Radiographic assessment of secondary autogenous alveolar bone grafting in cleft lip and palate patients

The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
J KindelanM R Bromige

Abstract

To assess if a 4-point, radiographically based scale could be used between operators to reliably assess the success of secondary alveolar bone grafting. The study was retrospective with the clinicians blind to patient identity. Radiographs were examined twice by two clinicians with 1 week between assessments. The research was carried out in a hospital-based orthodontic/oral and maxillofacial unit. All patients who had secondary alveolar bone grafting in this unit between February 1992 and March 1995 were included in this study. There were 38 patients with a total of 48 grafted sites. The bone graft site was radiographed following orthodontic expansion prior to grafting. The radiograph was repeated postoperatively at a mean of 4 months after surgery. The degree of bony fill in the cleft area was assessed using a 4-point scale: Grade 1 > 75% bony fill; Grade 2 50-75% bony fill; Grade 3 < 50% bony fill; Grade 4 no complete bony bridge. Overall, 50% of grafts achieved grade 1, 23% were grade 2, 22% grade 3, and 5% grade 4. Levels of intra- and inter-observer agreement were highly variable (.33 to .72 kappa statistic). The 4-point scale described could be used to assess the success of autogenous secondary alveolar bone grafting. It ...Continue Reading

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