Citation: Wiedel A-P, Svensson H, Hellén-Halme K, Ghaffari H and Becker M. Two-Dimensional Intra-Oral Radiographs Compared to Three-Dimensional CBCT at Six-Month Post-Operative Evaluation of Secondary Bone-Grafting in Patients with Cleft Lip and Palate. J Dent App. 2021; 7(1): 451-455. J Dent App - Volume 7 Issue 1 - 2021 ISSN : 2381-9049 | www.austinpublishinggroup.com Wiedel et al. © All rights are reserved Journal of Dental Applications Open Access Abstract Background: The aim of this study was to investigate whether a complementary Cone-Beam Computed Tomography (CBCT) in patients with Cleft Lip and Palate (CLP) after alveolar bone-grafting to clefts gave substantial additional information, and particularly whether such new information had any implications for the further care of the patients. Methods: Seventeen children, with complete CLP, 10 unilateral and seven bilateral clefts, in all 24 clefts, were evaluated six months after secondary alveolar bone-grafting with two-dimensional intra-oral radiographs complemented with CBCT. The mean age at bone-grafting was 8.8 years. Three different examiners evaluated the radiographic documentation. Results: The mean pre-operative cleft width was 5.8mm. In 15 of the 24 clefts the same interpretation was made on both two-dimensional radiographs and CBCT. In the remaining nine clefts, CBCT added important information to the treatment decision. Conclusions: For the evaluation six months post-operatively of the success of alveolar bone-grafting to clefts, the two-dimensional radiograph should be complemented with CBCT unless the two-dimensional radiograph without doubt reveals open residual cleft and clinical fndings indicate graft failure. Keywords: Alveolar cleft; Secondary bone-grafting; Orthodontic; Two- Dimensional radiographs; Three-dimensional radiographs; CBCT Introduction For alveolar crest repair in patients with clefs, Secondary Alveolar Bone-Grafing (SABG), which was frst described by Boyne and Sands in 1972, has become the golden standard and is one of the mandatory surgical procedures [1,2]. Alveolar bone-grafing closes oro-nasal residual clefs, stabilizes the maxillary arch, provides bone support for clef-adjacent teeth and facilitates orthodontic up righting of teeth [3]. To evaluate the result of alveolar bone-grafing radiographically, two-dimensional periapical or occlusal intra-oral radiographs are used widely [2,3]. One of the most common indexes for two-dimensional radiographs in assessing bone graf height is the Bergland index [2]. Lately the three-dimensional radiographs in the form of Cone-Beam Computed Tomography (CBCT) have become more widely used [4- 6]. Measurements using CBCT for evaluation of the results of alveolar clef repair afer alveolar bone-grafing have been suggested, namely the vertical height of the bone, the buccal-palatal thickness of the bone, and the nasal foor or nasal foor height diference [5,6]. Extensive bone resorption has been found in the buccal-palatal dimension of the alveolar portion of the transplant visible in CBCT analyses but is ofen underestimated in two-dimensional radiographs [7]. Research Article Two-Dimensional Intra-Oral Radiographs Compared to Three-Dimensional CBCT at Six-Month Post-Operative Evaluation of Secondary Bone-Grafting in Patients with Cleft Lip and Palate Wiedel A-P 1 *, Svensson H 2 , Hellén-Halme K 3 , Ghaffari H 4,5 and Becker M 2 1 Department of Oral and Maxillofacial Surgery, Skane University Hospital, Malmö, Sweden 2 Department of Plastic and Reconstructive Surgery, Skane University Hospital and Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden 3 Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden 4 Department of Plastic and Reconstructive Surgery, Skane University Hospital Malmö, Sweden 5 Department of Plastic Surgery, St George’s Hospital, London, Great Britain *Corresponding author: Anna-Paulina Wiedel, Department of Oral and Maxillofacial Surgery, Jan Waldenströmsgata 18, Skane University Hospital, Malmö, 20502, Sweden Received: April 30, 2021; Accepted: May 22, 2021; Published: May 29, 2021 Two-dimensional intra-oral radiographs have constituted the clinical routine for many years at our clef centre. However, we had a few patients in whom an evaluation also using CBCT was performed at the six-month post-operative evaluation. Te reason for the extended investigation with CBCT was the uncertainty in the evaluation of the intra-oral radiographs according to the healing process. Te aim of this study was therefore to investigate whether a complementary CBCT in these patients gave substantial additional information, and particularly whether such new information had any implications for the further care of the patients. A secondary aim was to evaluate other potential benefts of CBCT at this evaluation. Material and Methods Patients Altogether, 24 clefs in 17 children, (14 boys, three girls) with complete CLP and a mean age of 8.8 years (range 7.9 -10.5 years) at secondary alveolar bone-grafing surgery were eligible for evaluation at the CLP care-centre, Skane University Hospital in Malmo, Sweden. Ten clefs were unilateral CLP, with nine lef-sided and one right-sided. Seven clefs were bilateral CLP. Inclusion criteria was patients with CLP, bone grafed to the clef area and with both two- dimensional intra-oral radiograph and CBCT for evaluation of bone