Postoperative Evaluation of Grafted Bone in Alveolar Cleft Using Three-Dimensional Computed Tomography Data

Objective: Postoperative evaluation of bone formation in the alveolar cleft by computed tomography imaging has been reported. We quantitatively evaluated bone grafts in the alveolar cleft preoperatively and postoperatively using three-dimensional data and superimposition of images. Subjects: A total of 12 patients with complete unilateral cleft lip and palate (six left-sided and six right-sided) were studied. Methods: Helical computed tomography scans were taken immediately before surgery and at 6 months after surgery and the DICOM files obtained were processed using Mimics and 3-matic software for three-dimensional data analysis. The preoperative and postoperative computed tomography data were superimposed, and the position and length of the unerupted canines and width of the alveolar cleft measured. Results: Strong and significant correlations were observed between bone formation in the alveolar cleft bone graft region and preoperative canine position (r = -.766, p < .01) and canine length (r = .681, p < .05). Stepwise multiple regression analysis demonstrated that only the preoperative canine position was independently and significantly correlated with bone formation in the alveolar cleft. Conclusion: These results indicate that the optimal timing for surgery is when the canine cusp is close to the alveolar plane.