A National Racial Disparity in the Timing of Alveolar Bone Grafting

Objective: Standard bone grafting between ages 6 and 12 has become the preferred treatment of choice for alveolar clefts. Given the importance of surgical timing in complete cleft palate repairs, it is important to identify any populations at-risk for delayed alveolar bone grafting. The objective of this study is to identify whether a racial disparity is present nationally in the timing of alveolar bone grafting. Methods: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program pediatric database was performed from 2012 to 2019. Inclusion criteria involved patients who underwent alveolar bone grafting identified by current procedure terminology (CPT) code 42210. Patients were stratified by age at time of operation based on the following parameters: early bone grafting (before 6 years of age), standard bone grafting (between 6 and 12 years of age), and late bone grafting (after 12 years of age). Results: Overall, 20.28% of the cohort received alveolar bone graft after 12 years of age. African American (29.33%) and Hispanic (24.42%) patients received late alveolar bone grafting more frequently than other racial and ethnic groups (p < 0.001). Conclusion: Racial and ethnic disparities are present in the frequency at which patients receive late alveolar bone grafting for complete cleft palates. Given the suboptimal surgical results of late compared to standard alveolar bone grafting, it is important to further investigate the driving factors of these disparities. Corresponding Author: Darin Patmon, 4254 Oak Forest Ct. SE Apt H8, Grand Rapids, MI 49546