99mTc-diphosphonates bone scintigraphy for vitality evaluation in cleft palate

Cleft of the lip, palate and alveolus are congenital oro-maxillofacial malformation with an established treatment protocol. At present, there is great interest in the alveolar bone grafting procedures that involve the use of platelet-rich-plasma (PRP), to enhance bone formation and specifically to promote bone graft healing in head and neck tissues regeneration. The aim of this retrospective case report study was to assess the condition and viability of the standard bone grafting in association with PRP (platelet rich plasma) to enhance osteogenesis and maintain osteointegration in alveolar cleft with a follow up of eight years from the surgical procedure. The viability of bone grafts was documented by means of head bone scintigraphy (99mTc-MDP). The scintigrams revealed the decreased uptake at the cleft region and the increased uptake at the adjacent alveolus of the cleft. From these findings we suggest that platelet concentrates decrease the need of further surgical intervention in cleft palate patients. In addition, scintigraphy may be useful to evaluate postoperative bone formation in the alveolar cleft.