Comparison between combined cortical and cancellous bone graft and cancellous bone graft in alveolar cleft: Retrospective study of complications during the first six months post-surgery

Abstract

Background: In patients with alveolar cleft, alveolar bone graft is usually performed before the permanent maxillary canine or incisor eruption and using cancellous bone harvested from the iliac crest. The authors sought to compare the early complication rate in patients who received cancellous bone graft alone and cortical bone graft in addition to cancellous bone to reconstruct the nasal floor.

Methods: For this observational, retrospective, monocentric study, patients with alveolar cleft who underwent autologous alveolar bone graft and gingivoperiosteoplasty at Montpellier Hospital were divided into two groups: group A, who had cortical and cancellous bone graft; and group B, who had only cancellous bone graft. Both groups were followed for 6 months after surgery, and complications were recorded.

Results: In total, 319 grafts (group A, 163; group, 156) were performed from June 1999 to May 2016. The major complication rates were 8% and 5.8% in group A and B, respectively, and were not significantly different (p = 0.52). Similarly, the rates of minor complications and of donor site morbidity were not different between groups.

Conclusions: This preliminary study shows that adding a cortical bone graft for the nasal floor reconstruction does not increase the risk of complications in 6 months following the graft. Long-term benefits such as alveolar height and a piriform aperture symmetrisation will have to be analysed to study the contribution of the technique.

Keywords: Alveolar bone graft; Autograft; Bone regeneration; Cleft lip and palate; Post-operative complications.