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Lee KC, Yau V, Khoshnevisan MA, Eisig SB. Dental Rehabilitation of the Unilateral Cleft Dental Gap: A Single Institution Experience With Long-Term Follow-Up. J Craniofac Surg 2024; 35:199-202. [PMID: 37934972 DOI: 10.1097/scs.0000000000009802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/26/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE The purpose of this study was to identify factors associated with the management of the cleft dental gap after alveolar bone grafting. METHODS This was a retrospective cohort study of patients with unilateral cleft lip and alveolus or palate who had successful alveolar bone grafting. Our primary study outcome was alveolar cleft management (orthodontic closure or space maintenance). Our secondary study outcome was the rate of fixed dental rehabilitation. Univariate comparisons were made with SAS 9.4. RESULTS The final study sample consisted of 54 patients. Most patients were treated with orthodontic closure (55.6%). Patients missing multiple teeth ( P < 0.01) were less likely to receive orthodontic closure. Orthodontic closure was not associated with differences in intermaxillary midline coincidence ( P = 0.22) or the need for LeFort advancement ( P = 0.15). Only 41.7% of patients who were managed with space maintenance obtained a fixed prosthesis. Hispanic ethnicity ( P < 0.01) and Medicaid insurance ( P < 0.01) were associated with lower rates of fixed dental rehabilitation. CONCLUSIONS Orthodontic closure was the most common approach, and it did not result in significant maxillary midline distortion. Less than half of patients treated with space maintenance obtained fixed restorations. Socioeconomic barriers are likely preventing access to definitive dental rehabilitation in patients with unilateral cleft lip and alveolus or palate.
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Affiliation(s)
- Kevin C Lee
- Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian Morgan Stanley Children's Hospital/Columbia University Irving Medical Center, New York, NY
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Ma X, Ju X, Shen J, Zheng L. Efficacy of recombinant human bone morphogenetic protein-2 for bone regeneration in alveolar defects: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31958. [PMID: 36626533 PMCID: PMC9750558 DOI: 10.1097/md.0000000000031958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There is still a lack of credible evidence in the literature regarding the effectiveness of recombinant human bone morphogenetic protein 2 (rhBMP-2) in bone regeneration of alveolar bone defects. Therefore, the purpose of this study is to evaluate the efficacy and safety of rhBMP-2 in autogenous bone graft in bone regeneration of alveolar bone defects and to provide basis for clinical practice. METHODS As of March 2023, two independent investigators will identify target literature by searching seven major databases (EMBASE, Google Scholar, PubMed, Cochrane Library, Wan Fang, CNKI, and Web of Science). All clinical cohort studies evaluating the efficacy of rhBMP-2 will be included. The outcomes of the study include changes in the depth of the dental pocket at the involved site, increased clinical attachment levels, patient satisfaction, and adverse events. The Cochrane risk of bias tool will be independently used to evaluate the risk of bias of included randomized cohort studies by two reviewers. A modified version of the Downs and Black tool is adopted to evaluate the quality of nonrandomized cohort studies. RESULTS We hypothesized that rhBMP-2 plays an active role in bone regeneration in alveolar bone defects. CONCLUSIONS It is worthy to critically review the evidence of the assessment of rhBMP-2 to inform clinical practice.
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Affiliation(s)
- Xudong Ma
- Department of Dentistry, Huzhou University, Huzhou, China
| | - Xueqi Ju
- Famous Doctor Hall, Hangzhou Dental Hospital, Hangzhou, China
| | - Juehui Shen
- Department of Periodontology, Hangzhou Dental Hospital, Hangzhou, China
| | - Lala Zheng
- General Department, Hangzhou Dental Hospital Group Nanxun Dental Clinic, Huzhou, China
- * Correspondence: Lala Zheng, General Department, Hangzhou Dental Hospital Group Nanxun Dental Clinic, Huzhou, Zhejiang Province 313000, China (e-mail: )
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Motamedian SR, Mohaghegh S, Lakmazaheri E, Ahmadi N, Kouhestani F. Efficacy of regenerative medicine for alveolar cleft reconstruction: A systematic review and meta-analysis. Curr Stem Cell Res Ther 2022; 17:446-465. [DOI: 10.2174/1574888x17666220204145347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/05/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022]
Abstract
Objective:
Objective: To analyze the efficacy and complications of regenerative medicine compared to autogenous bone graft for alveolar cleft reconstruction.
Method:
Method: Electronic search was done in PubMed, Scopus, Embase and Cochrane database for studies published until May 2021. No limitations were considered for the type of the included studies. The risk of bias (ROB) of the studies was assessed using the Cochrane Collaborations and NIH quality assessment tool. Meta-analyses were performed to assess the difference in the amount of bone formation and rate of complications. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for analyzing the level of the evidence.
Results:
Results: Among a total of 42 included studies, 21 studies used growth factors, 16 studies delivered cells, and five studies used biomaterials for bone regeneration of the alveolar cleft. Results showed no significant difference in the amount of bone formation between bone morphogenic protein-2 and iliac graft treated patients after six months (P=0.44) and 12 months (P=0.17) follow-up. Besides, higher swelling (OR=9.46,P<0.01) and less infection (OR=0.19,P=0.01) observed in BMP treated patients. Using stem cells can reduce the post-treatment pain (OR=0.04,P=0.01) but it has no significant impact on other complications (P>0.05). Using tissue engineering methods reduced the operation time (SD=1.06,P<0.01). GRADE assessment showed that results regarding the amount of bone formation volume after six and 12 months have low level of evidence.
Conclusion:
Conclusion: Tissue engineering methods can provide a comparable amount of bone formation as of the autogenous graft and reduce some of the complications, operation time and hospitalization duration.
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Affiliation(s)
| | - Sadra Mohaghegh
- Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Ehsan Lakmazaheri
- Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Nima Ahmadi
- University of Medical Sciences, Tehran 1983963113, Iran
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Zhang D, Sun XC, Wang H, Li JH, Yin LQ, Yan YF, Ma X, Xia HF. Repair of alveolar cleft bone defects in rabbits by active bone particles containing modified rhBMP-2. Regen Med 2021; 16:833-846. [PMID: 34463127 DOI: 10.2217/rme-2020-0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: A model of alveolar cleft phenotype was established in rabbits to evaluate the effect of active bone particles containing modified rhecombinant human BMP-2 on the repair of the alveolar cleft. Methods: 2-month-old Japanese white rabbits were selected and randomly divided into four groups: normal, control, material and BMP groups. Blood biochemical analysis, skull tomography (microfocus computerized tomography), and histological and immunohistochemical staining analysis of paraffin sections were performed 3 and 6 months after operation. Results: Both types of collagen particles showed good biocompatibility and promoted bone regeneration. The effect of active bone particles on bone repair and regeneration was better than that of bone collagen particles. Conclusions: Active bone particles containing modified rhecombinant human BMP-2 can be used for incisors regeneration.
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Affiliation(s)
- Dan Zhang
- Reproductive & Genetic Center of National Research Institute for Family Planning, Beijing, 100081, China.,Graduate Schools, Peking Union Medical College, Beijing, 100730, China
| | - Xue-Cheng Sun
- Reproductive & Genetic Center of National Research Institute for Family Planning, Beijing, 100081, China.,Graduate Schools, Peking Union Medical College, Beijing, 100730, China
| | - Hu Wang
- Reproductive & Genetic Center of National Research Institute for Family Planning, Beijing, 100081, China.,Graduate Schools, Peking Union Medical College, Beijing, 100730, China
| | - Jian-Hui Li
- Reproductive & Genetic Center of National Research Institute for Family Planning, Beijing, 100081, China.,Graduate Schools, Peking Union Medical College, Beijing, 100730, China
| | - Li-Qiang Yin
- Yantai Zhenghai Bio-Tech Co., Ltd. Shandong, 264006, China
| | - Yu-Fang Yan
- Yantai Zhenghai Bio-Tech Co., Ltd. Shandong, 264006, China
| | - Xu Ma
- Reproductive & Genetic Center of National Research Institute for Family Planning, Beijing, 100081, China.,Graduate Schools, Peking Union Medical College, Beijing, 100730, China
| | - Hong-Fei Xia
- Reproductive & Genetic Center of National Research Institute for Family Planning, Beijing, 100081, China.,Graduate Schools, Peking Union Medical College, Beijing, 100730, China
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