Effectiveness of corticocancellous bone graft in cleft lip and palate patients: A systematic review

Both cancellous bone graft and corticocancellous bone graft are the most common grafts for repairing alveolar cleft, but there is no clear conclusion as to which method is beneficial to repair the alveolar cleft. The aim was to determine the effectiveness of corticocancellous bone graft in cleft lip and palate patients.

Electronic databases including PubMed, Ovid, Embase, Cochrane Library, Web of Knowledge, and China Biology Medicine disc (SinoMed) were searched. Only studies published in English or Chinese were included. The last search was updated on 1 January 2020. 2638 articles remaining after the exclusion of duplicates. Finally, there were 16 publications (15 in English and 3 in Chinese) eligible for systematic review according to the previously established inclusion and exclusion criteria. A descriptive statistical method was used to present data. The methodological index for non-randomized studies (MINORS) was used to determine the risk of bias.

Sixteen articles were included in this review, of which 15 publications were retrospective study and one was a comparative study. The average success rate of reconstruction with block bone was approximately 90.8%, while the success rate of the cancellous bone graft was about 85.3%. The incidence of wound dehiscence was approximately 10% to 16%, and infection is about 9% to 20%. The incidence of oronasal fistula resulting from severe bone resorption and infection was approximately 7.5% to 10.5%.

There is a higher bone formation rate of corticocancellous bone graft in patients with the alveolar cleft. However, more studies with high methodological quality and with a longer follow-up are needed to offer more safety for practitioners and patients regarding the surgical method selected to repair the cleft alveolar.