Alveolar Cleft Reconstruction Using Different Grafting Techniques

Aida Mossaad; Tarek El Badry; Moustapha Abdelrahman; Ahmad Abd Elazeem; Wael Ghanem; Susan Hassan; Nahed Adly; Wael Shawkat

doi:10.3889/oamjms.2019.236

Authors

Aida Mossaad Orodental Gernetics Department, National Research Center, Cairo, Egypt
Tarek El Badry Orodental Gernetics Department, National Research Center, Cairo, Egypt
Moustapha Abdelrahman Orodental Gernetics Department, National Research Center, Cairo, Egypt
Ahmad Abd Elazeem Orodental Gernetics Department, National Research Center, Cairo, Egypt
Wael Ghanem Plastic Pediatric Department at Ain Shams University, Cairo, Egypt
Susan Hassan Oral & Maxillofacial Surgery Department at Al Azhar University Girls, Nasr City, Cairo Governorate, Egypt
Nahed Adly Oral & Maxillofacial Surgery Department at Al Azhar University Girls, Nasr City, Cairo Governorate, Egypt
Wael Shawkat Oral & Maxillofacial Department at Nasr City Insurance Hospital, Nasr City, Cairo Governorate, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.236

Keywords:

Alveolar cleft, Hydroxy apatite, Stem cells, Iliac crest

Abstract

BACKGROUND: Cleft lip and palate CLP is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral anomalies due to either genetic or acquired causes. Alveolar cleft graft ACG remains controversial as regard timing, grafting materials and surgical techniques. The primary goal of alveolar cleft grafting in ACG patients is to provide an intact bony ridge at the cleft site to allow maxillary continuity for teeth eruption, proper orthodontic treatment for dental arch alignment, oronasal fistula closure and providing alar support for nasal symmetry.

AIM: This study aims to compare different grafting techniques to treat the alveolar cleft defect.

METHODS: This study included 24 cases divided into three groups of patients: Group A was treated with autogenous iliac crest bone; Group B was treated with nano calcium hydroxyapatite with collagen membrane and Group C was treated with tissue engineering method using bone marrow stem cells extract and PRF membrane.

RESULTS: According to clinical and radiographic examination measuring bone density in the CT preoperatively compared to six months postoperatively. Group C with bone marrow stem cells extract showed superior results among all followed by group B, while group A with autogenous iliac crest showed resorption in some cases and gave the least values, in addition to its drawbacks as regard donor site affection with pain & scar formation.

CONCLUSION: Bone substitutes as Nano calcium hydroxyapatite and bone marrow stem cells extract showed to be reliable methods for bone grafting than autogenous iliac crest.

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