Deproteinized Bovine Bone Graft in Maxillary Alveolar Cleft Reconstruction

Abstract

Though alveolar grafting continues to be a viable treatment regimen, its associated protocols and techniques are many and varied. The present study was conducted to evaluate the use of deproteinized bovine bone xenograft mixed with autogenous mandibular symphyseal bone graft in secondary maxillary alveolar cleft reconstruction compared to the gold standard anterior iliac crest autogenous graft. 10 patients (mean age 9.3years 1.33) with unilateral maxillary alveolar cleft defect requiring secondary alveolar cleft grafting were included in this study. Patients were selected from the outpatient clinic, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University. The study was conducted from June 2012 till February 2013. Patients were divided randomly into 2 equal groups. Group A received the gold standard anterior iliac crest graft. Group B received mandibular symphyseal bone mixed with deproteinized bovine bone in a 1:1 ratio. For each patient, 3 CBCT scans were ordered: preoperatively, immediately postoperatively and 6 months postoperatively. Volumetric and densitometric measurements were made using the Mimics[1] software. Data were collected and statistical analysis was performed using SPSS (Statistical package for the social sciences)[2]. Data were represented as mean standard deviation. Paired sample student t-test was used to compare each pair of the studied variables within the studied group of patients. Independent sample t test was used to compare variables between the two studied groups. The test result was considered statistically significant if the Pvalue was equal to or less than 0.05. Results showed the percentage of defect filling immediately postoperatively to be 90.8 9.2% for Group A and 94.2 4.3% for Group B, while percentage of defect filling 6 months postoperatively was 86.6 10.0% for Group A and 88.4 2.8% for Group B. Comparison of the 2 groups regarding the percentage of defect filling by the graft immediately postoperatively and at 6 months showed no statistical significant difference with a P-value of 0.483 and 0.736 respectively. Comparison of the percentage of graft resorption between the 2 groups also showed no statistical significant difference. (P-value 0.704) Similarly, comparison of graft density between Group A and Group B immediately postoperatively (P-value 0.52) and after 6 months (P-value 0.81) showed no statistical significant