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

Abstract

The aim of this study was to use a literature review to evaluate and compare the different biomaterials used in surgeries for the closure of the palatal and alveolar clefts as alternatives to isolated autografting. For the search strategy, the PubMed and Medline databases were used with the indexing terms “’cleft palate’ (Mesh), ‘biocompatible materials’ (Mesh), and ‘dentistry’ (Mesh).” There was no restriction on language or publication time. After the research, 26 articles were found, and then, only the filter for clinical trials was selected. With this methodology, five articles were selected. The full texts have been carefully evaluated. The main issue among the five selected articles was the closure of a cleft palate and/or alveolar bone with the use of different types of biomaterials (e.g. autogenous bone from the iliac crest and chin, deproteinized bovine bone (DBB), β-tricalcium phosphate (β-TCP), synthetic resorption based on calcium sulfate, and the engineering of bone tissue); they evaluated preoperative and postoperative clinically and through imaging tests. The autogenous bone associated with DBB or β-TCP significantly reduces the amount of autogenous bone harvested from the iliac crest, morbidity, and the hospitalization of the patient, and the isolated use of bovine hydroxyapatite resulted in lower bone density compared to that from autogenous bone.

3D Printing of Bone Grafts for Cleft Alveolar Osteoplasty – In vivo Evaluation in a Preclinical Model

“…For small oral bone defects alloplastic and xenogenic materials are well established, but for congenital and critical size defects the clinical results of these materials are currently not sufficient (Feinberg et al, 1989). Hence, there are great efforts to develop bone grafts, which can be used for the reconstruction of critical size defects like alveolar clefts (Silva Gomes Ferreira et al, 2018). The bone grafts should have the following characteristics: osteoconductivity, mechanical stability, promotion of vascular ingrowth and stem cell recruitment, and progressive resorption during the replacement by native tissue (Hutmacher et al, 2007;Kim et al, 2017).…”

Alveolar cleft reconstruction using iliac bone graft: a clinical case report

“…The study found that combining autogenous bone with deproteinized bovine bone or β- tricalcium phosphate significantly reduced the need for harvesting bone from the iliac crest, minimized patient morbidity and hospitalization. On the other hand, the use of bovine hydroxyapatite alone resulted in lower bone density compared to that achieved with autogenous bone 15 .…”