Abstract: Objective: To analyze the impact of preoperative cleft management measures on the outcomes of alveolar cleft bone grafting in adolescents. Methods: A retrospective analysis was conducted on 110 patients with unilateral complete alveolar cleft who underwent cancellous iliac bone grafting at the Affiliated Stomatology Hospital of Nanchang University. The patients were divided into four groups based on the cleft management measures adopted: preoperative orthodontics group, preoperative extraction group, intraoperative extraction group, and no intervention group. Cone-beam computed tomography (CBCT) was collected both preoperatively and at least 3 months postoperatively. The postoperative osteogenesis outcomes were evaluated using the Padwa three-dimensional assessment scale, and the postoperative wound dehiscence rate and infection rate were compared among the groups. Results: The clinical success rates of the preoperative orthodontics group, preoperative extraction group, intraoperative extraction group, and no intervention group were 97.2%, 86.4%, 90.5%, and 90.3%, respectively. There was no statistically significant difference among the four groups (P=0.438). The intraoperative extraction group had higher postoperative wound dehiscence rate (P=0.237) and infection rate (P=0.482) compared with the other three groups. Only 36.8% of the cases in this group achieved Class Ⅰ surgical outcomes, which was lower than that of the other three groups (P=0.303). Conclusion: Preoperative orthodontics and preoperative extraction are effective cleft management measures for alveolar cleft bone grafting in adolescents. Performing extraction during the bone grafting surgery may have a negative impact on the clinical outcomes.

Key words: preoperative cleft management, alveolar cleft, iliac cancellous bone, cone-beam computed tomography