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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Cleft Alveolar Bone Grafting Using Mandibular Symphyseal Bone Graft and Resorbable Collagen Membrane: A CBCT-Based
Andi Setiawan Budihardja1,2, Dimas Satria Putra3, Lia Hapsari Andayani4
1Faculty of Dentistry, Universitas Pelita Harapan, Tangerang, Indonesia.
Summary
Mandibular bone grafts with collagen membranes show promising results for secondary alveolar bone grafting (SABG). This technique effectively reduces cleft width and forms a solid bone bridge in cleft lip/palate patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Medicine
- Craniofacial Surgery
Background:
- Iliac cancellous bone grafts, the traditional method for secondary alveolar bone grafting (SABG), face challenges including high resorption rates and donor-site morbidity.
- Alternative bone graft sources and techniques are needed to improve outcomes for patients with cleft lip/palate (CL/P).
Purpose of the Study:
- To evaluate the radiographic outcomes of SABG using a mandibular symphyseal bone graft combined with a double-layer resorbable collagen membrane.
- To assess the technique's efficacy through standardized 3-dimensional cone-beam computed tomography (CBCT)-based morphometric analysis.
Main Methods:
- A retrospective study involving 18 patients with unilateral cleft lip/palate (UCLP) or bilateral CL/P (BCLP) who underwent SABG.
- CBCT scans were used to measure preoperative and 1.5-year postoperative cleft width reduction and bone bridge thickness at mid-root and apical levels.
Main Results:
- Significant reduction in cleft width was observed at all measurement levels (P < .001) 1.5 years postoperatively.
- Mean postoperative bone bridge thickness was 5.97 ± 2.02 mm at the mid-root and 6.62 ± 2.50 mm at the apical level.
Conclusions:
- Mandibular symphyseal bone grafting with a resorbable collagen membrane provides favorable radiographic outcomes for SABG in CL/P patients.
- The technique demonstrates substantial defect reduction and satisfactory bone formation, suggesting it as a viable option for selected cases.
- Further prospective studies with larger cohorts and longer follow-up are recommended to confirm long-term stability and comparative effectiveness.
