Iliac crest bone graft harvesting techniques: a comparison

Area of Science:

• Oral and Maxillofacial Surgery
• Pediatric Dentistry
• Regenerative Medicine

Background:

• Traditional iliac bone graft harvesting for alveolar cleft repair involves significant morbidity.
• Minimally invasive techniques offer potential advantages in patient outcomes and recovery.

Purpose of the Study:

• To compare the morbidity associated with traditional iliac bone graft harvesting versus two minimally invasive techniques (bone grinder and trephine) for alveolar cleft grafting.

Main Methods:

• A comparative study involving 55 pediatric patients (ages 6.5-16) divided into three groups: traditional open harvest, bone grinder harvest, and trephine harvest.
• Outcomes measured included pain medication duration, operative time for bone harvest, incision length, complication rates, ambulation time, and hospital stay.

Main Results:

• Both minimally invasive techniques demonstrated statistically significant improvements (p < 0.05) in reduced pain medication duration, operative time, and incision length compared to the traditional method.
• Minimally invasive techniques led to fewer complications, earlier ambulation, and shorter hospital stays.
• The bone grinder technique showed faster ambulation and less need for analgesia than the trephine technique, though not statistically significant.

Conclusions:

• Minimally invasive techniques, particularly the bone grinder, are superior to traditional iliac bone graft harvesting for alveolar cleft repair when structural support is not required.
• The trephine technique remains valuable when structural grafts are needed, especially in conjunction with maxillary osteotomies.
• The authors have abandoned the traditional open harvesting technique in favor of minimally invasive approaches.