A national survey of current practice in pre-alveolar bone graft orthodontics in the United Kingdom

Objective: To obtain an overview of current practice for pre-alveolar bone graft (pre-ABG) orthodontics at cleft centres across the United Kingdom.

Design: Cross-sectional survey.

Setting: Web-based.

Methods: The survey was distributed online to UK orthodontic consultants undertaking cleft care and was piloted before use. The domains explored included level of experience, perceived benefits and concerns with undertaking pre-ABG orthodontics, types of appliances used and ABG outcomes.

Results: A total of 38 consultant orthodontists responded, with a response rate of 56%. Pre-ABG orthodontics was performed most commonly (81.6%) in patients with a bilateral cleft lip and palate; however, 21.1% never performed it in any cleft phenotypes. The most common types of appliances used were fixed slow expanders and fixed appliances. No respondents reported poor ABG outcomes.

Conclusion: There was no clear protocol for providing pre-ABG orthodontic treatment, with wide variation across the UK. A variety of orthodontic treatment approaches are being undertaken, and the outcomes of ABGs remain successful. Multidisciplinary teams should have a holistic approach to patient care when deciding to perform pre-ABG orthodontics and involve patients in decision making. Future UK research should focus on additional secondary outcomes and determining a standardised approach to ensure best possible care is delivered.