Randomized Controlled Trial Comparing Resorption Rates of Mandibular Cortical and Iliac Cancellous Bone Grafts in Alveolar Cleft Repair

Abstract

Objective

The main objective of the randomized controlled trial (RCT) was to evaluate the short-term osteogenic effects of mandibular cortex bone (MCB) versus iliac cancellous bone (ICB) after secondary alveolar bone graft.

Design

RCT.

Setting

Department of Oral and Cranio-Maxillofacial Surgery in the Shanghai Ninth People's Hospital from September 1, 2020, to August 31, 2023.

Patients

Patients with unilateral alveolar cleft.

Interventions

Those who met the inclusion criteria were randomly assigned to receive either MCB or ICB grafting. Clinical and radiographic examinations were performed preoperatively and immediately, as well as at 1, 3, 6, 12, 18, and 24 months postoperatively.

Main Outcome Measure(s)

The bone resorption rate was measured 6 months postoperatively. Clinical observations included adverse events and hospitalization details including length of surgery, intraoperative bleeding, length of stay, and costs.

Results

A total of 28 patients were included, with 16 allocated to the MCB group and 12 to the ICB group. The bone resorption rate in the MCB group (45.20 ± 29.81%) was significantly lower than that in the ICB group (74.87 ± 18.48%) (P = 0.005). Two adverse events were reported in the MCB group. The MCB group had significantly greater costs (P < 0.001), a significantly shorter length of stay (P < 0.001), and a significantly longer duration of surgery (P = 0.026). However, there were no significant differences in terms of intraoperative bleeding.

Conclusion

Compared with ICB, MCB demonstrated a slower bone resorption rate in the short term for treating secondary alveolar cleft in this study, albeit with increased surgical time and costs.

Trial Registration

Registry number: ChiCTR2000034227 [URL: https://www.chictr.org.cn/showprojEN.html?proj=55737].