Secondary alveolar cleft grafting using autogenous mineralized plasmatic matrix (MPM) versus cancellous bone particles derived from anterior iliac crest

Abstract

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.

Integrating Virtual Surgical Planning and 3D-Printed Tools with Iliac Bone Grafts for Orbital and Zygomatic Reconstruction in Hemifacial Microsomia Patients

“…Additionally, they show fewer autoimmune reactions compared with the use of prosthetic materials [34]. Notably, Omara et al [35] compared the resorption rate of autogenous mineralized pulp matrix (MPM) with cancellous bone particles from the anterior iliac crest for the repair of an alveolar cleft, where the resorption rate in the control group was 48.91%, which was essentially the same as the bone resorption rate in this study. In the current study, we hypothesize that the elevated rate of bone resorption is attributable to the insufficient depth of the titanium mesh, coupled with suboptimal vascularization in the surrounding tissues compared with areas such as the alveolar eminence.…”