Effectiveness of iliac cancellous bone grafting in alveolar cleft repair and analysis of factors affecting it

doi:10.7518/hxkq.2023.2022446

Abstract

Abstract:

Objective To review the effectiveness of secondary alveolar bone grafting using iliac cancellous bone in patients with unilateral complete alveolar cleft and to investigate the factors influencing it. Methods A retrospective study of 160 patients with unilateral complete alveolar clefts who underwent iliac cancellous bone graft repair at the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, was conducted. Eighty patients in the young age group (6-12 years) and 80 in the old age group (≥13 years) were included. Bone bridge formation was determined using Mimics software, and the volume was measured to calculate the iliac implantation rate, residual bone filling rate, and resorption rate. The factors that affected bone grafting in both subgroups were investigated. Results Using bone bridge formation as the clinical success criterion, the success rate for the entire population was 71.25%, with a significant difference of 78.75% and 63.75% for the young and old age groups, respectively (P=0.036). The gap volume in the latter was significantly larger than that in the former (P<0.001). The factors that influenced bone grafting in the young group were the palatal bone wall (P=0.006) and history of cleft palate surgery (P=0.012), but only the palatal bone wall affected the outcome in the old age group (P=0.036). Conclusion The results of alveolar bone grafting for the old age group were worse than those for the young age group. The palatal bone wall was an important factor that affected alveolar bone grafting, and alveolar bone grafting in the young patients was influenced by the history of cleft palate surgery.

Key words: alveolar cleft, iliac cancellous bone, bone wall, scars, cone beam CT

CLC Number:

R 782.2⁺2

Jing Bingshuai, Shi Bing, Zheng Qian, Li Chenghao.. Effectiveness of iliac cancellous bone grafting in alveolar cleft repair and analysis of factors affecting it[J]. West China Journal of Stomatology, 2023, 41(3): 284-289.

Figures/Tables 4

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特征	分类	所有患者	小年龄组	大年龄组	P值
年龄/岁		12.5（9.0，16.0）	9.0（9.0，11.0）	16.0（13.0，18.0）	<0.001
性别	男	107	56	51	0.401
	女	53	24	29	0.401
患侧	左	99	53	46	0.255
	右	61	27	34	0.255
腭侧骨壁	有	91	51	40	0.079
	无	69	29	40	0.079
腭裂手术史	有	125	62	63	0.848
	无	35	18	17	0.848
裂隙体积/mm³		1 204.88（1 000.45，1 145.06）	1 117.43（907.35，1 314.77）	1 268.41（1 125.10，1 702.60）	<0.001
髂骨植入率/%		81.93（69.27，91.13）	81.14（68.88，91.23）	82.90（70.34，91.11）	0.364
复查间隔/d		363.50（221.75，615.75）	368.00（221.25，628.00）	355.50（221.75，571.50）	0.828

指标	分类	所有患者	小年龄组	大年龄组	P值
骨桥形成结果	有	114	63	51	0.036
	无	46	17	29	0.036
剩余骨充填率/%		22.57（7.59，40.92）	23.65（8.46，39.62）	21.55（6.66，41.76）	0.947
吸收率/%		69.42（49.76，89.33）	67.03（51.18，88.15）	72.09（47.45，90.20）	0.792

因素	分类	小年龄组			大年龄组
因素	分类	成功	失败	P值	成功	失败	P值
年龄		10（9，11）	9（9，10）	0.597	15（13，18）	16（14，18）	0.379
性别	男	44	12	0.952	31	20	0.464
	女	19	5	0.952	20	9	0.464
患侧	左	41	12	0.670	29	17	0.878
	右	22	5	0.670	22	12	0.878
腭侧骨壁	有	45	6	0.006	30	10	0.036
	无	18	11	0.006	21	19	0.036
腭裂手术史	有	45	17	0.012	37	26	0.072
	无	18	0	0.012	14	3	0.072
牙槽突裂体积/mm³		1 109.63（880.185，1 301.62）	1 150.12（992.8，1445.23）	0.414	1 286.94（1 132.87，1 624.78）	1 221.48（1 107.48，1 713.98）	0.872
髂骨植入率/%		81.42（68.42，91.23）	81.04（69.78，85.25）	0.889	83.02（76.29，90.84）	82.26（68.18，92.39）	0.984

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