J Korean Assoc Oral Maxillofac Surg.  2022 Apr;48(2):85-93. 10.5125/jkaoms.2022.48.2.85.

Cone-beam computed tomographic comparison of chin symphysis bone particles and allograft versus iliac crest bone graft alone for reconstruction of alveolar bone defects in cleft patients

• Attar BM
• Soltani P
• Davari D
• Mehdizadeh M

• KMID: 2529921
• DOI: http://doi.org/10.5125/jkaoms.2022.48.2.85

Abstract

Objectives
The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate.
Patients and Methods
This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, conebeam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups.
Results
Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days).
Conclusion
Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

Keyword

Alveolar bone grafting; Bone transplantation; Cone-beam computed tomography; Cleft palate

Figure

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  Fig. 1 Symphysis bone graft mixed with allograft packed in the alveolar defect.

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  Fig. 2 Iliac crest bone graft packed in the alveolar defect.

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  Fig. 3 Axial view of cone-beam computed tomography before bone graft (Group A patient). Group A: patients treated with chin symphysis bone+allograft.

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  Fig. 4 Measurement of the area of the bone defect in axial cone-beam computed tomography images.

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  Fig. 5 Axial view of cone-beam computed tomography after bone graft (Group A patient). Group A: patients treated with chin symphysis bone+allograft.

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  Fig. 6 Box plot of operation duration. Group A: patients treated with chin symphysis bone+allograft, Group B: patients treated with iliac bone graft.

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  Fig. 7 Reformatted panoramic view before bone graft (Group B patient) (arrow). Group B: patients treated with iliac bone graft.

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  Fig. 8 Reformatted panoramic view after bone graft (Group B patient). Group B: patients treated with iliac bone graft.

Reference

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