Radiographic Comparison of Alveolar Bone Grafting in Cleft Lip and Palate: Iliac Crest Versus Mandibular Symphysis

Abstract

Objective

To compare the radiographic success rates of alveolar bone grafts (ABG) performed using bone harvested from the mandibular symphysis (MS) or the anterior iliac crest (IC). The null hypothesis was that the outcomes would be similar for both groups, regardless of the timing of surgery.

Design

Retrospective cohort study with consecutive sampling of 144 periapical radiographs taken 12 months after surgery.

Setting

A single tertiary craniofacial center.

Participants

One hundred forty-four patients with complete unilateral cleft lip and palate (UCLP) and a median age of 14 years were divided into 2 groups according to the donor site.

Interventions

A standardized surgical technique was used in the 144 recipient sites. Radiographic outcomes of ABG were classified as success or failure by three blinded evaluators based on the modified Bergland scale.

Main Outcome Measures

The primary outcome was the radiographic success rate according to the grafting material. Intra- and interrater reliability was evaluated using Kappa statistics. The Mann–Whitney test was applied to compare intergroup age medians. Intergroup comparison of bone graft success rates was performed using the chi-square test (P < .05).

Results

There was no statistically significant difference in patient age at grafting between the MS and IC groups (P = .116). Both groups had success rate above 90%, with no significant difference between them (P = .190).

Conclusion

ABG using the MS donor site is a viable option for patients with complete UCLP.