In the assessment of patients for an alveolar bone graft, consideration has to be given to:
Size and shape of the alveolar defect
Alignment of the alveolar segments
Presence of fistulae
Need for dental extractions or other procedures
In the unilateral cleft, when the lesser segment is collapsed inwards, it is often desirable for that to be corrected and the segments aligned before alveolar bone grafting. This can usually be achieved by orthodontics.
2. Imaging and radiology
Assessment of the alveolar cleft defect is first and foremost clinical but is facilitated by radiographs. As a minimum an orthopantomogram (OPT) and a plane oblique occlusal radiograph of each cleft defect is required. When it is difficult to identify the teeth present and their position, cone beam CT (CBCT) is valuable.
Clefts of the lip and/or palate occur variably in different populations. In European Caucasians the incidence is approximately 1/600 live births. By contrast, the incidence in Japan is approximately 1/400 and in Africans and African Americans it is only 1/3000 live births.