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Siddiqui HP, Sennimalai K, Kaur A, Selvaraj M, Monga N, Mohaideen K. Does the adjunctive use of autologous platelet concentrate during secondary alveolar bone grafting reduce the risk of wound dehiscence? A systematic review and meta-analysis. J Craniomaxillofac Surg 2024:S1010-5182(24)00165-3. [PMID: 38729847 DOI: 10.1016/j.jcms.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
Wound dehiscence is a common complication after secondary alveolar bone grafting (SABG), leading to unfavourable surgical outcomes. Studies have shown that autologous platelet concentrates (APC) may enhance wound healing and improve outcomes. Therefore, this review aimed to evaluate in patients with alveolar clefts, whether using APC and iliac crest bone graft can mitigate the likelihood of wound dehiscence formation compared with those who underwent iliac bone grafting only following SABG. A comprehensive literature search was conducted using various electronic databases, including PubMed, Embase, Scopus, Web of Science, EBSCOhost, Ovid MEDLINE, LILACS, Cochrane Library, and grey literature, to include studies until July 31, 2023, without any restriction to language and time of publication. Only randomized (RCT) and controlled (CCT) clinical trials were included. Two independent reviewers screened the studies based on the predefined criteria, after which a qualitative and quantitative analysis was conducted. The search yielded 821 studies, of which seven were deemed eligible for systematic review. The risk of bias assessment done using "The Cochrane collaboration tool for risk of bias assessment" for six RCTs and the "Risk of Bias in Non-randomized Studies - of Interventions" for one CCT revealed a moderate to high risk of bias. The meta-analysis of five studies showed that the overall risk of developing wound dehiscence was lower in the APC group (RR = 0.33; 95% CI: 0.16, 0.71; p = 0.005; χ2 = 0.82; I2 = 0%). Subgroup analyses based on study design further supported these findings. Although the adjuvant use of APC for alveolar cleft reconstruction reduces the risk of wound dehiscence, more studies with increased scientific rigour and fewer confounding variables are warranted.
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Affiliation(s)
| | - Karthik Sennimalai
- Department of Orthodontics, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu & Kashmir, India.
| | - Amanjot Kaur
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu & Kashmir, India.
| | - Madhanraj Selvaraj
- Division of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | - Nitika Monga
- Division of Non-Communicable Diseases, Indian Council of Medical Research Headquarters, New Delhi, India.
| | - Kaja Mohaideen
- Department of Dentistry, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
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Vásquez-Álvarez M, Wang Q, Zapata U. The Use of Platelet Concentrates in the Reconstruction of the Alveolar Cleft Defect: A Systematic Review and Meta-Analysis. Cleft Palate Craniofac J 2024:10556656231222076. [PMID: 38196271 DOI: 10.1177/10556656231222076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE Evaluate quantitative and qualitative outputs when comparing the incidence of platelet concentrates (PCs) combined with autogenous bone grafts to an autograft control group for the reconstruction of alveolar cleft defects. DESIGN Systematic review and meta-analysis. PATIENTS/PARTICIPANTS Randomized and nonrandomized controlled clinical trials where PCs were used in the reconstruction of alveolar cleft defects. INTERVENTIONS Use of PCs in combination with autogenous bone graft in the experimental group and autogenous bone graft alone in the control group. MAIN OUTCOME MEASURE(S) Average bone formation and bone density were evaluated, mean differences were calculated and pooled by a meta-analysis technique. Additionally, clinical outcomes such as wound dehiscence, closure of the oronasal fistula, pain, swelling, discharges, infections, and bleeding were considered in the qualitative synthesis. RESULTS After an evaluation of forty-nine articles, nineteen were considered for the review. The qualitative assessment of bone density, bone formation, and clinical outcomes showed no differences between groups in most of the included studies. The meta-analysis showed no statistical differences between PCs groups when compared to the control group in bone density at three months (mean difference 45.67 HU, P = .23) and six months (mean difference 48.57 HU, P = .64). Neither were statistical differences in the percentage of regenerated bone volume at six months (mean difference 6.39%, P = .15) and the volume of newly formed bone at 12 months (mean difference 0.37 mm3, P = .99). CONCLUSIONS There were no significant differences in terms of bone formation, bone density, and clinical outputs between groups.
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Affiliation(s)
- Mariana Vásquez-Álvarez
- Mechanical Engineering Department, School of Applied Sciences and Engineering, Eafit University, Medellin, Antioquia, Colombia
| | - Qian Wang
- Biomedical Sciences Department, School of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Uriel Zapata
- Mechanical Engineering Department, School of Applied Sciences and Engineering, Eafit University, Medellin, Antioquia, Colombia
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Siddiqui HP, Sennimalai K, Bhatt K, Samrit VD, Duggal R. Effect of adjuvant autologous platelet concentrates on secondary repair of alveolar clefts: A systematic review and meta-analysis. SPECIAL CARE IN DENTISTRY 2024; 44:12-27. [PMID: 36721338 DOI: 10.1111/scd.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review the existing evidence on the adjuvant use of autologous platelet concentrates (APCs) with iliac crest bone graft (ICBG) in the reconstruction of the secondary alveolar cleft. METHODS Electronic databases were searched systematically until November 2022. Clinical trials comparing the three-dimensional radiological outcomes of patients who underwent secondary alveolar bone grafting (SABG) with ICBG and APCs to those with ICBG alone and the radiological outcomes assessed 6 months after surgery were included. Two authors performed the study selection and the assessment of the risk of bias. Meta-analysis was performed using the random-effects model to determine the risk ratio (RR) for developing wound dehiscence and the mean difference (MD) with a 95% confidence interval (CI) for the percentage of newly formed bone. RESULTS Nine studies (seven RCT and two CCT) were included with a low to high risk of bias. At the 6-month follow-up, the study group revealed insignificant results regarding the percentage of newly formed bone (MD = 6.49; 95% CI: -0.97, 13.94; p = .09; χ2 = 0.01; I2 = 71%). In addition, the overall risk of developing wound dehiscence was lower in the study group (RR = 0.34; 95% CI: 0.15, 0.78; p = .01; χ2 = 0.67; I2 = 0%). CONCLUSION Currently, there is insufficient evidence to support the adjuvant use of APCs with ICBG on enhanced bone regeneration following secondary alveolar bone grafting. However, combining ICBG and APCs might be beneficial in reducing the risk of developing wound dehiscence.
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Affiliation(s)
- Hamza Parvez Siddiqui
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Karthik Sennimalai
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
- Department of Orthodontics, All India Institute of Medical Sciences, Jammu, J&K, India
| | - Krushna Bhatt
- Division of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vilas D Samrit
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Li T, Wang YY, Liu C. The effectiveness of using platelet-rich concentrate with iliac bone graft in the repair of alveolar cleft: a meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg 2023; 52:1049-1056. [PMID: 36925370 DOI: 10.1016/j.ijom.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 12/28/2022] [Accepted: 01/06/2023] [Indexed: 03/18/2023]
Abstract
The purpose of this study was to review the existing evidence from randomized controlled trials (RCTs) on the effect of autogenous bone grafts combined with a platelet-rich concentrate on alveolar clefts. An electronic search was conducted in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases for studies published between January 2000 and April 2022. This study included six RCTs to evaluate bone quantity (bone formation ratio, %) and quality (bone density in Hounsfield units, HU), as well as complications as a way to assess the safety of the technique. Two independent reviewers assessed the risk of bias. There was no statistically significant difference in bone formation ratio at 6 months of follow-up between the use of autologous bone alone for alveolar bone grafting or adding platelet-rich plasma (PRP) (mean difference (MD) 14.33%, 95% confidence interval (CI) - 7.19% to 35.85%; P = 0.196) or platelet-rich fibrin (PRF) (MD 9.38%, 95% CI -2.36% to 21.12%; P = 0.123) to autologous bone. The MD for the change in bone density at 6 months was in favour of PRP added to autologous bone graft (MD 155.69 HU, 95% CI 99.29-212.09 HU; P < 0.001); however, this result was based on only two studies, one of which had a high risk of bias. Patients who received autologous bone graft with PRP were significantly less likely to experience complications (odds ratio (OR) 0.21, 95% CI 0.05-0.92; P = 0.038), but this was no longer statistically significant after a sensitivity test (OR 0.24, 95% CI 0.04-1.56; P = 0.138). In conclusion, this systematic review and meta-analysis appears to show no benefit to using a platelet-rich concentrate combined with autologous bone for alveolar cleft grafting in terms of bone volume, bone density, or complications.
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Affiliation(s)
- T Li
- Medical College of Nanchang University, Nanchang, Jiangxi Province, China; Department of Plastic Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China
| | - Y Y Wang
- Medical College of Nanchang University, Nanchang, Jiangxi Province, China; Department of Plastic Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China
| | - C Liu
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China; The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
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Vishva P, R N, Harikrishnan S. The Effect of Platelet-Rich Plasma on Bone Volume in Secondary Alveolar Bone Grafting in Alveolar Cleft Patients: A Systematic Review. Cureus 2023; 15:e46245. [PMID: 37908953 PMCID: PMC10614025 DOI: 10.7759/cureus.46245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
This systematic review aims to investigate the impact of platelet-rich plasma (PRP) in conjunction with bone grafting on bone volume outcomes in secondary alveolar bone grafting (SABG) procedures among alveolar cleft patients. An exhaustive search involving PubMed, Cochrane, and Google Scholar databases yielded 20 relevant titles, ultimately leading to the inclusion of four articles meeting all specified criteria. Based on the Cochrane risk of bias in systematic reviews (ROBIS) tool, the studies showed a high risk of bias. The primary outcome, bone volume assessment, was analyzed across these articles. While the Cochrane ROBIS tool deemed the included articles to have a high risk of bias, the comparison between PRP and Non-PRP groups did not reveal a significant difference in bone volume. Radiographic data illustrated an initial three-month period of bone resorption post-graft, regardless of PRP application, followed by a six-month phase of heightened bone density, particularly discernible in the PRP groups. To sum up, our findings indicate an absence of substantial bone density increase in cleft patients undergoing SABG with PRP augmentation. Nonetheless, there was a modest trend that suggests potential incremental bone density improvement with PRP usage, underscoring the need to conduct rigorously designed, randomized controlled trials (RCTs) with low bias to validate these observations.
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Affiliation(s)
- Prem Vishva
- Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Navaneethan R
- Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sruthi Harikrishnan
- Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Eslami N, Heidarian Miri H, Rastegar M, Sabzevari B. Effect of Platelet-rich Plasma on the Clinical Success of Alveolar Grafts in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis. J Craniofac Surg 2023; 34:1246-1251. [PMID: 37157129 DOI: 10.1097/scs.0000000000009315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/07/2023] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVES This study assessed the effect of platelet-rich plasma (PRP) on the clinical success of alveolar grafts in patients with cleft lip and palate. MATERIALS AND METHODS In this meta-analysis, a search of the literature was conducted in Medline, Scopus, ISI Web of Science, and Cochrane Central Register of Controlled Trials for randomized clinical trials using PRP or platelet-rich fibrin (PRF) along with autogenous bone for alveolar ridge grafts in patients with cleft lip and palate. The methodological quality of the studies was analyzed using Cochrane's risk of the bias assessment tool. The extracted data underwent meta-analysis using the random-effects model. RESULTS Of a total of 2256 articles retrieved, 12 met the eligibility criteria and were enrolled; out of which 6 did not undergo meta-analysis due to heterogeneous data. The percentage of defects filled by bone graft was 0.648% (95% confidence interval: -0.15 to 1.45), which was not statistically significant ( P =0.115). Subgroup analysis showed no significant difference based on the use of PRF or PRP ( P =0.28), type of cleft (unilateral/bilateral; P =0.56), or type of radiographic modality (3D/2D; P =0.190). Meta-regression analysis showed that the duration of follow-up and the difference in the mean age of patients did not have a significant effect on the results (R=0, I2: high). CONCLUSION The application of PRP/PRF in combination with autogenous bone graft did not have a significant effect on the percentage of alveolar cleft filled by a bone graft. Future clinical studies are required to further elucidate the effect of PRP in the regeneration of alveolar clefts.
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Affiliation(s)
| | - Hamid Heidarian Miri
- Department of Biostatistics, Health Sciences Research Center, School of Health, Mashhad University of Medical Sciences
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Alkaabi S, Alsabri G, Natsir Kalla D, Alavi S, Nurrahma R, Forouzanfar T, Helder M. Regenerative graft materials for maxillary sinus elevation in randomized clinical trials: A meta-analysis. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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AKDAG O, Erkol EE, Yildiran G, Koplay TG, SUTCU M, Tosun Z. Reconstruction of Previously Failed Alveolar Bone Grafts with Medial Femoral Condyle Flap in Pediatric Cleft Lip and Palate Patients. J Plast Reconstr Aesthet Surg 2022; 75:3768-3773. [DOI: 10.1016/j.bjps.2022.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 04/26/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022]
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Hasiba-Pappas SK, Tuca AC, Luze H, Nischwitz SP, Zrim R, Geißler JC, Lumenta DB, Kamolz LP, Winter R. Platelet-Rich Plasma in Plastic Surgery: A Systematic Review. Transfus Med Hemother 2022; 49:129-142. [PMID: 35813605 PMCID: PMC9210026 DOI: 10.1159/000524353] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION Platelet-rich plasma (PRP) is gaining popularity and is applied in a variety of clinical settings. This review aims to present and evaluate available evidence regarding the use of PRP in various applications in plastic surgery. METHODS PubMed, Web of Science, Medline, and Embase were searched using predefined MeSH terms to identify studies concerning the application of PRP alone or in combination with fat grafting for plastic surgery. The search was limited to articles in English or German. Animal studies, in vitro studies, case reports, and case series were excluded. RESULTS Of 50 studies included in this review, eleven studies used PRP for reconstruction or wound treatment, eleven for cosmetic procedures, four for hand surgery, two for burn injuries, five for craniofacial disorders, and 17 as an adjuvant to fat grafting. Individual study characteristics were summarized. Considerable variation in preparation protocols and treatment strategies were observed. Even though several beneficial effects of PRP therapy were described, significance was not always demonstrated, and some studies yielded conflicting results. Efficacy of PRP was not universally proven in every field of application. CONCLUSION This study presents an overview of current PRP treatment options and outcomes in plastic surgery. PRP may be beneficial for some indications explored in this review; however, currently available data are insufficient and systematic evaluation is limited due to high heterogeneity in PRP preparation and treatment regimens. Further randomized controlled trials employing standardized protocols are warranted.
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Affiliation(s)
- Sophie K. Hasiba-Pappas
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Alexandru Cristian Tuca
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Hanna Luze
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Sebastian P. Nischwitz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Robert Zrim
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Judith C.J. Geißler
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - David Benjamin Lumenta
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Lars-P. Kamolz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- COREMED − Cooperative Centre for Regenerative Medicine, Joanneum Research GmbH, Graz, Austria
| | - Raimund Winter
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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Wickramasinghe ML, Dias GJ, Premadasa KMGP. A novel classification of bone graft materials. J Biomed Mater Res B Appl Biomater 2022; 110:1724-1749. [DOI: 10.1002/jbm.b.35029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/19/2022]
Affiliation(s)
- Maduni L. Wickramasinghe
- Department of Biomedical Engineering General Sir John Kotelawala Defense University Ratmalana Sri Lanka
| | - George J. Dias
- Department of Anatomy, School of Medical Sciences University of Otago Dunedin New Zealand
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Alkaabi SA, Alsabri GA, NatsirKalla DS, Alavi SA, Mueller WEG, Forouzanfar T, Helder MN. A systematic review on regenerative alveolar graft materials in clinical trials: Risk of bias and meta-analysis. J Plast Reconstr Aesthet Surg 2021; 75:356-365. [PMID: 34642060 DOI: 10.1016/j.bjps.2021.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/16/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alveolar cleft grafting is a necessary procedure to restore bone defects. Randomized clinical trials (RCTs) are regarded as a golden standard for investigating the efficacy of treatments. Nevertheless, risk of bias (RoB) can still affect the validity of these trials. We aimed to conduct a systemic review of all control trials (CTs) using regenerative materials for alveolar cleft reconstructions to evaluate their RoB and perform a meta-analysis of new bone formation. METHODS Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE AND Google Scholar were searched up to October 2020. Thereafter, the articles underwent quality assessment (according to the Jadad scale and the Delphi list) for the evaluation of the RoB. RESULTS A total of 15 trials met the inclusion criteria, none of which reached a full score. Of these, 20% didn't randomize the trails, 73,33% failed to describe the way of randomization, and none reported the double-blinded criteria. Furthermore, allocation concealment (99.9%), intention to treat (100%), and patient awareness (100%) were inadequately described. The meta-analysis found no significant difference between regenerative materials and iliac crest graft. CONCLUSION This review showed high RoB in CTs implying quality improvement of CTs is necessary. Meta-analysis showed no significant difference between the regenerative materials and autogenous grafts.
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Affiliation(s)
- S A Alkaabi
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Oral and Maxillofacial Surgery, Fujairah Hospital, Ministry of Health, United Arab Emirates.
| | - G A Alsabri
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - D S NatsirKalla
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - S A Alavi
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - W E G Mueller
- Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - M N Helder
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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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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Assessment of Bone Formation After Secondary Alveolar Bone Grafting With and Without Platelet-Rich Plasma Using Computer-Aided Engineering Techniques. J Craniofac Surg 2020; 31:549-552. [PMID: 31934980 DOI: 10.1097/scs.0000000000006256] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to analyze the newly formed bone volume (FV), 6 months after secondary alveoloplasty using iliac cancellous bone graft, with and without platelet-rich plasma (PRP). Forty patients with unilateral alveolar cleft were involved in this randomized, prospective, comparative study, with 20 patients each forming the control (group A) and PRP (group B) groups, respectively. The preoperative alveolar defect volume (DV) and the postoperative FV were automatically calculated by the computer-aided engineering software using the patients' pre and postsurgical computed tomography data. The volume of the actual bone graft (AV) was identical to the DV calculated before surgery. The bone formation ratio (BF%) was calculated as follows: BF% = (FV/AV) × 100%. The mean BF% was 42.54 ± 9.32% in group A and 46.97 ± 18.49% in group B. There was no statistically significant difference between the 2 groups for BF% (P > 0.05). The study presents a fast and accurate method for assessing the effect of PRP in alveolar grafting. However, the study found no conclusive evidence on the effect of PRP on bone growth.
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Quick Method for Presurgical Volumetric Analysis of Alveolar Cleft Defects. J Craniofac Surg 2020; 31:821-824. [DOI: 10.1097/scs.0000000000006235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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An Accurate Volumetric Analysis Method for Evaluating Outcomes of Alveolar Cleft Reconstruction. J Craniofac Surg 2020; 31:e38-e41. [PMID: 31609949 DOI: 10.1097/scs.0000000000005864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
An accurate volumetric analysis method for evaluating the outcomes of different types of alveolar cleft reconstruction is essential because it can help determine which graft material is more effective, confirm favorable times for alveolar bone grafting, and improve surgical techniques. This study aimed to introduce a novel method of precisely calculating the bone formation ratio using computer-aided engineering after surgery. A patient with a unilateral alveolar cleft who was treated with anterior iliac crest bone grafting was enrolled in this study. Helical computed tomography scans were performed preoperatively and 12 months postoperatively. The Digital Imaging and Communications in Medicine (DICOM) data were reconstructed as three-dimensional images and saved in the STL format by using Mimics software. STL data were processed by Geomagic Wrap 2017, using the Boolean operation, the newly formed bone of the alveolar was segmented by identifying the differences between the preoperative and the postoperative three-dimensional images. For this patient, the mean volume of the newly formed bone was 0.387 cm, the morphology was clear, the bone formation ratio was 41.4%, the mean time required for calculating the newly formed bone volume was 23 minutes, and the bone survival ratio was 38.7%. This method is a clinically practical, accurately measurement and time-saving method to evaluate the outcome of alveolar cleft reconstruction. Both the volumetric assessment and morphological analysis of the newly formed bone could be determined in a precise manner.
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Liu B, Li BH, Chen SX, Xiao R, Wang YQ. A novel accurate volumetric analysis protocol for evaluating secondary alveolar cleft reconstruction. J Craniomaxillofac Surg 2020; 48:632-637. [PMID: 32507670 DOI: 10.1016/j.jcms.2020.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 02/07/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022] Open
Abstract
An accurate volumetric analysis protocol for secondary alveolar cleft reconstruction is essential. It can help confirm favorable times for bone grafting, determine which graft material is more effective, and improve surgical techniques. This study aimed to introduce a novel protocol for precisely calculating the bone formation ratio (BF%) using computer-aided engineering. The helical computed tomography (CT) datasets of 14 patients who underwent alveolar cleft reconstruction was included in this study. CT scans performed preoperatively and 1 year postoperatively were evaluated by two investigators. Digital Imaging and Communications in Medicine (DICOM) data were reconstructed as three-dimensional (3D) images using Mimics software and processed by Geomagic Wrap (2017). Using the Boolean operation, the newly formed bone of the alveolar cleft was segmented by identifying the differences between pre- and postoperative 3D images. The volumetric assessment and morphological analysis of the newly formed bone could be determined in a precise manner, the mean BF% was 47.7% ± 16.4%, the mean time required for calculating was 23.57 ± 3.64 min. For the difference in the volume of newly formed bone between the two observers, the intraclass correlation coefficient (ICC) was 0.92, p < 0.001. This method is clinically practical and precise measurement, which has good reproducibility for evaluating outcome of different grafting materials for alveolar clefts.
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Affiliation(s)
- Bing Liu
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - Bing H Li
- Digital Simulation Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - Shu X Chen
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - Ran Xiao
- Research Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - Yong Q Wang
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China.
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Bran S, Baciut G, Baciut M, Mitre I, Onisor F, Hedesiu M, Manea A. The opportunity of using alloplastic bone augmentation materials in the maxillofacial region– Literature review. PARTICULATE SCIENCE AND TECHNOLOGY 2019. [DOI: 10.1080/02726351.2018.1455784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Simion Bran
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ileana Mitre
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Avram Manea
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
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Stasiak M, Wojtaszek-Słomińska A, Racka-Pilszak B. Current methods for secondary alveolar bone grafting assessment in cleft lip and palate patients - A systematic review. J Craniomaxillofac Surg 2019; 47:578-585. [PMID: 30733132 DOI: 10.1016/j.jcms.2019.01.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/16/2018] [Accepted: 01/08/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The development of 3D X-ray diagnostics has led to new methods for secondary alveolar bone grafting (SABG) assessment. The aim of this study was to collect and present literature from the years 2007-2018, and review on the current treatment outcome assessment methods for SABG. MATERIALS AND METHODS A systematic review of literature from 2007 to 2018 was carried out, following PRISMA guidelines. 426 records were identified after duplicate references had been removed. 25 articles were included in the review. The Cochrane Collaboration tool or the methodological index for non-randomized studies was used for quality evaluation. RESULTS Computed tomography and cone beam computed tomography were preferentially used for SABG treatment outcome verification. There were different assessment protocols. Due to the ways in which results were presented, methods were divided into five groups: linear measurements, volumetric measurements, density measurements, percentage ratios, and scales. There was only one randomized, controlled trial with high methodological quality. CONCLUSIONS 1. Currently, 3D X-ray imaging is a standard treatment outcome verification method for SABG. 2. It is necessary to establish the required postoperative follow-up time for best SABG treatment outcome assessment. More prospective studies to assess bone graft outcomes after 6 months and 1 year are required.
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Affiliation(s)
- Marcin Stasiak
- Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Al. Zwycięstwa 42c, 80-210, Gdańsk, Poland.
| | - Anna Wojtaszek-Słomińska
- Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Al. Zwycięstwa 42c, 80-210, Gdańsk, Poland.
| | - Bogna Racka-Pilszak
- Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Al. Zwycięstwa 42c, 80-210, Gdańsk, Poland.
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De Mulder D, Cadenas de Llano-Pérula M, Jacobs R, Verdonck A, Willems G. Three-dimensional radiological evaluation of secondary alveolar bone grafting in cleft lip and palate patients: a systematic review. Dentomaxillofac Radiol 2019; 48:20180047. [PMID: 29947253 PMCID: PMC6398910 DOI: 10.1259/dmfr.20180047] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To systematically review the existing literature on the three-dimensional (3D) radiological evaluation of secondary alveolar bone grafting (SABG) in cleft lip and palate (CLP) patients, with specific interest in 3D imaging protocols and assessment methods. METHODS A comprehensive literature search on PubMed, Embase and the Cochrane Library was conducted. Included publications concerned 3D imaging for evaluation of SABG in CLP patients while articles about primary or tertiary bone grafting or using of two-dimensional images only were excluded. Study quality was evaluated using the Methodological Index for Non-Randomized Studies or the Cochrane Collaboration tool for assessing risk of bias. RESULTS The search yielded 1735 citations, of which 38 met the inclusion criteria. We noticed a large variability in imaging protocols and bone graft evaluation methods between studies. Most articles were observational studies with medium to low methodological quality, except for the one randomised clinical trial having a low risk of bias. CONCLUSIONS There is a lack of prospective, controlled trials based on a consistent imaging protocol with a sufficiently long follow-up period. A pressing need exists for the development of a consistent optimized imaging protocol for diagnosis and follow up of SABG in CLP patients. Although 3D evaluation methods seem to be more precise than two-dimensional methods, we should be careful when comparing the outcomes arising from different 3D measuring techniques.
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Affiliation(s)
- Dries De Mulder
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging & Pathology, Faculty of Medicine, OMFS IMPATH, University Leuven & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Verdonck
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Autologous Bone Marrow Concentrates and Concentrated Growth Factors Accelerate Bone Regeneration After Enucleation of Mandibular Pathologic Lesions. J Craniofac Surg 2018; 29:992-997. [DOI: 10.1097/scs.0000000000004371] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Yadav A, Deshpande R, Borle R, Kala A, Jajoo SN, Thakkar D. Comparative efficacy of autologous alveolar bone grafting with autologous platelet-rich plasma and without platelet-rich plasma in cleft alveolus patients. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2017. [DOI: 10.4103/jclpca.jclpca_38_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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