A comparative evaluation of iliac crest bone graft with and without injectable and advanced platelet rich fibrin in secondary alveolar bone grafting for cleft alveolus in unilateral cleft lip and palate patients: A randomized prospective study

J Stomatol Oral Maxillofac Surg. 2021 Jun;122(3):241-247. doi: 10.1016/j.jormas.2020.07.007. Epub 2020 Aug 8.

Abstract

Purpose: Platelet rich fibrin enhances bone healing and results in better graft intake and helps in faster periodontal healing. In this study we have used a combination of two newly developed forms of platelet rich fibrin: injectable and advanced along with iliac bone graft for secondary alveolar bone grafting and compared it with cases in which only iliac bone graft was used.

Methods: 30 patients with alveolar cleft, with age group of ≥7 years, having complete unilateral cleft alveolus were included and divided into 2 groups of 15 patients each randomly. In Group A, secondary alveolar bone grafting was done using iliac bone graft along with injectable and advanced palate rich fibrin and in Group B, secondary alveolar bone grafting was done only with iliac bone graft. Success of the treatment was assessed using radiographic and clinical methods which included: The bone resorption of the interalveolar septum height of the teeth adjacent to the cleft, evaluated as per Bergland classification, assessment of periodontal status of the teeth adjacent to cleft alveolus.

Results: After 3 months and 6 months postoperatively: study group had better overall scores as per Bergland criteria. Periodontal status improved in both groups but was more in study group compared to control group. For both evaluations the data was clinically favorable in the study group.

Conclusion: On preliminary investigations it shows that combination of injectable and advanced platelet rich fibrin seems to enhance bone formation in alveolar clefts when admixed with autologous cancellous bone harvested from the iliac crest than using iliac bone graft alone. It also reduces the chances of bone resorption and show higher percentage of bone volume. Secondary alveolar grafting improves periodontal health around the cleft alveolus.

Keywords: Alveolar bone grafting; Iliac graft; Platelet rich fibrin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Alveolar Bone Grafting*
  • Child
  • Cleft Lip* / diagnosis
  • Cleft Lip* / surgery
  • Cleft Palate* / diagnosis
  • Cleft Palate* / surgery
  • Humans
  • Ilium / surgery
  • Platelet-Rich Fibrin*
  • Prospective Studies