Cleft Patient-Reported Postoperative Donor Site Pain Following Alveolar Autologous Iliac Crest Bone Grafting

Abstract

This prospective randomized study showed no difference in pain intensity among cleft patients who had postoperative pain. However, a greater number of patients in group 1 reported "no pain" in comparison to patients in group 2.

Comparison of minimally invasive versus conventional open harvesting technique for iliac bone graft in secondary alveolar bone grafting in cleft palate patients: a systematic review

“…Secondary alveolar cleft bone grafting is an integral part of contemporary rehabilitation for patients with cleft lip and palate, and any cleft patient with an alveolar defect should be considered for bone grafting1. Restoring the continuity of the maxillary arch with native bone allows the closure of oronasal fistulae, a proper platform for tooth eruption, and bone support for the alar base of the nose and lip2. The incorporation of a bone graft into the alveolar cleft allows the surgeon to create a morphologically and physiologically responsive alveolus3.…”

“…Classically, iliac bone grafts have been obtained using an open approach (3–4 cm incision to obtain adequate visualization, blunt dissection down to the iliac crest, and bone harvesting with an osteotome) described by Lindeman in 1915 and popularized by Wolfe and Kawamoto in 19782. Even though the conventional open method is relatively safe and effective, concerns about an unacceptably high morbidity rate for this procedure, including impaired ambulation, significant pain, visible scar, contour deformities, sensory loss, and prolonged recovery time, have led to a search for less invasive harvesting methods3.…”

“…Even though the conventional open method is relatively safe and effective, concerns about an unacceptably high morbidity rate for this procedure, including impaired ambulation, significant pain, visible scar, contour deformities, sensory loss, and prolonged recovery time, have led to a search for less invasive harvesting methods3. Recently, iliac bone grafts have been obtained using minimally invasive techniques (closed approach) with different surgical devices, such as a trephine, percutaneous needle, Volkmann curette, modified bone core biopsy trocar, cylinder osteotome, manually driven osteotome, motorized CORB needle, bone grinder, grinding harvester, and mechanized coring2.…”

Evaluation of the different biomaterials used in alveolar cleft defects in children

“…Thus, the autografts for medium and large defects, such as palatal and alveolar cracks, may lead to higher morbidity for the patient, greater volume loss, and longer times for recovery to normal functions, especially walking. [9] It was clear that, when unused autografts (iliac crest), most of the factors related to postoperative complications were reduced and still maintained the characteristics satisfying the bone-rebuilding process, such as the bone volume and the density of the postreconstruction of the bone tissue. [92728] Therefore, the use of autografts is satisfactory, but they should be used in smaller quantities and should be supplemented with osteoconductive bone substitutes with slow degradation.…”

“…The gold standard for these procedures involves the use of autogenous grafts arising from the iliac crest, but the capture surgery of this bone routinely comes with increased postoperative morbidity and lengthier hospital stays for patients. [6789] Studies also show that some areas are excellent as donor sites – such as the mandibular symphysis,[1011] rib,[12] skullcap,[13] and tibia. [14]…”