The use of 2D radiographs for the assessment of effectiveness of secondary alveolar bone grafting in patients with cleft lip and palate. A literature review

Clefts of the lip and the palate (CLP) represent the most common craniofacial developmental defects. The CLP surgical treatment protocol involves an autogenous secondary alveolar bone grafting (SABG).

Aim
The aim of the study was to review the methods for the SABG assessment in CLP patients based on 2D radiographs and the assessment of the effectiveness of the foregoing surgical procedure based on those methods.

Material and methods
Papers, published in the years 1981-2018, regarding SABG assessment in CLP patients based on 2D radiographs were reviewed. Nineteen papers in which the material was closely associated with the study assumptions were qualified for the review.

Results
A major part of the papers under analysis use a single post-operative radiograph. The others are based on two or three radiographic projections. There are seven basic methods and three modified methods used for the assessment of SABG effectiveness. The SABG assessment methods based on 2D radiographs are similar to one another. The main criterion of surgery effectiveness is the position of the alveolar process edge within the cleft with relation to the tooth roots adjacent to the cleft. Said classification results differ in terms of the degree of complexity and the manner of presentation of the surgery outcomes. The Abyholm (Bergland) scale was the most commonly applied assessment method. As demonstrated in all the studies in which 2D radiographs were used, the SABG effectiveness varied from 71% to 95%.

Conclusions
1. The SABG assessment methods based on 2D radiographs are a useful manner of surgical procedure assessment. 2. The studies in which the SABG assessment methods based on 2D radiographs are used demonstrate a high effectiveness of the SABG procedure.