Abstract
Objectives: The purpose of this study is to assess the effectiveness of mineralized plasmatic matrix in the soft tissue closure of naso-alveolar fistula, to estimate the postoperative bone fill and volume of the graft placed in the alveolar cleft defect using cone-beam computed tomography (CBCT) at 3rd- month and 6th- month. Material and methods: 10 patients, in the age group of 15‑30 years were included in this study. They were diagnosed with unilateral cleft lip and alveolus defects with or without a cleft palate requiring late secondary alveolar bone grafting. Alveolar cleft defects were closed with mineralized plasmatic matrix (MPM), a combination of autogenous iliac bone graft and platelet rich plasma (PRP) and platelet rich fibrin (PRF). Results: The mean defect volume pre-operatively is 0.75 cm3 and at the end of 3rd-month postoperatively is 0.51 cm3 and at 6th-month postoperatively is 0.27 cm3. The average percentage of bone fill between preoperative (A) & 3th- month postoperatively (B) is 33.4% and between 3rd-month (B) and 6th-month post operatively (C) is 49.5%. Conclusions: Utilization of this new matrix (MPM), has shown to be effective in the closure of the cleft defect, oro-nasal fistula and also reduction in the volume of the residual cleft defect seen with sequential cone-beam computed tomography (CBCT) radiographs.
Highlights
An anterior osseous defect is found in 75% of all cleft lip and palate patients and is mostly associated with fistulas [1]
Normal facial and dental function of the alveolar defect is restored by a technique known as secondary alveolar bone grafting (SABG)
Several authors described SABG which was accepted as a means of uniting and stabilizing the segments of maxilla, prior to definitive orthodontic and restorative dental treatment [2]
Summary
An anterior osseous defect is found in 75% of all cleft lip and palate patients and is mostly associated with fistulas [1]. Normal facial and dental function of the alveolar defect is restored by a technique known as secondary alveolar bone grafting (SABG) This is a highly technique-sensitive procedure which needs proper reconstruction of the osseous deformity, failure of which may result in oronasal fistula, fluid reflux, speech pathology, anteroposterior and transverse deficiency of the maxilla, lack of bone support for the incisors and cuspids, dental crowding, and facial asymmetry. Several authors described SABG which was accepted as a means of uniting and stabilizing the segments of maxilla, prior to definitive orthodontic and restorative dental treatment [2]. This technique preferentially describes the usage of cancellous bone, which improves
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