Eruption path of permanent maxillary canines after secondary alveolar bone graft in patients with nonsyndromic complete unilateral cleft lip and palate

Abstract

Introduction: Successful eruption of the maxillary canine after secondary alveolar bone grafting (SABG) improves dentoalveolar outcomes in the final occlusal rehabilitation of patients with cleft lip and palate (CLP). We aimed to study eruptive positions of the maxillary canine in CLP post-SABG.

Methods: This retrospective longitudinal study included 27 patients with complete unilateral CLP who received standardized SABG from the same surgeon. Rigorous selection criteria enabled a relatively homogeneous sample. Using panoramic radiographs, angulation, horizontal and vertical positions of the maxillary canines were recorded 3 times. Linear proportions along with sectorial methods were used. Linear regression and t tests were performed to assess and compare the position of the canine on the cleft side (CS) and noncleft side from pre-SABG (T1) to a minimum 2 years post-SABG (T3); to evaluate its displacement and identify predictors for its impaction, and to analyze the characteristics of the impacted canines vs the nonimpacted canines at T3.

Results: The CS maxillary canine was more acutely angulated and more apically positioned than the noncleft side canine at all times. It was relatively more distally positioned at T1 and exhibited significantly greater mesial movement from T1 to T3 (P <0.0001). Canine impaction on the CS was associated with a more apical position at 1-year post-SABG (P = 0.022) and a more acute angulation of this tooth.

Conclusion: More acute angulation and more apical position of the CS maxillary canine before SABG may be associated with an increased risk of its impaction after SABG.