aizawa takako

In recent years, some reports on postoperative computed tomography evaluations of secondary bone grafting into the alveolar cleft have been published. Here, we report a retrospective study on the prognostic factors of bone bridge formation after secondary bone grafting into the alveolar cleft, evaluated with computed tomography.<br>In 13 cases, we evaluated the bone bridge formations at a total of 9 points: each of the 3 points of the buccal, central, and palatal sites in 3 different height slices of the central incisor in the cleft side (root tip, middle, and alveolar crest).<br>The frequencies of bone bridge formations were as follows: all cases in middle/buccal, 9 (69.2%) in middle/central, 8 (61.5%) each in root tip/buccal and alveolar crest/central, 6 (46.2%) in alveolar crest/buccal, 5 (38.5%) in middle/palatal, 4 (30.8%) in alveolar crest/palatal, and 3 (23.1%) each in root tip/central and root tip/palatal. Moreover, a univariate logistic regression analysis clearly showed that the preoperative width of the alveolar cleft could be a predictive factor of postoperative bone bridge formation in the central and palatal regions at the middle height of the tooth root.

In our center, oral surgeons discuss presurgical orthodontic treatments and the preferable timing for alveolar bone grafting (BG) with orthodontic dentists.<br>We evaluated the results of BG retrospectively.<br>Objects and methods: Among cases given BG in 2007-2010, we focused on 27 unilateral cleft lip alveolar (UCLA) cases and 58 unilateral cleft lip alveolar and palate (UCLP) cases, and investigated the gender distribution, age at surgery, cleft width, presence and eruption of lateral incisors in the cleft side, eruption and root formation of canines in the cleft and non-cleft sides at surgery, weight of transplanted bone, and marginal bone level obtained, and compared them between the UCLA and UCLP groups.<br>Results: 1. There were 13 males and 14 females with UCLA, and 35 males and 23 females with UCLP. Age at surgery was 118.4+/-20.5 (92-171) months in the UCLA group, and 119.1+/-14.7 (89-168) months in the UCLP group. There was no significant difference in gender distribution or age at surgery between both groups.<br>2. Cleft width (at alveolar crest and nasal floor) was 5.7+/-2.3 and 12.1+/-4.5mm in the UCLA group, and 7.3+/-2.7 and 14.6+/-3.9mm in the UCLP group. Weight of transplanted bone was 2.1+/-1.0g in the UCLA group, and 2.5+/-1.0g in the UCLP group. Thus, there were significant differences between both groups (<i>p</i> < 0.05).<br>3. At surgery, canines erupted in 8 UCLA and 5 UCLP cases in the cleft side. There was a significant difference between both groups (<i>p</i> < 0.05).<br>4. Canine root formation was more than half full in 14 UCLA and 11 UCLP cases in the cleft side, in 13 UCLA and 12 UCLP cases in the non-cleft side. Canine root formation was significantly faster in the UCLA group than the UCLP group in both sides (<i>p</i> < 0.05). <br>5. For the evaluation of marginal bone level, Enemark's level of more than 2 was obtained in 96.3% of UCLA and 98.3% of UCLP cases. There was no significant difference between both groups. <br>Conclusion: In this study, significant differences were detected in cleft width, weight of transplanted bone, eruption of canines in the cleft side, and root formation of canines in the cleft and non-cleft sides at surgery between both groups, but marginal bone formation was excellent in both groups.

The Cleft Lip and Palate Centre of Fujita Health University Hospital was started in 1992, and it has been treating congenital anomalies of the jaw and face including cleft lip and palate.<br>A long period, various knowledge and good techniques are required for treating cleft lip and palate. With the team approach, it is important how the team is managed and operated. The styles of the medical treatment team can be considered as follows: (a) relay system, (b) conductor system, (c) coordinator system, (d) assembly system, etc.<br>The Fujita Health University Hospital Cleft Lip and Palate Centre currently uses (c) the coordinator system. More than 1600 patients have been treated so far. In future, it is necessary to create a more exact and efficient team system.