Alveolar Bone Graft Supplemented With Stromal Vascular Fraction in Patients With Permanent Dentition: A Randomized
Kleber Tetsuo Kurimori1, Endrigo Oliveira Bastos1, Paulo Roberto Pelucio Camara1
1Burn and Plastic Surgery Department, São Paulo University, Sao Paulo, Brazil.
Abstract:
ObjectiveTo evaluate bone development in patients with alveolar clefts and permanent dentition treated with alveolar bone graft supplemented with stromal vascular fraction (SVF).DesignClinical, prospective, randomized.LocationSingle tertiary care institution.PatientsEighteen participants with unilateral alveolar cleft and permanent dentition were included. Patients with other comorbidities were excluded.InterventionThe control group underwent alveolar bone grafting (ABG) using iliac crest bone, while the experimental group underwent the same treatment, supplemented with SVF. Adipose tissue was collected by abdominal liposuction, and the SVF was processed using mechanical methods (decantation, microfragmentation, and filtration).Main Outcome MeasurementBone formation and bone graft integration rate in alveolar cleft at 6 months postsurgery using 3-dimensional tomographic methods and density measurements.ResultsThe amount of bone graft correlated with an improvement in the relationship between the cleft and noncleft sides (R = 0.78, P < .001) and an improvement in alveolar cleft density (R = 0.69, P = .005), but did not correlate with the graft integration rate. The experimental group showed larger cleft sizes (0.83 × 1.74 cm3, P = .021) and older patients (17.35 × 27.6 years, P = .002), and did not differ in terms of bone development variables when compared to the control group.ConclusionABG supplemented with SVF showed statistically similar bone development results, but with a better trend than conventional ABG. Additionally, the studied groups had asymmetric pre-existing characteristics, with greater severity in the experimental group. A larger study will be necessary to mitigate preoperative characteristic differences and to more accurately compare the results between the methods.
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