Objective
The essential concern of alveolar cleft grafting in patients of cleft lip and palate at the mixed dentition phase is to gain bone within the cleft area that provides closure of the oronasal communication with continuous and stable maxilla for future cleft teeth eruption or implantation. This study aimed to compare the effectiveness of mineralized plasmatic matrix (MPM) versus cancellous bone particles harvested from anterior iliac crest in secondary alveolar cleft grafting.
Patients and methods
This prospective randomized controlled trial was conducted on ten patients with unilateral complete alveolar cleft requiring cleft reconstruction. Patients were randomly divided into two equal groups; group (1) included 5 patients who received particulate cancellous bone derived from anterior iliac crest (control group) and group (2) included 5 patients who received MPM graft prepared from cancellous bone derived from anterior iliac crest (study group). All patients received CBCT preoperatively, immediately postoperatively and after 6 months. On the CBCT, graft’s volume, labio-palatal width, and height were measured and compared.
Results
The outcome of the studied patients 6 months postoperatively showed that the control group had significant decrease in the graft volume, labio-palatal width, and height compared to the study group.
Conclusion
MPM allowed for the integration of bone graft particles inside a fibrin network, which offers positional stability of the bone particles, thus preserving their shape with subsequent “in situ” immobilization of the graft components. This conclusion was reflected positively in terms of maintained graft volume, width, and height compared to that of the control group.
Clinical relevance
MPM allowed for maintenance of grafted ridge volume, width, and height.
Objectives: This study assessed the use of beta-tricalcium phosphate as particulate bone graft material in alveolar ridge splitting in a horizontally deficient posterior mandible.Materials and Methods: 5 patients (ten surgical sites) were recruited for this study. They were all bilaterally treated with modified ridge splitting technique once with and once without using beta-tricalcium Phosphate material (B-TCP). Then a delayed implant placement was done after 6 months. Bone gain was assessed radiogarphically using cone beam CT and histologically before and after addition of bone graft. Repeated measures ANOVA test was used to compare between mean buccolingual bone widths pre and post-operatively. The significance level was set at P ≤ 0.05.
Results:A statistically significant increase in mean bucco-lingual bone width postoperatively at the crestal, middle and apical bone levels in the side which we used (BTCP) as bone grafting material. BTCP group recorded higher values of M= 3.65, 3.41 and 2.65 with statistical significance at level 2mm, 5mm and 10mm respectively than the non-grafting group that recorded 1.84, 0.86 and 0.64 for the same levels tested.
Conclusion:Modified ridge splitting technique with using beta-tricalcium Phosphate material (B-TCP) for horizontal augmentation of the posterior mandibular atrophic ridges provides predictable and reliable results in bone recovery.
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