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Randomized Controlled Trial
. 2025 Apr 15;29(5):248.
doi: 10.1007/s00784-025-06288-3.

Alveolar cleft reconstruction using autogenous double iliac corticocancellous bone blocks technique versus particulate autogenous spongy bone graft from anterior iliac crest

Louai Raafat  1 , Mohammed Omara  2 , Ragia Mounir  2
Affiliations
Randomized Controlled Trial

Alveolar cleft reconstruction using autogenous double iliac corticocancellous bone blocks technique versus particulate autogenous spongy bone graft from anterior iliac crest

Louai Raafat et al. Clin Oral Investig. .

Abstract

Objective: The primary goals for alveolar cleft grafting are to gain and maintain bone in the cleft area that provides continuity for the maxillary segments, allowing the stability of the maxilla and building the bony foundation for the erupting cleft teeth and closure of the oronasal communication. The current study compared the effectiveness of the double iliac corticocancellous bone blocks technique versus the particulate autogenous spongy bone graft from the anterior iliac crest in alveolar cleft grafting in the mixed dentition stage.

Patients and methods: The current randomized clinical study included 18 patients with unilateral alveolar clefts. They were divided into two equal groups according to the technique used for grafting; group (1) included nine patients in whom grafting with double iliac corticocancellous bone blocks with cancellous bone particulates in between was used (study group), and group (2) included nine patients in whom conventional cancellous particulate bone grafting from anterior iliac crest was used (Control group).

Results: Nine months postoperatively, the study group showed superior results regarding graft width, height, and volume compared to the control group in the current study.

Conclusion: Regarding the graft success factors represented by the maintained graft labio-palatal width, graft height, and total graft volume, the technique of double iliac corticocancellous bone blocks was markedly effective in reconstructing alveolar clefts when compared with the conventional grafting technique that utilized cancellous particulate bone alone from the anterior iliac crest.

Clinical relevance: The double iliac corticocancellous bone blocks technique maintained the grafted bone volume, width, and height.

Keywords: Anterior iliac crest; Double iliac corticocancellous bone blocks; Iliac cancellous bone graft; Phase of mixed dentition; Secondary alveolar cleft bone grafting.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted following the Declaration of Helsinki's guidelines for medical research, and the research ethics committee of Cairo University's Faculty of Dentistry provided a clarification letter. All participants that were included in the study signed a written informed consent. Publication consent: The authors affirm that all research participants and/or their guardians signed informed consent for the publication of the images. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Clinical photographs showing alveolar cleft grafting using conventional cancellous bone particles derived from the anterior iliac crest. (Control group)
Fig. 2
Fig. 2
Clinical photographs showing the Medial approach to the anterior iliac crest and cortical bone block harvesting and preparation (Study group)
Fig. 3
Fig. 3
Clinical photographs showing alveolar cleft grafting using double iliac corticocancellous bone blocks with cancellous bone particles in between (Study group)
Fig. 4
Fig. 4
Two different iliac cortico-cancellous bone blocks bent, adapted, and fixed to the maxillary segments (Study group)
Fig. 5
Fig. 5
Photo-radiograph for standardization of A) immediately after surgery and B) 9 months post-operative width and height measurements for the study group
Fig. 6
Fig. 6
Photo-radiograph for standardization of A) immediately after surgery and B) 9 months post-operative width and height measurements for the control group
Fig. 7
Fig. 7
Photo-radiograph of A) immediately after surgery and B) 9 months post-operative labio-palatal width measurements for the study group
Fig. 8
Fig. 8
Photo-radiograph ofA) immediately after surgery and B) 9 months post-operative height measurements for the study group
Fig. 9
Fig. 9
Photo-radiograph of A) immediately after surgery and B) 9 months post-operative labio-palatal width measurements for the control group
Fig. 10
Fig. 10
Photo-radiograph of A) immediately after surgery and B) 9 months post-operative height measurements for the control group
Fig. 11
Fig. 11
 A) Photo-radiograph of immediate post-operative volume measurements for the study group. B) Photo-radiograph of 9 months post-operative volume measurements for the study group
Fig. 12
Fig. 12
A) Photo-radiograph of immediate post-operative volume measurement for the control group. B) Photo-radiograph of 9 months post-operative volume measurement for the control group
Fig. 13
Fig. 13
Case from study group showing A) Dehiscence of recipient site B) After healing
See this image and copyright information in PMC

References

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