Factors Influencing Timely Preparation of Alveolar Bone Grafting: A Survey of the ACPA

Objective: To identify factors that are commonly felt to impact a team’s ability to ensure patients are orthodontically and dentally prepared for alveolar bone grafting at the appropriate time. Design: Cross-sectional survey. Setting: American Cleft Palate-Craniofacial Association (ACPA)-approved multidisciplinary cleft teams. Participants: Cleft team coordinators. Interventions: Cleft team coordinators were asked to complete the survey. Results: Fifty-three team coordinators from the 167 ACPA-certified cleft teams completed the survey (response rate = 32%). The majority (83.02%) of cleft teams feel having a case manager increases or would increase the rate of timely bone graft preparation. Orthodontic and dental coverage varied greatly between teams with university/hospital employed dentists and volunteer private practice orthodontists representing the most frequent models. The reported percentage of patients seeking regular dental and orthodontic care with providers affiliated with the team did not correlate with the likelihood of timely bone graft preparation (P =.17; P =.43). Great variability was noted in the manner and frequency of team communication with families during orthodontic bone graft preparation. The presence of a designated case manager on the team was not significantly associated with the percentage of patients who were reported to be orthodontically prepared for bone graft surgery (P =.25). Conclusion: Within our survey data, there is great variability noted in factors that may potentially impact orthodontic bone graft preparation. The majority of teams felt that a case manager did or would help with this process, however, our study does not support this fact. Significant recall bias concerning the success of bone graft preparation may affect these results.