Radiographic Evaluation of Secondary Alveolar Bone Grafting in Patients With Alveolar Cleft

Study Overview
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Brief Summary
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Study about the comparison of post-operative results of secondary alveolar grafts according to two age groups: early secondary (4 to 7 years) versus late secondary (8 to 11 years) using a recently proposed score based on post-operative 3D CT analysis. Comparison of the initial results of the graft in the two groups, with a reference 2D score and evaluation of the concordance between the results found with this score and those of the 3D score. Finally, comparison of graft bone densities and nasal floor level (using 3D visualization) on post-operative TDMs in the 2 groups. The aim of this study is to determine the optimal age for grafting using three-dimensional CT assessment.

Official Title
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3D Radiographic Evaluation of the Long Terms Results of Secondary Alveolar Bone Grafting in Patients With Alveolar Cleft: Comparison of Early Versus Late Secondary Grafting SABG : Secondary Alveolar Bone Grafting

Conditions
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Alveolar Cleft

Participation Criteria
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Eligibility Criteria
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Inclusion criteria: - Patients operated with an alveolar bone grafting for a single or bilateral labio-alveolar cleft in the pediatric plastic surgery department of the University Hospital of Montpellier between 1999 and 2021 and having had 3D imageries defined as: Group 1: o Patients operated with an early secondary alveolar grafting between the ages of 4 to 7 years with a 3D imaging (CT, CBCT or scan) performed between the ages of 8 to 11 years. Group 2: Patients operated with a late secondary alveolar graft between the ages of 8 to 11 years with a 3D imaging (CT, CBCT or scan) performed at least 1 year after the operation. Exclusion criteria: Patients operated with an alveolar bone grafting before 4 years or after 11 years Patients without post-operative CT

Ages Eligible for Study
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Minimum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1<br>Patients operated with an early secondary alveolar grafting between the ages of 4 to 7 years with a 3D imaging (CT, CBCT or scan) performed between the ages of 8 to 11 years. | |
| Group 2<br>Patients operated with a late secondary alveolar graft between the ages of 8 to 11 years with a 3D imaging (CT, CBCT or scan) performed at least 1 year after the operation. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kamperos's score | Kamperos's score (a post-operative tri-dimensional scanographic score) This score includes 3 items measured on the post-operative CT: graft bone thickness (0 to 2), bone graft height (0 to 4) and nasal floor height (0 to 4). A total score of 0 to 8 is considered a failure and 9 to 10 a success | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bergland's score | Bergland's score (a post-operative two-dimensional radiographic score) Post-operative two-dimensional radiographic score : Use of the Bergland score (reference score). This score evaluates the height of the inter-dental bone septum up to the cemento - enamel junction (1 to 4). | day 1 | 
| Post-operative average bone density of the grafted area in axial slice | Post-operative average bone density of the grafted area : in axial slice using radiological image processing software (Myrian®) to segment regions of interest. | day 1 | 
| Nasal floor level of the grafted side compared to the non grafted side using 3D visualization by volume rendering | Nasal floor level by analyzing the level of the piriform orifice in relation to the grafted area using 3D visualization by volume rendering: percentage of the height between the piriform orifice to the alveolar crest of the grafted side relative to the controlateral side (the healthy side considered as the reference 100% side). | day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Secondary alveolar bone grafting, 3D score, Navigation system, 3D-reconstruction, Bone loss