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Sales PHDH, Cetira Filho EL, Goberlânio de Barros Silva P, Gurgel Costa FW, Leão JC. Effectiveness of Autogenous Chin Bone Graft in Reconstructive Surgery of Cleft Patients: A Systematic Review With Meta-Analysis and Algorithm of Treatment. J Oral Maxillofac Surg 2023:S0278-2391(23)00391-9. [PMID: 37182542 DOI: 10.1016/j.joms.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/30/2023] [Accepted: 04/17/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE Bone grafting is fundamental in the treatment of cleft patients, and several grafting materials have been used for this purpose. The objective of this study is to evaluate the effectiveness of autogenous bone graft from the chin in the reconstruction of cleft alveolus. METHODS Searches were performed in six databases (PubMed, Scopus, Cochrane, LILACS, Embase, and Google Scholar) by two researchers individually until July 2022. This study was registered in the International Prospective Register of Systematic Reviews (CRD42021267954) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The predictor variable is reconstruction technique, grouped into three levels: autogenous genial grafts, other endochondral autogenous grafts, and bio- or tissue-engineered materials. The outcome variables were alveolar cleft healing rate and bone height. The secondary variables were complications that included infections, necrosis, paresthesia, and dehiscence. Data analysis included the risk of bias and assessment of the certainty of evidence by the risk of bias in nonrandomized studies of interventions and grading of recommendations, assessment, development, and evaluation tools, respectively. The meta-analysis was performed with heterogeneity based on random effects of I2 and 95% confidence. RESULTS In the initial search, 4,833 articles were found, and 10 of them were included in this systematic review. The included studies were from six countries on three different continents, with a sample of 692 patients. It was observed that the chin bone graft (214 patients) when compared to the endochondral bone graft (386 patients) reduced by 0.42 [confidence interval 95% = 0.18, 0.95] times the prevalence of bone resorption (P = .040 and I2 = 70%) analyzed in radiographic images. Two studies evaluated the bone filling through computed tomography, and there was no statistically significant difference between the groups (P = .340, I2 = 0%). Only two studies had a low risk of bias. CONCLUSION Based on a low certainty of evidence, the chin autogenous bone graft proved to be similar to the endochondral graft in the reconstruction of the cleft alveolar; however, the limited number of studies with high heterogeneity and an uncertain risk of bias decreased the strength of the results found in this systematic review. New controlled primary studies should be carried out with the purpose of safely determining the effectiveness of chin bone grafts for the reconstruction of cleft alveolar.
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Affiliation(s)
- Pedro Henrique da Hora Sales
- Student, Post-graduated program in dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.
| | - Edson Luiz Cetira Filho
- Student, Post-graduated program in dentistry, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Jair Carneiro Leão
- Full Professor, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
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Attar BM, Soltani P, Davari D, Mehdizadeh M. Cone-beam computed tomographic comparison of chin symphysis bone particles and allograft versus iliac crest bone graft alone for reconstruction of alveolar bone defects in cleft patients. J Korean Assoc Oral Maxillofac Surg 2022; 48:85-93. [PMID: 35491139 PMCID: PMC9065643 DOI: 10.5125/jkaoms.2022.48.2.85] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/22/2022] [Accepted: 02/11/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Bijan Movahedian Attar
- Torabinejad Dental Research Center and Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, and Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Davari
- Department of Oral and Maxillofacial Surgery, Kashan University of Medical Sciences, Kashan, Iran
| | - Mojdeh Mehdizadeh
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, and Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Regenerative Strategies in Cleft Palate: An Umbrella Review. Bioengineering (Basel) 2021; 8:bioengineering8060076. [PMID: 34205126 PMCID: PMC8230219 DOI: 10.3390/bioengineering8060076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Alveolar bone defects or decreased alveolar bone height and width may have different causes, such as cleft palate. Regenerative procedures in oro-dental defects are challenging due to anatomical factors and the distinct cell populations involved. The iliac crest bone graft remains the gold-standard for cleft palate closure. However, tissue regeneration approaches have been employed and their outcome reviewed, but no conclusions have been made about which one is the gold-standard. (2) Methods: this umbrella review aims to critically appraise the effectiveness of the current approaches in bone defects regeneration in non-syndromic patients with cleft palate. A search was performed in PubMed, Cochrane Library, Scopus, Web of Science and EMBASE databases. (3) Results: Systematic reviews of randomized and non-randomized controlled trials with or without meta-analysis were included. Nine articles were included in the qualitative analysis and five in the quantitative one. The included studies quality was evaluated with AMSTAR2. (4) Conclusions: The use of new regenerative strategies, such as bone morphogenic protein 2, appears to provide similar results regarding bone volume, filling, and height to the standard technique with the iliac crest bone graft.
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Dissaux C, Ruffenach L, Bruant-Rodier C, George D, Bodin F, Rémond Y. Cleft Alveolar Bone Graft Materials: Literature Review. Cleft Palate Craniofac J 2021; 59:336-346. [PMID: 33823625 DOI: 10.1177/10556656211007692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Since the early stages of alveolar bone grafting development, multiple types of materials have been used. Iliac cancellous bone graft (ICBG) remains the gold standard. DESIGN/METHODS A review of literature is conducted in order to describe the different bone filling possibilities, autologous or not, and to assess their effectiveness compared to ICBG. This review focused on studies reporting volumetric assessment of the alveolar cleft graft result (by computed tomography scan or cone beam computed tomography). RESULTS Grafting materials fall into 3 types: autologous bone grafts, ICBG supplementary material, and bone substitutes. Among autologous materials, no study showed the superiority of any other bone origin over iliac cancellous bone. Yet ICBG gives inconsistent results and presents donor site morbidity. Concerning supplementary material, only 3 studies could show a benefit of adding platelet-rich fibrin (1 study) or platelet-rich plasma (2 studies) to ICBG, which remains controversial in most studies. There is a lack of 3-dimensional (3D) assessment in most articles concerning the use of scaffolds. Only one study showed graft improvement when adding acellular dermal matrix to ICBG. Looking at bone substitutes highlights failures among bioceramics alone, side-effects with bone morphogenetic protein-2 composite materials, and difficulties in cell therapy setup. Studies assessing cell therapy-based substitutes show comparable efficacy with ICBG but remain too few. CONCLUSION This review highlights the lack of 3D assessments in the alveolar bone graft materials field. Nothing dethroned ICBG from its position as the gold standard treatment at this time.
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Affiliation(s)
- Caroline Dissaux
- Maxillofacial and Plastic Surgery Department, Cleft Competence Center, 36604Strasbourg University Hospital, Strasbourg, France.,Laboratoire ICUBE, Département Mécanique UMR 7357 CNRS, 36604Université de Strasbourg, Strasbourg, France
| | - Laetitia Ruffenach
- Maxillofacial and Plastic Surgery Department, Cleft Competence Center, 36604Strasbourg University Hospital, Strasbourg, France
| | - Catherine Bruant-Rodier
- Maxillofacial and Plastic Surgery Department, Cleft Competence Center, 36604Strasbourg University Hospital, Strasbourg, France
| | - Daniel George
- Laboratoire ICUBE, Département Mécanique UMR 7357 CNRS, 36604Université de Strasbourg, Strasbourg, France
| | - Frédéric Bodin
- Maxillofacial and Plastic Surgery Department, Cleft Competence Center, 36604Strasbourg University Hospital, Strasbourg, France
| | - Yves Rémond
- Laboratoire ICUBE, Département Mécanique UMR 7357 CNRS, 36604Université de Strasbourg, Strasbourg, France
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Abstract
The goals of alveolar cleft repair include (1) stabilization of the maxilla, (2) permitting tooth eruption, (3) eliminating the oronasal fistula, (4) improving aesthetics, and (5) improving speech. Alveolar cleft repair should be considered one of the steps of a larger comprehensive orthodontic management plan. In conjunction with closure of the oronasal fistula, a variety of grafting materials can be used in the alveolar cleft. Autogenous grafts have been found to have greater efficacy compared with allogenic or xenogeneic bone, substitute bone, and alloplasts but with more donor site morbidity.
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Affiliation(s)
- Hilary McCrary
- Division of Otolaryngology-Head and Neck Surgery, University of Utah, 50 North Medical Dr., SOM 3C120, Salt Lake City, Utah 84132, USA
| | - Jonathan R Skirko
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona, Tucson, AZ, USA; Banner Diamond Children's Hospital, Tucson, AZ, USA.
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Mahardawi B, Boonsiriseth K, Pairuchvej V, Wongsirichat N. Alveolar cleft bone grafting: factors affecting case prognosis. J Korean Assoc Oral Maxillofac Surg 2020; 46:409-416. [PMID: 33377466 PMCID: PMC7783176 DOI: 10.5125/jkaoms.2020.46.6.409] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/17/2020] [Accepted: 06/05/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives The goal of this retrospective study was to determine the significance and impact of several factors on the alveolar cleft bone grafting procedure. Materials and Methods The medical records were reviewed. In addition, x-rays were checked. The size of every cleft was measured in this retrospective study. The analyzed factors included sex, age, type of cleft, size of the cleft, and the type of flap used in surgery. The patients were characterized into group A (no complications, Bergland scale 1 or 2), group B (complications or Bergland scale 3), or group C (failure cases). Statistical analysis was performed with a P-value set at 0.05. Results There were 32 cases in group A, 26 in group B, and 9 in group C. Multinomial logistic regression showed an association between the type of the cleft and the size of the cleft, with the presence of complications, or achieving type 3 on the Bergland scale, with odds ratios of 5.118 and 6.000, respectively. The type of cleft was related to failure with an odds ratio of 4.833. Given a small sample, statistical analysis could not be performed to evaluate the relationship between the size of the cleft and group C. Age, sex, and the type of the flap were not significant factors. Conclusion The cleft size of more than 10 mm and bilateral clefts were listed regarding their effect on the procedure. Clinicians should not overlook these factors. In addition, patients must be informed of any risks that are present.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kiatanant Boonsiriseth
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Verasak Pairuchvej
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Samieirad S, Khoshsirat A, Rezaeetalab F, Mianbandi V, Tohidi E, Eshghpour M. Will Obstructive Sleep Apnea and Apnea/Hypopnea Index Be Corrected Following Alveolar Cleft Reconstruction? World J Plast Surg 2020; 9:146-152. [PMID: 32934925 PMCID: PMC7482538 DOI: 10.29252/wjps.9.2.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea is a disorder of repetitive complete or partial airway obstruction during sleep. The aim of this study was to assess the impact of alveolar cleft reconstruction on the obstructive sleep apnea (OSA) condition and apnea/hypopnea index (AHI). METHODS In a double-blinded prospective quasi-experimental study, all healthy systemic children (n=30 female cleft patients) with unilateral alveolar cleft defects within the age range of 8-14 years and BMI less than 30 kg/m2 who admitted for alveolar cleft repair were enrolled. OSA monitoring was performed one week before surgery, and 3 months postoperatively by Apnea Link device. Sleep apnea indices such as AHI, respiratory disturbance index (RDI), oxygen desaturation index (ODI) and oxyhemoglobin saturation (SpO2) as well as pulse rate (PR) and respiratory rate (RR) were the variables. RESULTS The patients’ mean age was 11.0±1.4 years, and BMI average was 21.48±4.4 kg/m2. Mean AHI was 21.6±5.0 events/hour, preoperatively; which decreased significantly and reached 4.4±2.5 events/hour after alveolar cleft reconstruction surgery (p=0.005). Moreover, the other OSA variables (SpO2, RDI, and ODI), as well as vital signs (PR, and RR) improved postoperatively (p=0.005). In other words, the preoperative moderate OSA status relieved after alveolar cleft repair and reconstruction. CONCLUSION Our study showed that the OSA and AHI ameliorated after bone graft surgery in alveolar cleft repair. More clinical trials including larger sample sizes may be required for relevancy.
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Affiliation(s)
- Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Oral and Maxillofacial Surgery Department, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Khoshsirat
- Oral and Maxillofacial Surgery Department, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fariba Rezaeetalab
- Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vajiheh Mianbandi
- Student Research Committee, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Tohidi
- Oral and Maxillofacial Radiology Department, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Eshghpour
- Oral and Maxillofacial Surgery Department, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Reconstruction of a Unilateral Alveolar Cleft Using a Customized Allogenic Bone Block and Subsequent Dental Implant Placement in an Adult Patient. J Oral Maxillofac Surg 2019; 77:2127.e1-2127.e11. [DOI: 10.1016/j.joms.2019.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 11/30/2022]
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9
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Kim SG. Classification of the journal category "oral surgery" in the Scopus and the Science Citation Index Expanded: flaws and suggestions. J Korean Assoc Oral Maxillofac Surg 2019; 45:186-191. [PMID: 31508350 PMCID: PMC6728620 DOI: 10.5125/jkaoms.2019.45.4.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 12/29/2022] Open
Abstract
Objectives The aim of this study was to evaluate the journal category “oral surgery” in Scopus and in the Science Citation Index Expanded (SCIE). Materials and Methods The Journal of Oral and Maxillofacial Surgery (JOMS), The Journal of the Korean Association of Oral and Maxillofacial Surgeons (JKAOMS), and The Journal of Prosthodontic Research (JPR) were selected from the Scopus list of journals as oral surgery journals. Maxillofacial Plastic and Reconstructive Surgery (MPRS) was selected from PubMed as a Scopus oral surgery title. From these titles, 10 recently published articles were collected and used for reference analysis. Results The percentage of citations from oral surgery journals was 26.7%, 24.5%, and 40.1% for JKAOMS, MPRS, and JOMS, respectively. In total, 1.1% of JPR's citations were from oral surgery journals and significantly fewer from other journals (P<0.001). The percentage of citations from dentistry journals excluding oral surgery journals was 11.9%, 34.4%, and 15.8% for JKAOMS, MPRS, and JOMS, respectively. For JPR, 80.6% of citations were from dentistry journals and significantly more were from other journals (P<0.001). Conclusion Selected samples revealed that JPR is incorrectly classified as an oral surgery journal in Scopus. In addition, the scientific interaction among JKAOMS, MPRS, and JOMS was different to JPR in the reference analysis.
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Affiliation(s)
- Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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Rahpeyma A, Khajehahmadi S. Mandibular Ramus Cortical Tenting Graft and Particulate Allograft in the Management of Unilateral Alveolar Cleft. Ann Maxillofac Surg 2019; 9:355-358. [PMID: 31909015 PMCID: PMC6933958 DOI: 10.4103/ams.ams_96_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background: Alveolar bone grafting in the mixed dentition stage is an important step in the management of cleft lip/palate patients. Intraoral donor sites are favored by patients and their parents. Objective: This study investigated a novel bilaminar cortical tenting grafting technique. The technique used a combination of autogenous mandibular ramus cortical bone and particulate allograft in unilateral cleft lip/palate patients during the mixed dentition stage. Materials and Methods: Five patients with nonsyndromic unilateral cleft lip and/or palate, in mixed dentition stage, were included in the study. Results: The operation was performed on five patients, and patients were followed up at least for one-year postoperation. Permanent maxillary canine erupted in the grafted alveolar region spontaneously in 80% of the patients. One wisdom tooth bud that had been exposed during the ramus bone harvest was removed. There was no alteration in the sensation of the lower lip as checked by light static and two discrimination tests. Conclusion: Unilateral alveolar clefts can be repaired using mandibular cortical block ramus bone in the form of bilaminar tenting grafts combined with particulate allografts.
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Affiliation(s)
- Amin Rahpeyma
- Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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