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

ObjectiveTo 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.DesignRetrospective cohort study with consecutive sampling of 144 periapical radiographs taken 12 months after surgery.SettingA single tertiary craniofacial center.ParticipantsOne 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.InterventionsA 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 MeasuresThe 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).ResultsThere 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).ConclusionABG using the MS donor site is a viable option for patients with complete UCLP.