{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:39:01Z","timestamp":1793813941352,"version":"4.6.1"},"reference-count":28,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2025,7]]},"abstract":"\n Objective<\/jats:title>\n The current standard timing for alveolar bone grafting (ABG) occurs during mixed dentition, typically between the ages of six and twelve. A delay in receiving this operation is associated with an increase in graft loss and an overall thinner maxilla. This study aims to determine whether socioeconomic barriers are associated with a delay in timely ABG.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A retrospective analysis of patients who received ABG at our institution since 2012. Patient demographics, cleft classifications, operative details, and surgical dates were examined. A logistic regression model was created using socioeconomic variables to predict patients receiving delayed ABG. Significant variables were then included in a backwards selection logistic regression, followed by a final analysis of maximum likelihood estimates.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Single-institution, primary cleft care center.<\/jats:p>\n <\/jats:sec>\n \n Patients<\/jats:title>\n 202 patients with cleft palates who underwent ABG.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n ABG.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Timing in which patients received ABG: standard (6-12 years) and delayed (>12 years).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Female sex was a protective factor in the timing of ABG in our initial univariate analysis (OR\u2009=\u20090.44;\n p<\/jats:italic>\n \u2009\u2009=\u2009\u2009.015). Socioeconomic factors resulting in delayed presentation for ABG include median income (OR\u2009=\u20091.0;\n p<\/jats:italic>\n \u2009\u2009=\u2009\u2009.018) and public insurance status (OR\u2009=\u20093.75;\n p<\/jats:italic>\n \u2009<\u2009.001). Median income, sex, and driving distance to the cleft clinic were not significant following backward elimination, however, private insurance status remained significant (OR\u2009=\u20093.71;\n p<\/jats:italic>\n \u2009\u2009=\u2009\u2009.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Patients with public insurance are approximately 3.75 times more likely to receive ABG during permanent dentition. Multidisciplinary teams should work closely with patients on public insurance to ensure timely delivery of ABG.<\/jats:p>\n Level of Evidence III, Retrospective<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10556656241242695","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T02:53:25Z","timestamp":1712285605000},"page":"1190-1194","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Timing of Alveolar Bone Graft and Barriers to Care"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1918-1019","authenticated-orcid":false,"given":"Elizabeth E.","family":"Bushong","sequence":"first","affiliation":[{"name":"Michigan State University College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darin","family":"Patmon","sequence":"additional","affiliation":[{"name":"Michigan State University College of Human Medicine"},{"name":"Corewell Health, Grand Rapids, MI, USA"},{"name":"Corewell Health\/Michigan State University Plastic Surgery Residency, Grand Rapids, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Pfershy","sequence":"additional","affiliation":[{"name":"Michigan State University College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuyler","family":"Huffman","sequence":"additional","affiliation":[{"name":"Corewell Health, Grand Rapids, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Carlson","sequence":"additional","affiliation":[{"name":"Corewell Health\/Michigan State University Plastic Surgery Residency, Grand Rapids, MI, USA"},{"name":"Pediatric Plastic and Craniofacial Surgery, Helen DeVos Children's Hospital, Grand Rapids, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Girotto","sequence":"additional","affiliation":[{"name":"Corewell Health\/Michigan State University Plastic Surgery Residency, Grand Rapids, MI, USA"},{"name":"Pediatric Plastic and Craniofacial Surgery, Helen DeVos Children's Hospital, Grand Rapids, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-200311000-00005"},{"key":"e_1_3_2_3_2","volume-title":"Zur Technik der Uranoplastik","author":"ZEiselsberg A","year":"1901","unstructured":"ZEiselsberg A. Zur Technik der Uranoplastik. Vol 16. Arch Klin chir; 1901."},{"issue":"1","key":"e_1_3_2_4_2","first-page":"39","article-title":"Secondary bone grafting in cleft palate: A follow up of 145 patients","volume":"9","author":"Hogeman KE","year":"1972","unstructured":"Hogeman KE, Jacobsson S, Sarnas KV. Secondary bone grafting in cleft palate: A follow up of 145 patients. Cleft Palate J. 1972;9(1):39-42.","journal-title":"Cleft Palate J"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221104937"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2018.11.019"},{"key":"e_1_3_2_7_2","first-page":"11","article-title":"Historical development and current status of osteoplasty of lip-jaw-palate clefts","volume":"38","author":"Stellmach R","year":"1993","unstructured":"Stellmach R. [Historical development and current status of osteoplasty of lip-jaw-palate clefts]. 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Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg. 1972;30(2):87.","journal-title":"J Oral Surg."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)32408-1"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2018.07.022"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/scs.0b013e31814e059b"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.stomax.2008.10.009"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211073049"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2021.01.033"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221097813"},{"key":"e_1_3_2_27_2","unstructured":"Cubit Planning. Income By Zipcode. Updated 2021. 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