ORIGINAL ARTICLE DOI: 10.1111/j.1601-6343.2011.01507.x Early alveolar bone grafting has a negative effect on maxillary dental arch dimensions of pre-school children with complete unilateral cleft lip and palate P Fudalej J Janiszewska-Olszowska B Wedrychowska-Szulc C Katsaros Authors' affiliations: Piotr Fudalej, Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands Piotr Fudalej, Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland Piotr Fudalej, Department of Orthodontics, Palacky University, Olomouc, Czech Republic Joanna Janiszewska-Olszowska, Department of Orthodontics, Pomeranian Medical University, Szczecin, Poland Barbara Wedrychowska-Szulc, Private practice, Szczecin, Poland Christos Katsaros, Department of Orthodontics, University of Bern, Bern, Switzerland Correspondence to: Piotr Fudalej Department of Orthodontics and Craniofacial Biology Radboud University Nijmegen Medical Centre PO Box 9101, 6500 HB Nijmegen the Netherlands E-mail: orthodontics@dent.umcn.nl Structured Abstract Authors – Fudalej P, Janiszewska-Olszowska J, Wedrychowska-Szulc B, Katsaros C. Objective – To evaluate maxillary dental arch dimensions in pre-school children with a complete unilateral cleft lip and palate (CUCLP) after early alveolar bone grafting. Material and Methods – Intercanine and intermolar widths, length of dental arch and mesiopalatal inclination of both maxillary segments were measured directly on the dental casts of 42 children (27 boys and 15 girls; mean age = 5.2 years, SD 0.5; Early-grafted group), 30 children (18 boys and 12 girls; mean age = 5.8 years, SD 0.8; Non-grafted group), and 40 children (25 boys and 15 girls, mean age = 5.8, SD 0.4; non-cleft Control group). Children from Early-grafted and Non-grafted groups had a CUCLP repaired with a one-stage closure of the entire cleft. An alveolar bone grafting was performed in the Early-grafted group between 2 and 4 years (mean = 2.4, SD 0.6). A one-way ANOVA model with post hoc TukeyÕs multiple comparison procedures were used to identify intergroup differences. Results – The mesiopalatal inclination of the lesser segment in the Early-grafted group was decreased in comparison with the Non-grafted and Control groups. The intercanine width had a tendency to be reduced in the Early-grafted group relative to Non-grafted group. Conclusions – Early bone grafting results in a larger collapse of the lesser segment than bone grafting carried out between 9 and 12 years of age. Key words: alveolar bone graft; cleft palate; dental arch; early bone grafting; maxilla; surgery; treatment outcome; unilateral cleft lip and palate Introduction Alveolar bone grafting (ABG) has long been recognized as an important element of treatment of cleft lip and palate. Its aim is to provide support for cleft-adjacent teeth, to stabilize the maxillary segments, to eliminate the notched alveolar ridge, to support the alar bases, and to enable expansion of the interpremaxillary suture (1). Initially, ABG was performed at or around the time of lip repair (2). Increasing evidence that bone grafting performed at this age (so called, primary bone grafting) causes maxillofacial growth derangement (3, 4) resulted in a reduction in the number of cleft centers using primary ABG. Dates: Accepted 15 January 2011 To cite this article: Fudalej P, Janiszewska-Olszowska J, Wedrychowska-Szulc B, Katsaros C: Early alveolar bone grafting has a negative effect on maxillary dental arch dimensions of pre-school children with complete unilateral cleft lip and palate Orthod Craniofac Res 2011;14:51–57 Ó 2011 John Wiley & Sons A ⁄ S