The Effects of Maxillary Expansion on Late Alveolar Bone Grafting in Patients with Unilateral Cleft Lip and Palate

Publication date: Available online 27 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Aslıhan Uzel, M. Emre Benlidayı, Mehmet Kürkçü, Erol Kesiktaş

Abstract

Objective

The purpose of this study was to answer the research question of whether maxillary expansion provides enough postgraft stimulation to decrease the volume loss of alveolar bone grafts in patients with cleft lip and palate (CLP) who missed the appropriate treatment time

Methods

This study was designed as a prospective controlled clinical trial. Thirty patients in permanent dentition with unilateral CLP (UCLP) were divided into two groups. In Group I (mean age 19.33±5.16 years), slow maxillary expansion was performed before secondary alveolar bone grafting; in Group II (mean age 19.93±3.99 years), slow maxillary expansions were performed six weeks after secondary alveolar bone grafting (SABG). The iliac crest was preferred as a donor site for autogenous bone graft harvesting. Cone-beam computerized tomography images were taken one week (T1), 6 months (T2) and 12 months (T3) postoperatively. The volume and density of the alveolar bone graft were calculated using Mimics 13.1 software, and SPSS 19.0 was used for statistical analysis.

Results

The bone graft volume loss was significantly higher in Group I than in Group II after 6 months of healing (p=0.003). The increase in bone density was significantly higher in Group II than in Group I after 6 months of healing (p=0.017). Although the mean loss of volume was lower and the mean density of the bone graft was higher in Group II, there was no significant difference between the two groups in terms of mean graft volume and mean bone density 12 months after the operation. The mean bone graft volume loss was 46.3 and 34.6% and the mean increase in bone density was 16 and 49% for Groups I and II, respectively, after 12 months of healing.

Conclusions

Maxillary expansion after late secondary alveolar bone grafting may be taken into consideration as a treatment choice in selected UCLP patients to provide bone graft stimulation.

https://ift.tt/2LVNGh5