To assess differences in root development between the cleft side (CS) and noncleft side (NCS) for permanent maxillary central incisor and canine longitudinally in patients with nonsyndromic complete unilateral cleft lip and palate (cUCLP) who received secondary alveolar bone grafting (SABG) and to evaluate the effects of SABG on the acceleration of root development of these teeth.
Permanent maxillary central incisors and canines of 44 subjects with nonsyndromic cUCLP who had all their cleft-related surgeries performed by the same surgeon were analyzed retrospectively from chart notes and radiographs. Panoramic and periapical radiographs at time point 1 (T1) (age, 7.55 years), at SABG (time point 2 [T2], 10.13 years), and a minimum of 2 years after SABG were studied. Root development rating scores on the NCS and CS were compared using paired t-tests and analyses of proportions.
Mean root development score differences (NCS − CS) for canines and central incisors were greatest at T2 but diminished at time point 3 (T3). A larger proportion of teeth on the CS trailed the teeth on the NCS by at least 1 point at T2 than at T1 or T3, with the smallest proportion being observed at T3. The change in root development scores from T1 to T2 and from T2 to T3 showed relative CS acceleration from T2 to T3, indicating a catch-up of root development of cleft-adjacent teeth after SABG.
Root development of cleft-adjacent central incisors and canines is slow in comparison with their noncleft analogs. Root development of these teeth accelerates following SABG.
Author notes
The first two authors contributed equally to this work.
Staff Orthodontist, Holland Bloorview Kids Rehabilitation Hospital; and Instructor, Orthodontics, Faculty of Dentistry, University of Toronto, Toronto, Canada.
Professor and Director, Graduate Orthodontics, Faculty of Dentistry, University of Toronto; and Staff Orthodontist, Department of Dentistry, The Hospital for Sick Children, Toronto, Canada.
Medical Director, Cleft Lip and Palate Program, The Hospital for Sick Children, Toronto; and Professor, Department of Surgery, University of Toronto, Toronto, Canada.
Director of Orthodontics, Department of Dentistry, The Hospital for Sick Children, Toronto, Canada.
Associate Professor Emeritus, Faculty of Dentistry, University of Toronto, Toronto, Canada.
Professor and Head, Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Parts of this research were presented at the 123rd Annual Session of the American Association of Orthodontists, Chicago, IL, April 2023.