The Clinical Observation Of Biological Guide Membrane、anorganic Bovine Bone Mix Wiht Ilium For Alveolar Cleft

Background and objective:Alveolar cleft is one of most commonly associated symptoms to cleft lip and palate.Treatment for cleft lip and palate has been in transition from simple closure to the cleft lip and palate team approach,including orthodontic treatment,corrective repair,alveolar cleft grafting, voice training and psychological therapy.Using autologous iliac bone transplantation is the golden standard for the treatment of alveolar cleft.At present,there is no any artificial materials can replace the autogenous bone.But there are some problems in using the autologous bone to treat alveolar cleft,such as the low success rate,bone absorption after the operation and so on.In the recent years,as the development of oral biological materials,some biological guide membrane and bone substitutes were continuously used in clinical practice.Bio-Gide(biological guide membrane) and Bio-Oss(anorganic bovine bone) also are widely used in oral implantology. However,without systematic clinical research,there is a few reports about the Bio-Gide and Bio-Oss applied in the alveolar cleft. We report in this study reference from clinical outcome of combined using of Bio-Gide,Bio-Oss and iliac cancellous bone graft in treatment for alveolar cleft,which can provide a new way for treatment of alveolar cleft.Methods:1.Establishment of experimental and control groups:167patients aged9-22years from2010to2014with complete unilateral alveolar were randomly divided into3groups with group C(55patients) being set as control group to receive simple iliac cancellous bone graft.Group B(56patients) and A(56patients) were treated by combined using of Bio-Gide and iliac cancellous bone graft and combine using Bio-Gide,Bio-Oss and iliac cancellous bone graft respectively as experimental groups.2.Osteogenesis:6months after the operation,analysis of the bone height in the area of graft using full panoramic radiographs by modified Bergland score.and thickness of the graft by CBCT.Result:1.3patient in group A,5patient in group B and6patient in group C manifested congestion swelling but no obvious infection in iliac wound one-week postoperatively and swelling faded in2weeks.Among the8patients in group A,7patients in group B and10patients in group C which showed swollen gum,indicating infection,4in group A,2in group B and2in group C recovered after treatment,the rest showed notable leaked bone graft particles.2.Panoramic radiographs and CBCT revealed resorption of grafts in all three groups6-month postoperatively,which showed the least resorption grafted by combined using of Bio-Gide、Bio-Oss and iliac bone graft.Meanwhile,grafted bone partially or completely fused with surrounding bone and no significant difference was detected in density between newly formed bone and the originals.Combined using of Bio-Gide,Bio-Oss and iliac bone graft method took dramatic advantages over the other methods(P<0.05).Conclusion:Combined using of Bio-Gide,Bio-Oss and iliac bone graft method took dramatic advantages over the other methods.Grafted bone displayed resorption in treating alveolar cleft.Simply using iliac bone graft led to highest resorption whereas combined using of Bio-Gide,Bio-Oss and iliac bone graft resulted in lowest resorption and thickest labial and palatal bone.