/retrospective comparative study.