Demineralized Bone Matrix for Alveolar Cleft Management

Abstract

The aim of this article is to describe the results of the use of demineralized bone matrix putty in alveolar cleft of patients with cleft lip and palate. We performed a prospective, descriptive case series study, in which we evaluated the results of the management of alveolar clefts with demineralized bone matrix. Surgery was performed in 10 patients aged between 7 and 26 years (mean 13 years), involving a total of 13 clefts in the 10 patients. A preoperative cone beam computed tomography (CBCT) was taken to the patients in whom the width of the cleft was measured from each edge of the cleft reporting values between 5.76 and 16.93 mm (average, 11.18 mm). The densities of the clefts were measured with a CBCT, 6 months postoperative to assess bone formation. The results showed a register of gray values of 1,148 to 1,396 (mean, 1,270). The follow-up was conducted for 15 to 33 months (mean, 28.2 months). The results did not show satisfactory bone formation in the cleft of patients with the use of demineralized bone matrix.

Early Results on the Efficacy of Demineralized Bone Matrix, Bone Morphogenic Protein, and Freeze-dried Bone Chips in Alveolar Cleft Repair

“…Although alveolar cleft reconstruction has relied heavily on autologous ICBG, advances in allographic bone grafting agents have been shown more recently to be feasible, acting as potential substitutes. 16,17 While these agents alone have been demonstrated to be inferior to autogenic bone grafting when used individually, 18,19 acceptable outcomes have been reported when used in combination with each other or in conjunction with autologous bone grafting. 8,9 Our results suggest the feasibility of grafting using DBX, rhBMP-2, and FDBC in regard to overall graft take in the setting of early alveolar cleft repair, concomitant hard palate and alveolar cleft repair, secondary alveolar cleft repair, and regrafting from a failed ICBG.…”

Efficacy of Demineralized Bone Matrix for Revision Alveolar Bone Grafting in Patients Previously Treated with Bone Morphogenetic Protein 2 (BMP-2)

“…9,10 More recent meta-analysis of BMP-2 use in alveolar cleft repair found bone creation to be effective or higher with BMP-2 compared to traditional autologous grafting, however found a high risk of bias in the articles reviewed. 18–20 True clinical trials are required to verify these results which are lacking currently. In addition, complications associated with BMP-2 use have been reported including ectopic bone formation, osteolytic defects, carcinogenesis, wound complications, severe soft tissue swelling, dysphagia, and respiratory compromise, 12,14,17 although these have not been reported in association with cleft ABG procedures.…”