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 Table of Contents  
LETTER TO THE EDITOR
Year : 2018  |  Volume : 5  |  Issue : 2  |  Page : 128-129

Three-dimensional assessment of alveolar bone thickness in individuals with nonsyndromic unilateral cleft lip and palate


Department of Orthodontics, Manipal College of Dental Science, Manipal Academy of Higher Education, Manipal, Karnataka, India

Date of Web Publication26-Jul-2018

Correspondence Address:
Dr. Madhumitha Natarajan
Room 7, Second Floor, Dental OPD, Manipal College of Dental Science, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jclpca.jclpca_14_18

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How to cite this article:
Natarajan M. Three-dimensional assessment of alveolar bone thickness in individuals with nonsyndromic unilateral cleft lip and palate. J Cleft Lip Palate Craniofac Anomal 2018;5:128-9

How to cite this URL:
Natarajan M. Three-dimensional assessment of alveolar bone thickness in individuals with nonsyndromic unilateral cleft lip and palate. J Cleft Lip Palate Craniofac Anomal [serial online] 2018 [cited 2019 May 24];5:128-9. Available from: http://www.jclpca.org/text.asp?2018/5/2/128/237633



Sir,

Alveolar bone loss in ungrafted cleft region of unilateral cleft patients has researched using various radiographic methods. Bragger et al. reported that radiographic alveolar bone loss was greater at a cleft site compared with controls, due to the presence of a long supracrestal connective tissue attachment.[1] Teja et al. evaluated the periodontal conditions and bone levels using parallel periapical radiographs and showed reduced bone levels on both the mesial and distal surfaces of central teeth adjacent to the cleft, compared with contralateral control teeth.[2] Quirynen et al. evaluated the periodontal health status and showed that bone loss was significantly higher for teeth on the cleft side compared with the contralateral noncleft control teeth.[3]

Very few studies have researched bone loss using cone-beam computed tomography (CBCT) in untreated unilateral cleft patients, and I commend authors for their effort. However, Ercan et al. found that the thickness of the buccal bone level at the central incisor at the crest and 2 mm apically was thinner at the cleft region compared to noncleft teeth.[4] Buyuk et al. found dehiscences at the 43.2% of maxillary central incisors, 70.6% of lateral incisors, and 34.1% of canines teeth on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side.[5] Pan et al. found the alveolar bone thickness was decreased on the cleft side, greater CEJ-Alveolar crest distances in cleft-adjacent to U1, with more bone height reduction observed labially and distally.[6]

The results of the present study could have been correlated to the periodontal health of 16 untreated patients. In addition, the authors could have compared the alveolar bone thickness before and after grafting using CBCT. According to Gargiulo et al., the distance of the interdental bone from the cementoenamel junction is 1.0 mm and increased 2.8 mm with age.[7] As the average age of sample subjects chosen was 14.93 years, the authors could have chosen measurements at 1.0 mm distance from the cementoenamel junction instead of 3 mm, 6 mm, and 1 mm below apex, respectively.

Future research could be focused on the volume of the alveolar defect and correlated to age or cleft location or cleft type (unilateral and bilateral cleft palate or complete and incomplete cleft palate).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Brägger U, Nyman S, Lang NP, von Wyttenbach T, Salvi G, Schürch E Jr., et al. The significance of alveolar bone in periodontal disease. A long-term observation in patients with cleft lip, alveolus and palate. J Clin Periodontol 1990;17:379-84.  Back to cited text no. 1
    
2.
Teja Z, Persson R, Omnell ML. Periodontal status of teeth adjacent to nongrafted unilateral alveolar clefts. Cleft Palate Craniofac J 1992;29:357-62.  Back to cited text no. 2
    
3.
Quirynen M, Dewinter G, Avontroodt P, Heidbüchel K, Verdonck A, Carels C, et al. A split-mouth study on periodontal and microbial parameters in children with complete unilateral cleft lip and palate. J Clin Periodontol 2003;30:49-56.  Back to cited text no. 3
    
4.
Ercan E, Celikoglu M, Buyuk SK, Sekerci AE. Assessment of the alveolar bone support of patients with unilateral cleft lip and palate: A cone-beam computed tomography study. Angle Orthod 2015;85:1003-8.  Back to cited text no. 4
    
5.
Buyuk SK, Ercan E, Celikoglu M, Sekerci AE, Hatipoglu M. Evaluation of dehiscence and fenestration in adolescent patients affected by unilateral cleft lip and palate: A retrospective cone beam computed tomography study. Angle Orthod 2016;86:431-6.  Back to cited text no. 5
    
6.
Pan Y, Zeng Y, Zhang Z, Liu Y, Jing Y, Xiao L, et al. Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography. Angle Orthod 2018;88:299-305.  Back to cited text no. 6
    
7.
Gargiulo AW, Wentz FM, Orban B. Dimensions and relations of the dentogingival junction in humans. J Periodontol 1961;32:261-7.  Back to cited text no. 7
    




 

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