Outcome of Secondary Alveolar Cleft Reconstruction by Iliac Crest Bone Graft
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-8.13546Keywords:
Cleft lip, Cleft palate, CongenitalAbstract
Objective: To determine the outcome of iliac crest graft use in secondary alveolar reconstruction.
Study Design: Prospective observational study
Place and Duration of Study: Oral and Maxillofacial Surgery Department of Saidu Teaching Hospital, Saidu Sharif, Pakistan, from September, 2024 to April, 2025.
Methodology: A total of 65 patients with cleft lip and/or palate who underwent iliac crest bone grafting were studied. Patients were categorized based on Bergland scores at four months post-surgery, with successful reconstruction defined as a score ≤3. Furthermore, to assess the cosmetic outcome, patients’ satisfaction with their postsurgical looks was assessed as “Satisfied”, “Neutral” and “Dissatisfied”.
Results: The majority of patients were male 55 (84.6%), with 53 (81.5%) presenting with cleft lip and palate and 56 (86.2%) unilateral cases. The mean Bergland score was 2.01 ± 0.92, with 62 (95%) achieving satisfactory graft outcomes. Complications were infrequent, with infection 3 (4.6%), resorption 5 (7.7%), and suture dehiscence 2 (3.1%). Patient satisfaction and post-surgical complications were significantly associated with graft success (p < 0.001).
Conclusion: Iliac crest bone grafting for secondary alveolar cleft reconstruction yields high success rates, supporting both functional integration and cosmetic satisfaction. Careful patient selection and postoperative monitoring are critical for optimizing outcomes.
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References
1. Mattei R, Maggiulli F, Baumler C, Torres JH, Captier G. Evaluation of Alveolar Bone Reconstruction In Clefts With Early Or Late Secondary Bone Grafting: Use Of The 3d Kamperos score. J Craniofac Surg 2023; 34(6): 1682-1685. .
https://doi.org/10.1097/SCS.0000000000009445
2. Dong Z, Yang J, Fu Y, Li J. Comprehensive three-dimensional cone beam computed tomography assessment unilateral alveolar cleft reconstruction using autologous iliac cancellous bone combined with deproteinized bovine bone: A clinical retrospective evaluation. J Craniomaxillofac Surg 2024; 52(9): 1035-1041.
https://doi.org/10.1016/j.jcms.2024.06.002
3. Muller JN, Perez Rivera LR, Staffenberg DA, Flores RL. Exparel and Outpatient Alveolar Bone Grafting: A Feasibility Study. Cleft Palate Craniofac J 2025; 17: 10556656251313848.
https://doi.org/10.1177/10556656251313848
4. Kwon D, Shin Y, Jo T, Choi J, Kim J, Jeong W. Effect of Surgical Timing to Dental Health in Secondary Alveolar Bone Grafting: Three-Dimensional Outcomes. J Craniofac Surg 2025; 36(3): 922-927.
https://doi.org/10.1097/SCS.0000000000010665
5. Desai AK, Byadgi AA, Kumar N, Janardhan A, Manjunath T. Effect of "platelet rich" fibrin with bone marrow aspirate on the regenerative capacity of alveolar bone grafting with iliac bone graft: A randomized controlled trial. Natl J Maxillofac Surg 2024; 15(3): 460-466.
https://doi.org/10.4103/njms.njms_55_23
6. Mordukhovich I, Hill M, Fragomen FR, Meyers A, Gharb BB, Rampazzo A. A systematic review of wide alveolar cleft repair techniques. J Plast Reconstr Aesthet Surg 2025; 102: 335-347.
https://doi.org/10.1016/j.bjps.2025.01.053
7. Fowler PV, Al-Ani AH, Thompson JMD. Comparison of Reliability of Categorical and Continuous Scales for Radiographic Assessments of Bone Infill Following Secondary Alveolar Bone Grafting. Cleft Palate Craniofac J 2018; 55(2): 269-275.
https://doi.org/10.1177/1055665617723922
8. Doucet JC, Russell KA, Daskalogiannakis J, Mercado AM, Emanuele N, James L et al. Facial Growth of Patients With Complete Unilateral Cleft Lip and Palate Treated With Alveolar Bone Grafting at 6 Years. Cleft Palate Craniofac J 2019; 56(5): 619-627.
https://doi.org/10.1177/1055665618792791
9. Doucet JC, Alsabbagh A, Martyna S, Mercado AM, Daskalogiannakis J, Hathaway RR, et al. Graft Outcomes With or Without Use of Cortical Bone Graft for Nasal Floor Reconstruction in Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2025: 10556656251322619.
https://doi.org/10.1177/10556656251322619
10. Groff CK, Obinero CG, Cepeda A Jr, Barrera JE, Sobol DL, Nguyen PD, et al. Postoperative Radiologic Imaging in Secondary Alveolar Bone Grafting for Cleft Lip and Palate: A Systematic Review and Meta-Analysis. J Craniofac Surg 202435(3): 783-786.
https://doi.org/10.1097/SCS.0000000000010033
11. Lowry CH, Long RE, Russell K, Giltner JQ, Weaver L, Mercado AM et al. The Effect of Earlier Bone Grafting, Prior to Orthodontic Treatment, on SWAG Ratings of Graft Outcomes. Cleft Palate Craniofac J 2021; 58(2): 208-214. https://doi.org/10.1177/1055665620949433
12. Najar Chalien M, Mark H, Rizell S. Predictive factors for secondary alveolar bone graft failure in patients with cleft alveolus. Orthod Craniofac Res 2022; 25(4): 585-591.
https://doi.org/10.1111/ocr.12573
13. Philip-Alliez C, Fievet L, Serratrice N, Seiler M, Le Gall M, Charavet C et al. Cone Beam-CT-Based Bone Volume Assessments of Alveolar Synthetic Bone Graft GlassBONE™ in Cleft Lip and Palate Patients: A Retrospective Study. J Maxillofac Oral Surg 2024; 23(2): 342-352.
https://doi.org/10.1007/s12663-023-02056-6
14. K. Tomar, N.K. Sahoo NK. Evaluation of graft uptake from the iliac crest in secondary alveolar bone grafting: Bergland’s criteria revisited. J Oral Bio Craniofac Res 2018; 8: 171–176.
https://doi.org/10.1016/j.jobcr.2017.03.005
15. Lahooti RA, Khan MN, Amjad A. Radiographic assessment of secondary alveolar bone grafting. Pak Orthodont J 2017: 9(2) 93-97.
16. Ko EW, Huang CS, Chen YR, Lin WY, Chen PKT. Comparison of alveolar bone grafting outcomes using CBCT in individuals with UCLP based on the presurgical orthodontic treatment methods. Cleft Palate Craniofac J 2023; 60(4): 456–464.
https://doi.org/10.1177/10556656221143945
17. Zhang Y, Li X, Wang Y, Liu Y, Zhao Y. Effect of different membranes on vertical bone regeneration: A systematic review and network meta-analysis. Biomed Res Int 2022; 2022: 7742687.
https://doi.org/10.1155/2022/7742687
18. Oberoi S, Vyas RM, Chigurupati R. Orthodontic management of patients with cleft lip and palate: Phase I treatment. J Clin Orthod 2023; 57(4): 243–252.
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