Digital Guided Cortico-Cancellous Iliac Bone Grafting For Alveolar Cleft

Cancellous bone grafting, considered the gold standard for alveolar cleft repair, has a drawback of high bone resorption rate. This research evaluates the efficacy of digital guide plate-assisted cortico-cancellous iliac crest bone grafting, aiming to minimize bone resorption and optimize treatment outcomes. This retrospective study was approved by the Ethics Committee of this institution and analyzed 39 unilateral alveolar cleft patients from January 2018 to December 2023. Group 1 (n=21, mean age 15.33 ± 5.36 years) received iliac cancellous bone grafts, and Group 2 (n=18, mean age 14.17 ± 4.05 years) underwent digital guide plate-assisted iliac cortico-cancellous bone grafts. Preoperative and postoperative CBCT were conducted to assess new bone formation rates, alveolar width, bone density, and nasal base symmetry. Statistical analyses were performed using the t-test. The composite bone group exhibited the new bone formation rate of 61.25%, markedly superior to 38.86% of cancellous bone group, and had a significant advantage in preserving alveolar width over the cancellous graft. It is suggested through the new method, surgeons can accurately determine the size and shape of the bony defect preoperatively. The prepared bone harvesting guides could be more precise, simplifying the bone harvesting surgery and minimizing trauma. It is discovered that the cortico-cancellous iliac crest bone in alveolar cleft bone grafting yields better results than cancellous bone grafting and offers superior mechanical properties, structural support, blood supply reconstruction, and nasal contouring, and the canines can erupt normally postoperatively.