OBJECTIVETo propose a new three-dimensional method or grading scale in the evaluation of the secondary alveolar bone grafting, thus modifying the Bergland grading scale.

METHODSA total of 40 patients (26 male, 14 female) with unilateral cleft lip and palate (UCLP), who underwent secondary alveolar bone grafting at least 3 months ago, were enrolled. Regional cone-beam CT (CBCT) scans were taken to evaluate the height and thickness of the postoperative bone bridges. A new three-dimensional grafting scale was established, including four grades respectively in alveolar height and thickness.

RESULTSAccording to the new three-dimensional scale in this study, 15 grafted sites were rated grade T-I or T-II in the alveolar thickness among 18 sites of grade H-I in height, and 10 among 15 of grade H-II in height. Therefore, 25 grafted sites were considered as clinical success in the alveolar thickness (grade T-I or T-II) among 33 sites with clinical success in alveolar height (grade H-I and H-II). There were 24% of 33 sites with clinical success in height, which were considered as clinical failure in the alveolar thickness.

CONCLUSIONSIt is necessary to establish a new three-dimensional method or grading scale for evaluating the secondary alveolar bone grafting. The three-dimensional scale can take comprehensive view of the bone-grafted alveolar clefts and thus modify the Bergland grading scale.