Clinical study on osteogenic effect of sticky bone and autologous iliac cancellous bone graft in repairing unilateral alveolar cleft

doi:10.3969/j.issn.1674-8115.2025.08.009

Abstract

Abstract:

Objective ·To explore the clinical efficacy and safety of sticky bone [deproteinized porcine bone mineral granules combined with advanced platelet-rich fibrin (A-PRF) and liquid platelet-rich fibrin (L-PRF)] in the repair of unilateral alveolar cleft. Methods ·Patients diagnosed with unilateral alveolar cleft who met the inclusion and exclusion criteria were recruited from December 1,2023 to August 31,2024. The patients were randomly divided into 2 groups. The experimental group received sticky bone grafts, and the control group received autologous iliac cancellous bone grafts for alveolar cleft repair. The primary efficacy index was the bone resorption rate at 6 months post-surgery, calculated by measuring the grafted bone volume immediately after surgery and at 6 months using Simplant Pro 17.01 software based on patients' computed tomography data collected before surgery, immediately after surgery, and 6 months post-surgery. Secondary efficacy indices included bone density at 6 months after surgery, the occurrence of postoperative complications in patients, and the scores on the oral health-related quality of life scale. Prism 10 software was used for data analysis, and t-test and Pearson correlation analysis methods were adopted. Results ·Seventeen patients with unilateral alveolar cleft were included in the experimental group, and 15 in the control group. The remaining bone volume in the experimental group at 6 months after surgery was more than that in the control group. The bone resorption rate in the experimental group was 33.24%±17.16%, significantly lower than 66.31%±17.98% in the control group (P<0.001). One patient in the experimental group had vestibular mucosal dehiscence accompanied by bone powder discharge 2 weeks after surgery; 3 patients in the control group had vestibular mucosal dehiscence accompanied by cancellous bone discharge 1 month after surgery, with one case of grafted bone necrosis 4 months after surgery. The bone density in the experimental group at 6 months after surgery was significantly higher than that in the control group (P<0.001), and the scores on the oral health-related quality of life scale were lower. Conclusion ·Compared with iliac cancellous bone, when sticky bone is used in the treatment of patients with unilateral alveolar cleft, it shows a lower bone resorption rate and higher bone density, indicating better osteogenic ability. Fewer number of complications and lower scores on the oral health-related quality of life scale suggest greater safety, thereby supporting its strong potential for clinical promotion and application.

Key words: unilateral alveolar cleft, sticky bone, bone resorption rate, bone mineral density, oral health quality, bone grafting surgery

CLC Number:

R782.05

YU Zuyin, LIU Yiyun, XIE Jiahui, CAI Ming, SHEN Guofang. Clinical study on osteogenic effect of sticky bone and autologous iliac cancellous bone graft in repairing unilateral alveolar cleft[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(8): 1017-1026.

Figures/Tables 9

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References 42

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Indicator	Test group	Control group	P value
Gender (male)/n(%)	11 (64.7)	8 (53.3)	0.513
Age/year	15.47±6.00	13.93±4.85	0.518
Side (left)/n(%)	9 (52.9)	9 (60.0)	0.688
Hospital day/d	3.20±2.34	5.30±1.16	0.033
Patients receiving orthodontic treatment/n(%)	5 (29.41)	4 (26.67)	0.999
Width of piriform aperture on cleft side/mm	14.87±2.54	14.01±3.48	0.480
Width of alveolar crest of cleft side/mm	5.23±1.87	5.76±1.65	0.574

Indicator	Test group	Control group	P value
Gender (male)/n(%)	11 (64.7)	8 (53.3)	0.513
Age/year	15.47±6.00	13.93±4.85	0.518
Side (left)/n(%)	9 (52.9)	9 (60.0)	0.688
Hospital day/d	3.20±2.34	5.30±1.16	0.033
Patients receiving orthodontic treatment/n(%)	5 (29.41)	4 (26.67)	0.999
Width of piriform aperture on cleft side/mm	14.87±2.54	14.01±3.48	0.480
Width of alveolar crest of cleft side/mm	5.23±1.87	5.76±1.65	0.574

Influence factor	Test group		Control group
Influence factor	r	P	r	P
Width of apertura piriformis	0.427	0.146	0.516	0.086
Width of alveolar crest	0.493	0.087	0.825	0.001
Gender	0.327	0.254	0.564	0.089
Age	0.040	0.890	0.519	0.084
Cleft side	0.354	0.195	0.003	0.992
Orthodontic treatment	-0.200	0.474	0.287	0.367

Influence factor	Test group		Control group
Influence factor	r	P	r	P
Width of apertura piriformis	0.427	0.146	0.516	0.086
Width of alveolar crest	0.493	0.087	0.825	0.001
Gender	0.327	0.254	0.564	0.089
Age	0.040	0.890	0.519	0.084
Cleft side	0.354	0.195	0.003	0.992
Orthodontic treatment	-0.200	0.474	0.287	0.367

Influence factor	Test group			Control group
Influence factor	r	P		r	P
Width of apertura piriformis	0.184		0.547	0.184	0.547
Width of alveolar crest	0.256		0.398	0.256	0.547
Gender	0.514		0.050	0.009	0.977
Age	0.080		0.778	-0.048	0.883
Cleft side	0.259		0.352	-0.369	0.238
Orthodontic treatment	-0.145		0.621	0.390	0.203