Abstract
Aims and objectives: The reconstruction of the alveolar cleft is usually achieved through an autologous bone graft and associated with unpredictable results. We sought to analyse the efficacy of platelet-rich plasma in reduction of the resorption of the alveolar cleft bone graft. Patients and methods: 20 nonsyndromic patients with unilateral alveolar clefts treated with alveolar bone grafting during the period between June 2005 and December 2008 were included in this study. The patients were randomly assigned to two groups: In Group 1: the patients treated by autogenous bone graft with Platelet-Rich Plasma. In Group 2: the patient treated by autogenous bone graft only. Clinical and radiological follow-up examinations were carried out at 1, 6 and 12 months. The osseous resorption method was evaluated with the use of digital panoramic radiograph. Results: After 1 month, all cases in the two groups showed Grade I bone resorption. After 6 and 12 months, Group 1 showed higher prevalence of Grade I but with no statistically significant difference compared to Group 2. Of the 10 patients in Group 2, three patients with Grade III bone resorption underwent subsequent alveolar bone graft from intraoral sites (mandibular symphysis, lateral cortex of the mandibular ramus or combination of the previous sites), while one case with Grade IV bone resorption (failed bone graft) was treated by intraoral distraction osteogenesis. Conclusion: Based on the results presented in this study, it is possible to conclude that a more favourable result can be achieved with application of PRP to the alveolar bone graft.
Highlights
Secondary bone grafting in the cleft area was first reported by Boyne and Sands in the 1970s [1,2]
Based on the results presented in this study, it is possible to conclude that a more favourable result can be achieved with application of Platelet-Rich Plasma (PRP) to the alveolar bone graft
20 nonsyndromic patients with unilateral alveolar clefts treated with alveolar bone grafting during the period between June 2005 and December 2008 were included in this study
Summary
Secondary bone grafting in the cleft area was first reported by Boyne and Sands in the 1970s [1,2]. This procedure is an essential step in the overall management of patients with cleft lip and palate (CLP), and has been accepted as a means of stabilizing the segments of the maxilla, achieving continuity of the dental arch, guiding permanent teeth towards the cleft area, obliterating oronasal fistulae, and enhancing nasal base and facial appearance. Different methods for accelerating the speed of bone formation and reducing bone resorption in alveolar cleft bone grafting has been sought for sometime [1,6,7]
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