Abstract
Objective: An alternative to autogenous bone grafting for maxillary alveolar cleft repair is the application of recombinant human bone morphogenic protein in a collagen sponge matrix. Our aim was to quantify bone growth, examine parental satisfaction following the procedure, and evaluate dental/orthodontic outcomes for patients who underwent rhBMP-2 alveolar cleft repair.
Method: A retrospective review was performed on all patients who underwent alveolar cleft repair at a tertiary children’s hospital from 2007-2010. Satisfaction questionnaires were completed by parents, dentists, and orthodontists. Degree of bone fill was determined by independent grading of postoperative Panorefilms.
Results: Thirty-two of the 42 patient cohort had postoperative Panorefilms. Independent grading demonstrated 36.7% had >75% of the alveolar cleft filled, 47.8% had 50%-75% filled, and 17.3% had <50% filled. Mean length of follow-up was 24.4 months. One minor complication of bony overgrowth into the nasal cavity was reported. Parent and patient satisfaction regarding surgical outcome was 93.3% and 83.3% respectively. Of dentist respondents, 77.8% reported that the bone quality and alveolar ridge mucosal repair allowed for dental treatment. Of orthodontist respondents, 87.5% reported the graft enabled treatment, and 68.7% felt the graft prevented tooth root exposure and resorption.
Conclusion: Alveolar cleft repair using rhBMP-2 provides adequate bone growth to support dental and orthodontic treatment with minimal complications, while alleviating the need for autogenous bone grafting and its morbidity. In addition, the majority of patients and parents are highly satisfied with the surgical outcome.
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