The Optimal Timing of Secondary Alveolar Bone Grafting: A Literature Review

Publication date: Available online 26 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Artur Fahradyan, Michaela Tsuha, Erik M. Wolfswinkel, Kerry-Ann S. Mitchell, Jeffrey A. Hammoudeh, William Magee

Abstract

Background

Secondary alveolar bone grafting (SABG) during mixed dentition is the standard of care for alveolar clefts. However, early SABG at the age of 4-7 years before the eruption of lateral incisors versus late SABG at the age of 8-12 years before the eruption of maxillary permanent canines is still debated.

The purpose of this study is to perform a systematic review of the literature to evaluate the outcomes of early SABG in terms of residual bone volume or degree of bone resorption, maxillary canine movement or impaction rate, complications, aesthetic outcomes, and compare outcomes of early versus late SABG.

Methods

A comprehensive search of the PubMed database was performed following PRISMA guidelines. Keywords for alveolar cleft repair and inclusion criteria were used to screen articles for final review.

Results

The initial search yielded 6278 articles of which four retrospective and four prospective studies were chosen for final review. From these, seven studies compared outcome variables between early and late SABG while another looked at bone formation of patients who only underwent early SABG. In terms of outcome variables, three articles assessed bone volume with radiographic evaluation, two estimated maxillary permanent canine impaction rate, one evaluated surgical complications, operative time and length of hospital stay and the last looked at anterior incisor crown length. Overall, six studies concluded that early SABG provides a better outcome than late SABG and two found comparable results across the aforementioned variables.

Conclusion

This review suggests that the existing data may support the concept of early SABG, however, it is not sufficient for a definitive conclusion. A well-planned prospective study is needed to further investigate the rationale for early SABG.

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