Development of surgical techniques of secondary osteoplasty in cleft patients following 12 years experience

Theologie-Lygidakis, Nadia; Chatzidimitriou, Konstantina; Tzerbos, Fotios; Kolomvos, Nikolaos; Iatrou, Ioannis

doi:10.1016/j.jcms.2013.12.002

Cited by 14 publications

(17 citation statements)

References 52 publications

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“…It is noticeable that the bone density in cancellous bone graft group is significantly higher than that in block bone graft group at 1- and 3-month postoperatively, as shown in Figure 3A. This result is not surprising because the particulate iliac bone is usually compressed in the alveolar cleft during surgery (Theologie-Lygidakis et al, 2014). However, no significant difference of the bone density was found at 6-month postoperatively.…”

Section: Discussionmentioning

confidence: 89%

“…Block bone grafting technique is widely used for bone repairing and augmentation in radius and ulna (Barbieri et al, 1997), cranial wall (Cestari et al, 2009; Hwang et al, 2012), and oral cavity (Sjostrom et al, 2013; Fretwurst et al, 2015). Recently, this technique was applied for ABG in alveolar cleft patients with different modifications (Mikoya et al, 2010; Luque-Martin et al, 2014; Theologie-Lygidakis et al, 2014; Van Nhan et al, 2018). From the year of 2013, block iliac bone graft technique was approved at our center and was performed in older cleft patients.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Outcomes of Block and Cancellous Iliac Bone Grafting in Older Unilateral Alveolar Cleft Patients

Zhou

Pan

Tang

et al. 2019

The Cleft Palate-Craniofacial Journal

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Objective: To compare osseous outcomes of block and cancellous iliac bone grafting in older unilateral alveolar cleft patients. Design: Retrospective and observational follow-up study. Setting: Cleft Lip and Palate Centre, Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, China. Patients: Forty-five nonsyndromic patients with unilateral complete alveolar cleft were enrolled in this study (25 patients in block bone graft group and 20 patients in cancellous bone graft group). Interventions: In cancellous bone graft group, the alveolar cleft was filled with iliac cancellous bone particulate. In group of block bone graft, the harvested bone block was trimmed and fixed in alveolar defect. Main Outcome Measures: A novel method was proposed to investigate the volume and density of residual bone graft at 1-week, 3- and 6-month, 1- and 2-year postoperatively based on cone beam computed tomography scans. Results: No difference in bone graft volume was found between 2 groups at 1-week and 3-month postoperatively; however, the residual volume of block bone graft group was significantly larger than that of cancellous bone graft group at 6-month, 1- and 2-year postoperatively. The bone density of block bone graft group was lower at 1-week and 3-month postoperatively but was comparable at 6-month, 1- and 2-year postoperatively. Our method was reliable and accurate to identify the range of residual bone graft when the boundary of grafted bone could not be identified clearly. Conclusion: Block bone graft could achieve comparable bone density and retain a greater amount of residual bone comparing to cancellous bone graft.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Comparative Outcomes of Block and Cancellous Iliac Bone Grafting in Older Unilateral Alveolar Cleft Patients

Zhou

Pan

Tang

et al. 2019

The Cleft Palate-Craniofacial Journal

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“…The donor site of block bone could be iliac crest or mandible ( 16 , 17 ). Mandibular bone block could be less resorpted than that from iliac crest for it matched with the embryologic origin on craniofacial bone formation ( 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, block bone grafting technique has been widely used for bone augmentation in adults, with good long-term outcomes ( 13 , 14 ). The bone block could be trimmed to fit for the alveolar defect ( 15 ) or fixed with small titanium plates and screws ( 16 ). Recent studies reported on the use of block bone grafting in cleft patients of age window ( 17 , 18 ); however, for older alveolar cleft patients, this technique was rarely reported and the osseous outcomes of bone healing were not well investigated.…”

Section: Introductionmentioning

confidence: 99%

Block iliac bone grafting enhances osseous healing of alveolar reconstruction in older cleft patients: A radiological and histological evaluation

Du¹,

Zhou²,

Pan³

et al. 2018

Med Oral

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BackgroundOlder alveolar cleft patients (&12 years old) often have wide bone defect as well as teeth loss, resulting in poor osseous healing with conventional alveolar bone grafting (ABG). In this study, we investigated a surgical technique of block iliac bone grafting for the alveolar cleft reconstruction and evaluated the clinical and radiological outcomes of these cleft patients.Material and MethodsFifteen patients were included in this study. All cases received preoperative cone bean computed tomography (CBCT) scans for the alveolar cleft evaluation. Osseous outcomes of block iliac bone grafting were assessed at 1 week, 3- and 6-month postoperatively. Volume changes and bone resorption rates were calculated using the measurement modules of Simplant software. Bone samples from one patient undergoing dental implantation were assessed by micro-CT and histological examination. The morbidities of donor-site were analyzed by clinical examination and questionnaire survey.ResultsThe average age of the case series was 18.53±2.50 years. The intraoral incision of thirteen cases healed well. However, two cases had oronasal fistula and graft exposure at 1-week postoperatively. The results of follow-up CBCT scans showed significant resistance to radiation on both sides of the bone graft, suggesting a good osseous healing and new bone formation. The mean residual bone volume was 1.68±0.26 cm3, 1.29±0.23 cm3 and 1.15±0.23 cm3 at 1-week, 3- and 6-month postoperatively. Correspondingly, the mean bone resorption rates in 3- and 6-month postoperative were 21.78±6.88% and 30.66±8.97%, respectively. From micro-CT and HE examinations, the block bone samples exhibited a cancellous structure in which mature bone trabecula and functional blood vessels appeared. The average scores of donor-site morbidities were drastically decreased at 3- and 6-month postoperatively compared with those at 1-week postoperatively.ConclusionsOur results demonstrated that block iliac bone grafting could achieve satisfying osseous outcomes in older alveolar cleft patients, and this technique provided favorable bony condition for further treatments, especially dental implantation. Key words:Alveolar bone grafting, Block bone grafting, Osseous healing, CBCT.

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“…Conflicting results have been found for the effects of cleft size (Long et al, 1995;Honma et al, 1999;Aurouze et al, 2000;Van der Meij et al, 2003;Feichtinger et al, 2008;Kim et al, 2008;Oberoi et al, 2009) and age (both biological and dental) (Van der Meij et al, 2001;Williams et al, 2003;Boyarskiy et al, 2006;Oberoi et al, 2009;Toscano et al, 2012) on graft success. Additional factors, heretofore not seriously considered as possible influences on bone graft success, are the type and timing of coordinated orthodontic treatment, both before and after bone grafting, which have become commonplace with most treatment protocols (Abyholm et al, 1981;Theologie-Lygidakis et al, 2014). Presurgical orthodontics plays an important role in correcting misaligned central incisors or repositioning displaced maxillary alveolar segments, which are not uncommon findings in the cleft maxilla.…”

Section: Introductionmentioning

confidence: 99%

Presurgical and postsurgical orthodontics are associated with superior secondary alveolar bone grafting outcomes

Liao¹,

Huang²

2015

Journal of Cranio-Maxillofacial Surgery

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Development of surgical techniques of secondary osteoplasty in cleft patients following 12 years experience

Cited by 14 publications

References 52 publications

Comparative Outcomes of Block and Cancellous Iliac Bone Grafting in Older Unilateral Alveolar Cleft Patients

Comparative Outcomes of Block and Cancellous Iliac Bone Grafting in Older Unilateral Alveolar Cleft Patients

Block iliac bone grafting enhances osseous healing of alveolar reconstruction in older cleft patients: A radiological and histological evaluation

Presurgical and postsurgical orthodontics are associated with superior secondary alveolar bone grafting outcomes

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