{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:16:18Z","timestamp":1778516178922,"version":"3.51.4"},"reference-count":22,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Objective: Implant rehabilitation in grafted alveolar clefts requires a complex staged reconstructive approach, and a clinically important yet underexplored question is which patients require additional pre-implant block regrafting after primary grafting has already been completed. This single-centre retrospective cohort study aimed to evaluate whether a history of maxillary advancement is associated with a reduced likelihood of requiring pre-implant block regrafting (defined here as Re-graft 1), and to describe medium-term implant survival outcomes in a cleft implant cohort. Methods: Forty-two patients with Veau class III or IV cleft palate who underwent implant rehabilitation in grafted alveolar cleft sites between 2011 and 2023 were included. A total of 80 dental implants were evaluated at the implant level; analyses of primary grafting outcomes and the need for Re-graft 1 were performed at the patient level. Mean age at implant placement was 21.07 years (range, 17\u201338 years); mean follow-up was 83 months. Patients were categorised by maxillary advancement history: distraction osteogenesis (n = 11), orthognathic Le Fort I advancement (n = 9), or no advancement (n = 22). Bergland grades were assigned independently by two attending surgeons from postoperative radiographs. Implant outcomes were classified using the ICOI\/Misch four-level scale (success, satisfactory survival, compromised survival, failure). Group comparisons used chi-square and Fisher\u2019s exact tests. Results: Patients with any maxillary advancement history were significantly less likely to require Re-graft 1: 65.0% of patients with advancement did not require Re-graft 1, compared with 27.3% in the no-advancement group (Fisher\u2019s exact p = 0.029; OR = 4.95). Overall implant survival was 93.75%; 58.75% of implants were classified as complete success, and 30.00% as satisfactory survival. Conclusions: In this observational, hypothesis-generating cohort, maxillary advancement history was associated with a lower likelihood of requiring pre-implant block regrafting. Implant rehabilitation showed favorable medium-term survival. These findings are limited by the retrospective single-center design, modest sample size, and absence of multivariable adjustment, and require confirmation in larger prospective studies with standardized regrafting criteria.<\/jats:p>","DOI":"10.3390\/dj14050287","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:39:32Z","timestamp":1778513972000},"page":"287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implant Rehabilitation in Grafted Alveolar Clefts: Clinical and Radiographic Outcomes"],"prefix":"10.3390","volume":"14","author":[{"given":"Tal","family":"Capucha","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7490-0501","authenticated-orcid":false,"given":"Ahmad","family":"Hija","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Bilder","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaim","family":"Ohayon","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6820-7126","authenticated-orcid":false,"given":"Andrei","family":"Krasovsky","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dror","family":"Aizenbud","sequence":"additional","affiliation":[{"name":"Ruth & Bruce Rappaport Faculty of Medicine, Technion\u2013Israel Institute of Technology, Haifa 3200003, Israel"},{"name":"Department of Orthodontics and Craniofacial Anomalies, School of Graduate Dentistry, Rambam Health Care Campus, Haifa 3109601, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adi","family":"Rachmiel","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"},{"name":"Ruth & Bruce Rappaport Faculty of Medicine, Technion\u2013Israel Institute of Technology, Haifa 3200003, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omri","family":"Emodi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa 3109601, Israel"},{"name":"Ruth & Bruce Rappaport Faculty of Medicine, Technion\u2013Israel Institute of Technology, Haifa 3200003, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.ijom.2019.01.023","article-title":"Effectiveness of dental implants placed in bone graft area of cleft patients","volume":"48","author":"Sales","year":"2019","journal-title":"Int. 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Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1177\/1055665619886142","article-title":"Alveolar cleft reconstruction using morphogenetic protein (rhBMP-2): A systematic review and meta-analysis","volume":"57","author":"Uribe","year":"2020","journal-title":"Cleft Palate Craniofac. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e2347","DOI":"10.1097\/GOX.0000000000002347","article-title":"Safety and efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) in craniofacial surgery","volume":"7","author":"Ramly","year":"2019","journal-title":"Plast. Reconstr. Surg. Glob. 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