To evaluate the outcome of secondary alveolar bone grafting (SABG) in patients with cleft lip and palate at 16 years of age and to identify predictors associated with surgical failure. This retrospective follow-up included 91 patients with 100 cleft palates treated with SABG at a mean age of 9.2 years. The possible predictors for surgical failure analyzed were sex, dental development stadium, type of cleft, side, tooth erupting into the graft, cortical boundary, presence of a lateral incisor, extraction, preoperative expansion, oral hygiene, retention device, and age. The outcome variable for surgical success was Bergland score I and II. Surgical outcome was analyzed at 16 years of age based on intraoral radiographs, according to the Bergland index. Statistical analyses included estimation of odds ratios for predictor variables. The post-SABG success rate was 91% (Bergland score I and II) with a mean follow-up of 7.2 years. Surgical failure was significantly associated with poor oral hygiene. This study revealed a high success rate (91%) at a mean of 7.2 years post-SABG. Poor oral hygiene significantly increased the risk of surgical failure. This suggests that increased perioperative measures to maintain good oral health could reduce surgical failure.

Purpose Cleft lip and palate (CLP) patients often require orthognathic surgical correction due to maxillary hypoplasia secondary to primary surgeries, through either distraction osteogenesis (DO) or conventional orthognathic surgery (CO). The objective was to evaluate both surgical techniques regarding functional, aesthetics and quality-of-life and stability outcomes for the patient. Materials and Method The PubMed database was searched with the inclusion criteria: studies in English detailing maxillary orthognathic surgery on non-syndromic patients with CLP. Clinical trials, systematic reviews, meta-analysis, reviews, randomized control trials were included. Studies with less than five patients and studies reporting bimaxillary surgery were excluded. References lists of these studies were consulted for more studies to be included. Studies were then evaluated for relevance, quality checked for risk of bias and divided based on the results studied. In total, 22 studies published between 1997 and 2017 were included. Results Most studies had low levels of bias. The evidence to support one surgical technique before the other was low. DO offered better stability. No clear evidence exists on which technique had the best aesthetic results and functional improvement. DO may cause higher levels of anxiety and distress in patients compared to CO. Conclusion Regarding all outcomes studied, the scrutinized literature did not allow for the recommendation of one specific technique. Future multicentre collaboration may enable greater sample size and better statistical comparison of results of both techniques.

Local anaesthesia is taught early in the practical part of dental programs. However, dental students express uncertainty and concern before their practical training in local anaesthesia. The aim of this study was to evaluate how extra educational elements in the teaching of local anaesthesia affect students’ confidence using local anaesthesia. The students were divided into three groups (A, B and C). Group A received the same education that was used the previous year (i.e., four hours of theoretical lectures followed by four hours of practical exercises performed on a fellow student). Group B did their practical training on fellow students in groups of three, with each student taking turns performing, receiving and observing the procedure. Group C received training using an anatomically correct model before their practical training on a fellow student. After each training step, the students completed a questionnaire about their confidence administering local anaesthesia. The students experienced a significant increase in confidence after each educational step. Combining theory and practical instruction, including the use of anatomically correct models and peer instruction, improved students’ confidence in administering local anaesthesia. The greatest increase in confidence was in the students placed in groups of three where each student performed, received and observed the procedure.

This review describes the role of modern preprosthetic surgery. The atrophic edentulous jaw can cause severe functional impairment for patients, leading to inadequate denture retention, reduced quality of life, and significant health problems. The aim of preprosthetic surgery is to restore function and form due to tooth loss arising from congenital deformity, trauma, or ablative surgery. Alveolar bone loss is due to disuse atrophy following tooth loss. The advent of dental implants and their ability to preserve bone heralded the modern version of preprosthetic surgery. Their ability to mimic natural teeth has overcome the age-old problem of edentulism and consequent jaw atrophy. Controversies with preprosthetic surgery are discussed: soft tissue versus hard tissue augmentation in the aesthetic zone, bone regeneration versus prosthetic tissue replacement in the anterior maxilla, sinus floor augmentation versus short implants in the posterior maxilla—interpositional bone grafting versus onlay grafts for vertical bone augmentation. Best results for rehabilitation are achieved by the team approach of surgeons, maxillofacial prosthodontists/general dentists, and importantly, informing patients about the available preprosthetic surgical options.

Purpose: The aim was to assess skeletal stability after maxillary advancement using either distraction osteogenesis (DO) or conventional Le Fort I osteotomy (CO) in patients with cleft lip and palate (CLP) or cleft palate (CP) utilising a new superimposition-based cephalometric method. Method: This retrospective study included patients who were treated with DO (N = 12) or CO (N = 9). Sagittal and vertical changes after surgery, and skeletal stability at 18 months post-operatively were assessed with superimposition-based cephalometry, comparing lateral cephalograms performed pre-operatively (T0), post-operatively after CO or immediately after completed distraction in DO (T1), and at 18 months of follow-up (T2). Results: The mean sagittal movements from T0 to T2 in the DO and CO groups were 5.9 mm and 2.2 mm, respectively, with a skeletal relapse rate of 16% in the DO group and 15% in the CO group between T1 and T2. The vertical mean movement from T0 to T2 in the DO and CO groups was 2.8 mm and 2.0 mm, respectively, and the skeletal relapse rate between T1 and T2 was 36% in the DO group and 32% in the CO group. Conclusion: Sagittal advancement of the maxilla was stable, in contrast to the vertical downward movement, which showed more-extensive relapse in both groups. Despite more-extensive maxillary advancement in the DO group, the rates of skeletal relapse were similar.