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Orthopantomograms and clinical records were evaluated at three stages: pre-SABG, six months post-SABG, and post-orthodontic treatment. The R-value was classified as\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090,25\u2009\u2212\u20091,0, corresponding to 25\u2013100% root development, respectively. Assessed parameters included the canine mineralization stage, axis-angulation and vitality, limbus height, probing depths, and space closure strategy. Group comparisons were performed using t-tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Early SABG (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009\u2264\u20090,5) yielded significantly higher orthodontic space closure rates (71% versus 25% with late SABG,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090,05) with better graft preservation, but was associated with increased canine impaction (18,6% in lateral incisor agenesis cases). The mean axis-angle of cleft-side canines differed significantly between orthodontic and prosthodontic space closure (81,3\u00b0 vs. 91,0\u00b0, t\u2009=\u20095,702). Limbus alveolaris height was reduced when SABG occurred after root completion (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20091,0, t\u2009=\u20094,234). Periodontal probing depths remained\u2009&lt;\u20093\u00a0mm, and canine vitality was preserved in all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early SABG, timed according to canine mineralization, supports alveolar bone preservation and space closure without compromising periodontal health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>Tailoring SABG timing based on dental development can optimize orthodontic and prosthodontic outcomes in patients with CLP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-025-06594-w","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T02:58:15Z","timestamp":1761793095000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Timing matters: dental development and outcomes on secondary alveolar bone grafting in cleft lip and palate patients"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-2078","authenticated-orcid":false,"given":"Theodosia","family":"Bartzela","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3445-3564","authenticated-orcid":false,"given":"Jennifer","family":"Kluge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"J\u00e4ger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schmechel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Opitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"6594_CR1","volume-title":"Technik und ergebnisse der Spaltplastiken (Technique and results of plastic operations on clefts)","author":"Axhausen","year":"1952","unstructured":"Axhausen (1952) Technik und ergebnisse der Spaltplastiken (Technique and results of plastic operations on clefts). 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