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Li T, Wang YY, Li S, Hu Y, Sun Z, Liu C. Stem Cell Therapy's Efficiency in Reconstructing Alveolar Clefts: A System Review and Meta-Analysis of Randomized Controlled Trials. Stem Cells Int 2025; 2025:2780065. [PMID: 40196051 PMCID: PMC11972855 DOI: 10.1155/sci/2780065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Accepted: 02/17/2025] [Indexed: 04/09/2025] Open
Abstract
Objectives: The goal of this study was to examine the existing evidence from randomized controlled trials (RCTs) on the efficacy of cell treatment in alveolar cleft (AC). Design: An electronic search was done for studies published between January 2000 and May 2024 in the PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases. Primary outcomes were the radiographic assessment of bone graft volume, and the secondary outcome of interest was the number of complications after surgery. A random-effects model and fix-effect model were employed to pool effect sizes, and heterogeneity was assessed using I 2 statistics. Results: Four RCTs, comprising 51 patients, were included in the systematic review and meta-analysis. No statistically significant difference in bone volume (MD [mean difference] -0.82; 95% CI [-3.59, 5.24]; p=0.71) when using cells therapy to repair AC compared to using autologous iliac crest bone graft repair AC. Also, there is no difference in postoperative complications (MD 0.66; 95% CI [0.13, 3.39]; p=0.62) between the two groups. In this meta-analysis, cells therapy on alveolar bone grafting produced results comparable to autologous bone grafting in new bone formation rate and complications. Conclusions: In conclusion, this systematic review and meta-analysis appear to indicate no disadvantage to utilizing cell therapy in AC reconstruction versus autologous bone grafting in terms of bone volume or complications.
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Affiliation(s)
- Ting Li
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Yang Yang Wang
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Shan Li
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Yunzhe Hu
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Zixuan Sun
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Cheng Liu
- Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
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Khoswanto C, Dewi IK. The role of rhBMP-2 in mandibular bone regeneration following tooth extraction through HIF-1α and VEGF-A expression: An Immunohistochemical study. J Oral Biol Craniofac Res 2025; 15:359-364. [PMID: 40034370 PMCID: PMC11875168 DOI: 10.1016/j.jobcr.2025.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 02/01/2025] [Accepted: 02/04/2025] [Indexed: 03/05/2025] Open
Abstract
Background Dentists frequently conduct tooth extractions when there is damage to the tooth or the tissue that supports it. When a tooth is extracted, the alveolar bone will sustain injury. Most of the initial bone volume is lost following the healing phase after extraction. Rehabilitation must start as soon as a tooth is missing, mainly because the alveolar bone is severely damaged during the tooth extraction, particularly in the buccal region where the tooth is removed. Dental implant is one method of replacing lost teeth. One of the most important elements influencing the clinical result of dental implants is a change in the dimension of the alveolar bone. Several bone-grafting techniques, such as socket preservation techniques, have been developed to increase the volume of bone throughout the healing phase after tooth extraction. This study aims to assess the impact rhBMP-2 on creating bone regeneration through VEGF and HIF-1α in the mandibular socket post-extraction in Wistar rats. Method On the anterior side of the mandible, in the socket area where the tooth was extracted, rhBMP-2 was injected into the socket, and the xenograft material was applied with a syringe. Male, 9-week-old Wistar rats were chosen (n = 30). Result Our statistical evaluations have revealed a significantly higher VEGF-A and HIF-1α expression post-extraction of the rhBMP-2 and xenograft group compared to other group treatments. These findings are significant as they provide a deeper understanding of the mechanisms involved in bone regeneration post-extraction. Conclusion Our study suggests that injecting rhBMP-2 into the grafted material and socket extraction during GBR dramatically increases the expression of VEGF-A and HIF-1α. These findings have the potential to significantly impact oral surgery and regenerative dentistry, opening up new possibilities for enhancing bone regeneration techniques.
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Affiliation(s)
- Christian Khoswanto
- Department of Oral Biology Faculty of Dentistry, Airlangga University, Surabaya, Indonesia
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Wang QI, Tao Z, Zhao T, Qin D, He H, Hua F. THE USAGE AND REPORTING OF DENTAL PATIENT-REPORTED OUTCOMES AMONG SYSTEMATIC REVIEWS IN ORTHODONTICS: A METHODOLOGICAL STUDY. J Evid Based Dent Pract 2025; 25:102049. [PMID: 40087014 DOI: 10.1016/j.jebdp.2024.102049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 10/13/2024] [Accepted: 10/22/2024] [Indexed: 03/16/2025]
Abstract
OBJECTIVE To summarize and analyze the usage and reporting of dental patient-reported outcomes (dPROs) within systematic reviews (SRs) published in 5 leading orthodontic journals between 2015 and 2023. METHODS A manual search was conducted to identify intervention (therapeutic or preventive) involved SRs published in selected journals between 2015 and 2023 from the official online archives. Two authors independently and in duplicate extracted the characteristics of each included SR, recording both the usage of dPROs in the Methods sections and the reporting of dPROs in the Results sections. RESULTS A total of 244 SRs were found eligible and included, of which 81 (33.2%) included dPROs. Out of the 81 SRs, 19 (23.5%) described dPROs in the Methods sections, 6 (7.4%) reported dPROs exclusively in the Results sections, and 56 (69.1%) included dPROs in both sections. In the 75 SRs that stated dPROs in their Methods sections, 38 (50.7%) identified them as primary outcomes, while 37 (49.3%) considered them secondary outcomes. Among the 62 SRs that reported dPROs in the Results section, 17 (27.4%) performed quantitative synthesis, and the remaining 45 (72.6%) conducted only qualitative synthesis. A total of 26 dPROMs were identified, of which only 11 were included in meta-analyses. CONCLUSIONS Only about one-third of SRs published in leading orthodontic journals included dPROs. It is recommended that researchers consider the usage of dPROs and dPROMs during the design and registration stages of orthodontic SRs and ensure transparent reporting of the results, thus facilitating evidence-based practice and shared decision-making in clinical care.
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Affiliation(s)
- Q I Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhendong Tao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Danchen Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
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Francoisse CA, Sescleifer AM, Okeke RI, Tyson CV, Plikaitis C. Efficacy of Demineralized Bone Matrix for Revision Alveolar Bone Grafting in Patients Previously Treated with Bone Morphogenetic Protein 2 (BMP-2). Cleft Palate Craniofac J 2024; 61:1179-1185. [PMID: 36850061 DOI: 10.1177/10556656231159259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE This study investigates the effectiveness of demineralized bone matrix (DBX) to close alveolar clefts in patients previously treated with bone morphogenic protein-2 (BMP-2) who remained with bone nonunion. DESIGN This is an IRB-approved retrospective, single-center study. SETTING This study was conducted at a tertiary academic center. PATIENTS/PARTICIPANTS We searched for all surgical encounters with the Current Procedural Terminology (CPT) code 42210 from the years 2013-2019. Included patients were diagnosed with cleft alveolus, previous BMP-2 exposure and required revision bone grafting during mixed dentition for persistent alveolar defects. INTERVENTIONS 17 patients underwent revision alveolar bone grafting (ABG) with either DBX (n = 10) or autograft (n = 7) to repair persistent bony cleft. MAIN OUTCOME MEASURE(S) The primary study outcome measured was alveolar bone graft revision failure described as continued alveolar nonunion. RESULTS The median age at revision ABG was 13.1 ± 3.3 years, with a mean follow-up time of 4.9 years (1.1-9.2 years). Patients were 53% male, 47% had a unilateral cleft lip and alveolus. 58.8% of patients were treated with DBX in the cleft, 41.2% treated with autograft from iliac crest. Overall, 11.8% (n = 2) of all revisions failed, requiring a second revision. The average time to reoperation was 2.06 years, and both were re-grafted with autograft. There was no statistically significant difference between the type of bone graft source used and the failure rate obtained (P = .1544). CONCLUSIONS DBX and autologous iliac crest bone grafts achieve similar alveolar union rates during revision ABG in patients treated with previous BMP-2 to the alveolar cleft.
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Affiliation(s)
- Caitlin A Francoisse
- Division of Plastic Surgery, Saint Louis University, School of Medicine, St. Louis, MO, USA
| | - Anne M Sescleifer
- Department of General Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Raymond I Okeke
- Division of General Surgery, Saint Louis University, School of Medicine, St. Louis, MO, USA
| | - Cody V Tyson
- Division of Plastic Surgery, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA
| | - Christina Plikaitis
- Division of Plastic Surgery, Saint Louis University, School of Medicine, St. Louis, MO, USA
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Aldaghir OM, Naje AR, Ghadhban AT, Al Atabi HSH, Aldaghir OM. Effectiveness of maxillary cortical bone graft chips harvested by bone scraper, covered with platelet-rich fibrin (PRF), in reconstruction of alveolar clefts: comparative study. Oral Maxillofac Surg 2024; 28:205-216. [PMID: 36417043 DOI: 10.1007/s10006-022-01128-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study is to assess the effectiveness of maxillary cortical bone graft chips harvested by bone scraper, covered with platelet-rich fibrin (PRF) in alveolar clefts. PATIENTS AND METHODS Seventy-two cleft patients were examined for their eligibility to be part in this comparative study; they were randomly divided into group A, thirty-six patients had received cancellous bone chips from iliac crest; group B, thirty-six had received cortical bone chips harvested from maxilla using a curved bone scraper, covered with PRF. The clinical success over the follow-up period was evaluated on the basis of elimination of the oronasal fistula, radiographic assessment of bone graft volume, achievement of the osseous continuity of the alveolar arch, and the extent of the vertical bone height. RESULTS The mean of volume gained in group A was 0.8053 ± 0.9682, while for group B was 0.7397 ± 0.7703. The amount of vertical bone loss between groups was registered, and the chi-square test revealed insignificant differences between study groups (p = 0.547). The result of the frequency of fistula development after grafting in both groups was insignificant (p = 0.074). Also, for the continuity of the maxilla as a one piece, the results were insignificant differences between study groups (p = 0.058). CONCLUSION In conclusion of our study, intraoral harvesting of maxillary cortical chips by bone scraper covered with PRF is able to achieve a valid functional and aesthetic support in alveolar cleft patients, meeting the reconstructive goals.
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Marquez JL, Sudduth J, DeMay H, Kuo K, Battistini A, Yamashiro DK, Siddiqi FA, Gociman B. Early Results on the Efficacy of Demineralized Bone Matrix, Bone Morphogenic Protein, and Freeze-dried Bone Chips in Alveolar Cleft Repair. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5600. [PMID: 38322815 PMCID: PMC10846763 DOI: 10.1097/gox.0000000000005600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/15/2023] [Indexed: 02/08/2024]
Abstract
Background Conventional treatment for alveolar cleft repair is done using autologous iliac crest alveolar bone graft (ABG). However, this method may not be ideal in all patients. Analysis of the efficacy of a mixture of demineralized bone matrix (DBX), bone morphogenic protein (rhBMP-2), and freeze-dried bone chips (FDBC) as an alternative for alveolar cleft repair was performed. Methods Consecutive patients from August 2019 to June 2022 undergoing early alveolar cleft repair, concomitant hard palate and alveolar cleft repair, secondary alveolar cleft repair, and regrafting from a previously failed ABG were analyzed. Computed tomography scans were performed to evaluate graft take at least 6 months postoperatively. Images were reviewed and scored. Alveolar graft height and graft thickness were recorded. A standardized scoring system was developed, with a score of 0 representing no graft take and 3 representing best possible graft take. Results Fifty-five consecutive alveolar clefts (43 patients) were identified as having undergone ABG and satisfied all the other inclusion criteria. Of these, 29 underwent first time ABG and 26 underwent redo ABG. The mean graft height and graft thickness recorded for all clefts was 2.2 and 2.0, respectively. Conclusions Early results evaluating the efficacy of ABG using DBX, rhBMP-2, and FDBC show feasibility in regard to both graft height and thickness when using a maxillary computed tomography scan to measure the bone graft take. These results suggest that DBX, rhBMP-2, and FDBC may act as a versatile bone graft material in cleft care, although further studies are needed to determine long-term outcomes.
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Affiliation(s)
- Jessica L. Marquez
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jack Sudduth
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Henning DeMay
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Keith Kuo
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Andrea Battistini
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Duane K. Yamashiro
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Faizi A. Siddiqi
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Barbu Gociman
- From Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
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7
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Liao D, Pereira N, Obayemi A, Sclafani AP. Secondary Cleft Rhinoplasty. Facial Plast Surg Clin North Am 2024; 32:43-54. [PMID: 37981415 DOI: 10.1016/j.fsc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Secondary cleft rhinoplasty remains a challenging operation that requires an understanding of the aberrant anatomy in cleft lip nasal deformity as well as the ability to adapt various techniques suited to the needs of each patient. In this article, we review some of the classically described approaches in cleft rhinoplasty and different strategies to address the nasal subunits. Presurgical adjuncts, surgical interventions before facial skeletal maturity, and patient reported outcome measures are also discussed.
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Affiliation(s)
- David Liao
- Department of Otolaryngology, Weill Cornell Medicine, 1305 York Avenue, 5th Floor, New York, NY 10021, USA
| | - Nicola Pereira
- Department of Otolaryngology, Weill Cornell Medicine, 1305 York Avenue, 5th Floor, New York, NY 10021, USA
| | - Adetokunbo Obayemi
- Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical Center, Syracuse, NY, USA
| | - Anthony P Sclafani
- Department of Otolaryngology, Weill Cornell Medicine, 1305 York Avenue, 5th Floor, New York, NY 10021, USA.
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Chantiri M, Nammour S, El Toum S, Zeinoun T. Effect of rh-BMP-2 in the Initiation of Neovascularization in Human Gingival Tissue: A Split-Mouth Clinical Study. Life (Basel) 2023; 13:2298. [PMID: 38137899 PMCID: PMC10744365 DOI: 10.3390/life13122298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of this study is to evaluate the effect on the initiation of new blood vessel formation of rh-BMP-2 administration in the human gingival tissue during bone regeneration surgery. MATERIAL AND METHODS The randomized controlled clinical trial included twenty patients with bilateral partial edentulous of the mandibular premolar and molar region. Each patient received one implants on each side. Only one side received a 0.25 µg injection of rhBMP-2 into the gingival flap and grafted material during guided bone regeneration (GBR) for dental implantation. And the other side received GBR without injection. Three samples were collected from each patient as follows: one from the anterior area of the mandible (control group #1) collected at the time of all implant surgeries, and the two other samples during the placement of healing abutments at 4 months of follow-up, from treated side with rh-BMP-2 (test group) and untreated ones (control group #2). A total of 60 gingival samples were collected. Samples were stained with hematoxylin-eosin, and immunohistochemistry was performed with a vascular endothelial growth factor marker. The number of new vessels in each sample was counted. RESULT Statistical analyses showed a significantly higher number of new vessels in the gingival tissue of the test group. CONCLUSIONS Rh-BMP-2 injections into the gingival flap significantly improved new blood vessel formation.
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Affiliation(s)
- Mansour Chantiri
- Department of Periodontology, Faculty of Dental Medicine, Lebanese University, Beirut 27798, Lebanon;
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Sami El Toum
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut 27798, Lebanon;
| | - Toni Zeinoun
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut 27798, Lebanon;
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Strujak G, Marlière DAA, de Lima Medeiros Y, Carlini JL, de Lima AAS. Radiographic Assessment of Different Autogenous Bone Grafts in the Alveolar Cleft: A Retrospective Longitudinal Study. J Maxillofac Oral Surg 2023; 22:938-945. [PMID: 38105821 PMCID: PMC10719184 DOI: 10.1007/s12663-023-01981-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/19/2023] [Indexed: 12/19/2023] Open
Abstract
Objectives To assess feasibility and maintenance of bone after alveolar cleft reconstructions using graft from iliac crest and mandibular symphysis. Methods 51 alveolar clefts grafted with iliac crest and 51 ones grafted with mandibular symphysis bones were selected from patients aged between 7 and 12 years. At three (T1) and 12 months (T2) after surgeries, periapical radiographs were performed to measure the height of the grafted bone based on the modified Bergland scale. Chi-square and Mann-Whitney-Wilcoxon tests compared differences between T1 and T2 according to each bone graft. Results From the clefts grafted with mandibular symphysis bone, 47 were classified as type I (92.5%) and 04 as type II (7.84%) at T1. At T2, 36 were classified as type II (25.49%) and 02 as type III (3.92%). In the analysis of the clefts grafted with iliac crest at T1, 48 were classified as type I (94.11%) and three as type II (5.88%). At T2, 37 classifieds as type I (72.54%), 12 as type II (23.52%) and two as type III (3.92%). There was no statistically significant difference between treatments. Conclusions It was concluded that iliac crest and mandibular symphysis are adequate areas from which bone grafts can be obtained for reconstruction of alveolar cleft.
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Affiliation(s)
| | - Daniel Amaral Alves Marlière
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Limeira Avenue, 901, Areião, Piracicaba, São Paulo, 13414-903 Brazil
| | | | - João Luiz Carlini
- Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná Brazil
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Zielinski E, Santiago CN, Santiago GS, Zelko I, Hlavin R, Choudhary A, Purnell CA. Differences in Practice in Alveolar Bone Grafting Among American Cleft Palate-Craniofacial Association Members. Cleft Palate Craniofac J 2023; 60:1404-1410. [PMID: 35642289 DOI: 10.1177/10556656221104036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to determine areas of agreement and disagreement among American Cleft Palate-Craniofacial Association (ACPA)members in the clinical practice of alveolar bone grafting (ABG), to guide further research to optimize ABG practices. A cross-sectional survey was conducted. The respondents were in an academic, combination, or private practice. The respondents were either plastic or oral and maxillofacial surgeons (OMFS) from various countries. A de-identified 24-question online survey was distributed to ACPA surgeon members utilizing the Research Electronic Data Capture (REDCap) tool. Data collected included surgeon specialty, use of various alveolar bone graft surgical techniques, as well as protocols. There was more variability than consensus between specialties with regards to the preoperative workup, timing of surgery, materials used for bone graft, surgical techniques, perioperative management, and postoperative evaluation. There was consensus on grafting during mixed dentition, not staging soft and hard tissue closure, and using iliac crest for primary and secondary grafting. Disagreements involved factors used to time the procedure and type of imaging used to assess viability. Technical differences involved incision type, part of bone grafted, use of minimally invasive technique, and material used for revisions. Aside from areas of consensus among surgeons on ABG, several areas, including use of bone substitutes in revision grafting, incision and type of iliac crest graft used during initial grafting, and postoperative protocols, had no consensus. These areas should be targets of further research to determine if there truly is an optimal method to perform ABG. The study was approved by the University of Illinois at Chicago Institutional Review Board. A de-identified 24-question online survey was distributed to surgeon members of the ACPA utilizing the REDCap tool on August 7, 2020. The survey questions consisted of multiple choice and multiple selection questions including an option to select "other" and specify the information in a blank space. Data collected included surgeon specialty, use of various alveolar bone graft surgical techniques, as well as pre and postoperative protocols. The full survey is included in online Supplemental material. Data analysis was performed in SPSS Statistics 27 (IBM Corp.). Descriptive statistics were performed, and chi-square was used to test for significant differences in survey responses between groups.
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Affiliation(s)
- Eric Zielinski
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Chiara N Santiago
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Gaia S Santiago
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Ian Zelko
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert Hlavin
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Akriti Choudhary
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Chad A Purnell
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- Craniofacial Center, Division of Plastic, Reconstructive, and Cosmetic Surgery, University of Illinois at Chicago, Chicago, IL, USA
- Shriners Children's Hospital, Chicago, IL, USA
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11
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Sleman N. Alveolar cleft reconstruction using iliac bone graft: a clinical case report. Ann Med Surg (Lond) 2023; 85:5776-5781. [PMID: 37915633 PMCID: PMC10617901 DOI: 10.1097/ms9.0000000000001348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/16/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance Alveolar clefts are frequently occurring congenital anomalies that can significantly impact both the functional and aesthetic aspects of an individual's life. Thus, reducing the quality of life. These clefts can give rise to difficulties in feeding, speech, and dental development. Furthermore, the presence of a gap in the alveolar ridge can disrupt the proper alignment and eruption of permanent teeth. Various techniques have been developed to effectively repair these defects and restore oral function and rehabilitation. Case presentation An 18-year-old girl is presented with unilateral alveolar cleft which was successfully repaired by utilizing iliac bone grafting and augmenting the defect to restore proper bone architecture and gain suitable support for dental prostheses. Therefore, enhancing oral health by closing the oronasal fistula and improving aesthetics and functional abilities including speech. Clinical discussion Having an alveolar cleft can lead to challenges which may require a multidisciplinary approach, including surgical intervention, orthodontic treatment, and dental rehabilitation. The primary goal is to close the cleft, restore normal speech and feeding functions, and promote proper dental development. Conclusion Patients who suffer from alveolar clefts need appropriate treatment. This case report suggests a surgical technique of utilizing the combination of hard and soft tissue management to fix the problem for such individuals and achieve improved oral health, speech, and overall enhancement in quality of life.
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Affiliation(s)
- Nadim Sleman
- Department of Oral and Maxillofacial Surgery, Tishreen University Hospital, Latakia, Syria
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12
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Srivastav S, Tewari N, Antonarakis GS, Duggal R, Saji S, Lokade AK, Yadav R. Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate. J Clin Med 2023; 12:6002. [PMID: 37762942 PMCID: PMC10532364 DOI: 10.3390/jcm12186002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. OBJECTIVES To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. SEARCH METHODS The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. SELECTION CRITERIA Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. DATA COLLECTION AND ANALYSIS A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. RESULTS A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. CONCLUSIONS The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. REGISTRATION A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).
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Affiliation(s)
- Sukeshana Srivastav
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Nitesh Tewari
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Gregory S. Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Seba Saji
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Amol Kumar Lokade
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rahul Yadav
- Division of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
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Zhang Y, Zheng X, Zhang Q, He Z, Huang W, Yan X, Lv T, Yuan X. Clinical finite element analysis of mandibular displacement model treated with Twin-block appliance. Am J Orthod Dentofacial Orthop 2023; 164:395-405. [PMID: 37029052 DOI: 10.1016/j.ajodo.2023.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION The mechanical distribution of the mandible is an important factor that affects functional orthosis during Twin-block (TB) appliance correction. Changes in the mandible before and after TB appliance correction are also key factors in maintaining the therapeutic effect. Finite element analysis, a powerful numerical, analytical tool, is widely used to predict the stress and strain distribution of the craniofacial bone that orthodontics generates. METHODS The sample was a 14-year-old male patient with Class II malocclusion during growth. A cone-beam computed tomography scan was undertaken at pretreatment and posttreatment. In the Finite element analysis of the pretreatment model, the remote displacement model of the mandible was established with the sella point as the center. A mandibular model under TB appliance loading was established. Its mandibular displacement and von Mises stress were compared before and after loading. Three-dimensional registration was conducted on the pretreatment and posttreatment models to measure the sagittal displacement of the centrosome. RESULTS The force on the mandible occurred mainly in the condyle neck and medial mandible after the TB appliance moved the mandible. After displacement, the posterior upper margin of the condyle was farther away from the articular fossa. Three-dimensional registration results showed that new bone had formed behind and above the condyle after TB appliance treatment. CONCLUSION The TB appliance provides additional advantages in treating skeletal Class II malocclusions by helping to reduce the burden on the temporomandibular joint and promoting the adaptive reconstruction of the mandible.
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Affiliation(s)
- Yingyue Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Xinyu Zheng
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Qiang Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Zijing He
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Wenli Huang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Xiao Yan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Tao Lv
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Qingdao, China.
| | - Xiao Yuan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China.
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Khdairi N, Halilah T, Khandakji M, Bartzela T. Rapid Maxillary Expansion Treatment in Patients with Cleft Lip and Palate: A Survey on Clinical Experience in the European Cleft Centers. J Clin Med 2023; 12:jcm12093159. [PMID: 37176600 PMCID: PMC10179601 DOI: 10.3390/jcm12093159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Cleft lip and palate patients require complex interdisciplinary treatment, including maxillary expansion and secondary alveolar bone grafting. However, the evidence on these treatment procedures and outcomes is lacking. Therefore, this study aimed to survey the subjective observations of European maxillofacial surgeons and orthodontists on the maxillary expansion and bone grafting treatment protocols and the associated complications. An online questionnaire was sent to 131 centers. The questions assessed the participants' demographic data, maxillary expansion and alveolar bone grafting protocols, and the associated complications. Descriptive statistics and a t-test were used to analyze the data. The response rate was 40.5%. The average age for maxillary expansion was 9-10 years. The secondary alveolar bone grafting was planned 5-10 months after the expansion. The most common complications were asymmetric expansion, relapse, and fistula formation. The protocols and materials used vary widely among centers. Anatomical alterations and developmental processes, like tooth eruption adjacent to the cleft, should be seriously considered for treatment planning. This survey showed that there is still a lack of consensus on these treatment procedures. Further clinical trials should focus on long-term outcome evaluation to identify treatment components for optimal alveolar bone substitution and transversal maxillary expansion treatment in patients with clefts.
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Affiliation(s)
| | | | - Mohannad Khandakji
- Dental Department, Hamad Dental Center, Hamad Medical Cooperation, Doha P.O. Box 3050, Qatar
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 14197 Berlin, Germany
- Department of Orthodontics, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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Ambrosio ECP, Sartori IC, Jorge PK, Carrara CFC, Valarelli FP, Machado MAAM, Oliveira TM. Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study. J Appl Oral Sci 2022; 30:e20220120. [PMID: 35920507 PMCID: PMC9586431 DOI: 10.1590/1678-7757-2022-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Oral cleft surgical repairs are performed using different techniques worldwide. To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life. METHODOLOGY This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) - cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) - cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months - pre-surgical (T1) and six years of life- post-surgical (T2). The following linear measurements were analyzed: intercanine (C-C'), intertuberosity (T-T') distances; anterior dental arch (I-CC'), anterior intersegment (I-C'), and total arch (I-TT') lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05). RESULTS In G1, the intragroup comparison showed statistically significant smaller I-CC' and I-C' at T2 (p=0.001 and p<0.001, respectively), while T-T', I-TT', and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C-C' and I-C' at T2 (p=0.004, for both), whereas T-T', I-TT' and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I-CC' (p=0.014). The analysis of the intergroup differences (∆=T2-T1) showed that G1 had a statistically smaller I-CC' (p=0.043). CONCLUSION The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.
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Affiliation(s)
- Eloá Cristina Passucci Ambrosio
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Isabela Castro Sartori
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Paula Karine Jorge
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | | | | | - Maria Aparecida Andrade Moreira Machado
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Thais Marchini Oliveira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
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Sales PHDH, Oliveira-Neto OB, de Lima FJC, Carvalho ADAT, Leão JC. Effectiveness of rhBMP-2 versus iliac autogenous bone graft in reconstructive surgery of cleft patients: an umbrella review. Br J Oral Maxillofac Surg 2022; 60:723-730. [PMID: 35184916 DOI: 10.1016/j.bjoms.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/11/2021] [Accepted: 12/02/2021] [Indexed: 12/13/2022]
Abstract
The objective of this umbrella review was to determine the effectiveness of rhBMP-2 in the reconstructive surgery of cleft patients through an evaluation of bone filling and volume of newly formed bone in the cleft area. A systematic search was carried out in PubMed/ Medline, Scopus, Cochrane Database of Abstracts of Reviews of Effects (DARE), Latin American and Caribbean Health Sciences Literature (LILACS), and the System for Information on Grey Literature in Europe (SIGLE) via Open Grey, until June 2020. Risk of bias was assessed using the ROBIS tool. A total of 2739 articles were identified and, based on the inclusion and exclusion criteria, six were included for final evaluation. The bone filling rate was 74.23% in the rhBMP-2 group and 72.38% in the autogenous group. Regarding the risk of bias, none of the articles had a low risk, four had an uncertain risk, and two a high risk. The results of this umbrella review show that the studies had high and uncertain risks of bias, and high heterogeneity. There was a lack of evidence regarding the possible complications offered by this therapy. The recommendation to use BMP-2 for alveolar cleft reconstruction, especially in a paediatric population, should be viewed with caution. New primary studies are needed to assess this variable and safely determine the use of rhBMP-2 in reconstructive surgery for cleft patients.
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Affiliation(s)
- Pedro Henrique da Hora Sales
- Department of Prosthesis and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Recife, Brazil.
| | | | | | | | - Jair Carneiro Leão
- Department of Clinical and Preventive Dentistry, Dental School, Federal University of Pernambuco, Recife, Brazil
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"Improved Success Rate with Corticocancellous Block Compared to Cancellous-only Trephine Technique in Alveolar Bone Grafting from the Iliac Crest". Plast Reconstr Surg 2022; 150:387e-395e. [PMID: 35671445 DOI: 10.1097/prs.0000000000009352] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alveolar bone grafting is an important component of cleft lip and palate treatment, with iliac crest as the most common donor site. Although studies have attempted to quantify alveolar bone graft resorption, few have directly compared the outcomes of graft techniques. This study compared the long-term success rates of corticocancellous block to trephine cancellous-only alveolar bone grafting from the iliac crest. METHODS A retrospective review of all cleft lip and palate patients undergoing alveolar bone grafting over 14 years was performed. Power analysis was performed to determine sample size. Data including patient demographics, surgical technique, need for repeat grafting, complications, length of hospitalization, and follow-up were collected. Statistical analyses of outcomes were performed based on initial graft technique. RESULTS A total of 106 initial operations met criteria, with 73 using trephine technique, 30 utilizing corticocancellous block, and 3 undergoing open cancellous harvest. The overall regraft rate was 40% with an average follow-up of 43.5 months. Patients with corticocancellous block grafting had significantly lower rates of repeat grafting compared to trephine technique (16.7% vs. 47.9%, p<0.001). There was no significant difference in complications rates or length of admission between treatment groups. CONCLUSIONS The use of corticocancellous block alveolar bone grafting demonstrated significantly higher success rates when compared to cancellous-only trephine techniques with no difference in complication rates. Although this must be weighed against the minor disadvantages of open iliac harvest, surgeons should consider incorporating en bloc corticocancellous bone to optimize outcomes in alveolar bone grafting.
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Alfayez E, Alghamdi F. Clinical Application of Stem Cell Therapy in Reconstructing Maxillary Cleft Alveolar Bone Defects: A Systematic Review of Randomized Clinical Trials. Cureus 2022; 14:e23111. [PMID: 35425680 PMCID: PMC9002340 DOI: 10.7759/cureus.23111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 11/25/2022] Open
Abstract
An alveolar cleft is the most common congenital bone defect. This systematic review aimed to investigate the use of stem cells for alveolar cleft repair and summarize the outcomes of clinical research studies. The electronic databases PubMed, Scopus, Web of Sciences, and Google Scholar were utilized to search the literature for relevant studies after administering specific inclusion and exclusion criteria. The search included articles that were published from 2011 to 2021 and specific keywords were used in the databases. The search was completed by two independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Only four studies satisfied both the inclusion and exclusion criteria and were included in this systematic review. These studies investigated different aspects of bone reconstruction in the maxillary alveolar bone by stem cells, including cell types, clinical applications, biomaterial scaffolds, and follow-up period. The accumulated evidence in this systematic review is limited and insufficient to support the role of stem cell use in bone regeneration of maxillary alveolar bone defects. The outcome of using stem cells was studied only in 57 subjects from the four included studies. Although the noninvasive methods of isolating stem cells make them attractive resources for bone regeneration, more research is required in order to standardize and investigate stem cell therapy. This should be done beforehand in adults in less invasive procedures such as bone defect repair in dentistry prior to considering this type of therapy in this vulnerable patient population.
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Affiliation(s)
- Eman Alfayez
- Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Faisal Alghamdi
- Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Gill S, Prakash M, Forghany M, Vaderhobli RM. An ethical perspective to using bone grafts in dentistry. J Am Dent Assoc 2022; 153:88-91. [PMID: 34996535 DOI: 10.1016/j.adaj.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 01/15/2023]
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Liu C, Qin W, Wang Y, Ma J, Liu J, Wu S, Zhao H. 3D Printed Gelatin/Sodium Alginate Hydrogel Scaffolds Doped with Nano-Attapulgite for Bone Tissue Repair. Int J Nanomedicine 2021; 16:8417-8432. [PMID: 35002236 PMCID: PMC8722573 DOI: 10.2147/ijn.s339500] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/30/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Bone tissue engineering (BTE) is a new strategy for bone defect repair, but the difficulties in the fabrication of scaffolds with personalized structures still limited their clinical applications. The rapid development in three-dimensional (3D) printing endows it capable of controlling the porous structures of scaffolds with high structural complexity and provides flexibility to meet specific needs of bone repair. METHODS In this study, sodium alginate (SA)/gelatin (Gel) hydrogel scaffolds doped with different contents of nano-attapulgite were fabricated via 3D printing. The surface microstructure, hydrophilicity and mechanical properties were fully evaluated. Furthermore, mouse bone marrow-derived mesenchymal stem cells (BMSCs) were cultured with the composite hydrogels in vitro, and proliferation and osteoblastic differentiation were assessed. A rabbit tibia plateau defect model was used to evaluate the osteogenic potential of the composite hydrogel in vivo. RESULTS When increasing nano-ATP content, the Gel/SA/nano-ATP composite hydrogels showed better mechanical property and printability. Moreover, Gel/SA/nano-ATP composite hydrogels showed excellent bioactivity, and a significant mineralization effect was observed on the surface after being incubated in simulated body fluid (SBF) for 14 days. The Gel/SA/nano-ATP composite hydrogel also showed good biocompatibility and promoted the osteogenesis of BMSCs. Finally, histological analysis demonstrates that the Gel/SA/nano-ATP composite hydrogels could effectively enhance bone regeneration in vivo. CONCLUSION These properties render the Gel/SA/nano-ATP composite hydrogel scaffolds an ideal bone tissue engineering material for the repair of bone defects.
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Affiliation(s)
- Chun Liu
- Medical Research Centre, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
| | - Wen Qin
- Medical Research Centre, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
| | - Yan Wang
- Department of Clinical Laboratory, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
| | - Jiayi Ma
- Medical Research Centre, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
| | - Jun Liu
- Medical Research Centre, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
| | - Siyu Wu
- Medical Research Centre, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
| | - Hongbin Zhao
- Medical Research Centre, Changzhou Second People’s Hospital Affiliated to Nanjing Medical University, Changzhou, 213164, People’s Republic of China
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From Blood to Bone-The Osteogenic Activity of L-PRF Membranes on the Ex Vivo Embryonic Chick Femur Development Model. MATERIALS 2021; 14:ma14247830. [PMID: 34947427 PMCID: PMC8707053 DOI: 10.3390/ma14247830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022]
Abstract
(1) Background: To evaluate the effects of the direct and indirect contact of leukocyte and platelet-rich fibrin (L-PRF) on bone development, in an ex vivo embryonic chick femur model. (2) Methods: Both sections of L-PRF membranes (red and yellow portions) were evaluated with scanning electron microscopy and histochemical staining. The in vivo angiogenic activity was evaluated using a chorioallantoic membrane model. The osteogenic activity was assessed with an organotypic culture of embryonic chick femora through direct and indirect contact, and assessment was conducted by microtomographic and histological analysis. Descriptive statistics, One-Way ANOVA and Tukey’s multiple comparisons tests were performed for datasets that presented a normal distribution, and Kruskal-Wallis tests were performed for non-parametric datasets. A significance level of 0.05 was considered. (3) Results: The L-PRF induced angiogenesis reflected by a higher number and a larger and more complex gauge in the vessels that invaded the membrane. The physical presence of the membrane over the bone (direct contact) unleashes the full potential of the L-PRF effects on bone growth enhancement. The greatest increase in mineral content was observed in the diaphysis region. (4) Conclusion: The L-PRF direct contact group presented higher values on mineral content for bone volume, bone surface and bone mineral density than the indirect contact and control groups.
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22
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Alkaabi SA, Alsabri GA, NatsirKalla DS, Alavi SA, Mueller WEG, Forouzanfar T, Helder MN. A systematic review on regenerative alveolar graft materials in clinical trials: Risk of bias and meta-analysis. J Plast Reconstr Aesthet Surg 2021; 75:356-365. [PMID: 34642060 DOI: 10.1016/j.bjps.2021.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/16/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alveolar cleft grafting is a necessary procedure to restore bone defects. Randomized clinical trials (RCTs) are regarded as a golden standard for investigating the efficacy of treatments. Nevertheless, risk of bias (RoB) can still affect the validity of these trials. We aimed to conduct a systemic review of all control trials (CTs) using regenerative materials for alveolar cleft reconstructions to evaluate their RoB and perform a meta-analysis of new bone formation. METHODS Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE AND Google Scholar were searched up to October 2020. Thereafter, the articles underwent quality assessment (according to the Jadad scale and the Delphi list) for the evaluation of the RoB. RESULTS A total of 15 trials met the inclusion criteria, none of which reached a full score. Of these, 20% didn't randomize the trails, 73,33% failed to describe the way of randomization, and none reported the double-blinded criteria. Furthermore, allocation concealment (99.9%), intention to treat (100%), and patient awareness (100%) were inadequately described. The meta-analysis found no significant difference between regenerative materials and iliac crest graft. CONCLUSION This review showed high RoB in CTs implying quality improvement of CTs is necessary. Meta-analysis showed no significant difference between the regenerative materials and autogenous grafts.
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Affiliation(s)
- S A Alkaabi
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Oral and Maxillofacial Surgery, Fujairah Hospital, Ministry of Health, United Arab Emirates.
| | - G A Alsabri
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - D S NatsirKalla
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - S A Alavi
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - W E G Mueller
- Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - M N Helder
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Regenerative Strategies in Cleft Palate: An Umbrella Review. Bioengineering (Basel) 2021; 8:bioengineering8060076. [PMID: 34205126 PMCID: PMC8230219 DOI: 10.3390/bioengineering8060076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Alveolar bone defects or decreased alveolar bone height and width may have different causes, such as cleft palate. Regenerative procedures in oro-dental defects are challenging due to anatomical factors and the distinct cell populations involved. The iliac crest bone graft remains the gold-standard for cleft palate closure. However, tissue regeneration approaches have been employed and their outcome reviewed, but no conclusions have been made about which one is the gold-standard. (2) Methods: this umbrella review aims to critically appraise the effectiveness of the current approaches in bone defects regeneration in non-syndromic patients with cleft palate. A search was performed in PubMed, Cochrane Library, Scopus, Web of Science and EMBASE databases. (3) Results: Systematic reviews of randomized and non-randomized controlled trials with or without meta-analysis were included. Nine articles were included in the qualitative analysis and five in the quantitative one. The included studies quality was evaluated with AMSTAR2. (4) Conclusions: The use of new regenerative strategies, such as bone morphogenic protein 2, appears to provide similar results regarding bone volume, filling, and height to the standard technique with the iliac crest bone graft.
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Liu B, Yin NB, Xiao R, Li BH, Li HD, Chen SX, Li SL, Wang YQ. Evaluating the efficacy of recombinant human bone morphogenic protein-2 in the treatment of alveolar clefts with autologous bone grafting using computer-aided engineering techniques. Br J Oral Maxillofac Surg 2020; 59:757-762. [PMID: 34266703 DOI: 10.1016/j.bjoms.2020.08.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
Recent studies have indicated the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) to be a viable adjunctive to alveolar cleft reconstruction owing to its osteoinductive capacity. This study aimed to evaluate the efficacy of rhBMP-2 in the treatment of alveolar cleft with autologous bone grafts by precise volumetric analysis. Twenty-six patients (aged 8-14) with unilateral alveolar clefts were enrolled in this comparative study. Patients were divided into two groups: the iliac crest bone graft (ICBG) was placed at the side of the cleft in the control group (ICBG group), and rhBMP-2 was mixed with the ICBG in the rhBMP-2 group (BMP group). Helical computed tomographic images were obtained preoperatively and 12 months postoperatively. The datasets were reconstructed as three-dimensional (3D) images using Mimics software and processed using Geomagic Wrap. The newly formed bone of the alveolar cleft was segmented by identifying the differences between preoperative and postoperative 3D images. In the ICBG group, the volume of newly formed bone ranged from 0.25 to 0.88 cm3, and the mean (SD) bone formation percentage was 42.01% (15.57%). In the BMP group, the volume of newly formed bone ranged from 0.34 to 1.09 cm3, and the bone formation mean (SD) percentage was 55.79% (11.84%). There was a statistically significant difference between the two groups in terms of the postoperative percentage of bone formation (p = 0.022). Thus, rhBMP-2 combined with an autologous bone graft is a promising technique to improve the results of secondary alveolar bone grafting.
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Affiliation(s)
- B Liu
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - N B Yin
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - R Xiao
- Research Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - B H Li
- Digital Simulation Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - H D Li
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - S X Chen
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - S L Li
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China
| | - Y Q Wang
- Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China.
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Oliver JD, Jia S, Halpern LR, Graham EM, Turner EC, Colombo JS, Grainger DW, D'Souza RN. Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:215-237. [PMID: 32873216 DOI: 10.1089/ten.teb.2020.0181] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects. Impact statement Tissue-engineered scaffolds supplemented with osteogenic growth factors have attractive, largely unexplored possibilities to modulate molecular signaling networks relevant to driving palatogenesis in the context of congenital anomalies (e.g., cleft palate). Constructs that address this need may obviate current use of autologous bone grafts, thereby avoiding donor-site morbidity and other regenerative challenges in patients afflicted with palatal clefts. Combinations of biomaterials and drug delivery of diverse regenerative cues and biologics are currently transforming strategies exploited by engineers, scientists, and clinicians for palatal cleft repair.
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Affiliation(s)
- Jeremie D Oliver
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Shihai Jia
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Leslie R Halpern
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emily M Graham
- School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emma C Turner
- University of Western Australia Dental School, Perth, Western Australia
| | - John S Colombo
- University of Las Vegas at Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - David W Grainger
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Rena N D'Souza
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
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Osorio CC, Escobar LM, González MC, Gamboa LF, Chambrone L. Evaluation of density, volume, height and rate of bone resorption of substitutes of autologous bone grafts for the repair of alveolar clefts in humans: A systematic review. Heliyon 2020; 6:e04646. [PMID: 32954025 PMCID: PMC7484540 DOI: 10.1016/j.heliyon.2020.e04646] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/14/2020] [Accepted: 08/03/2020] [Indexed: 11/17/2022] Open
Abstract
Objective To assess clinical studies that compare synthetic or enriched natural materials to autologous osseous grafts among individuals with cleft lip and palate to determine which would be the substitute to autologous bone graft for alveolar cleft repair in humans. Materials and methods Randomized and controlled clinical trials on alveolar clefts treated with synthetic bone substitutes and autogenous bone grafts combined with osteoinductive factors compared with autogenous bone grafts alone (with ≥4-month follow-up and reporting clinical/radiographic data) were considered eligible. MEDLINE, EMBASE, and Central databases were searched for articles published until February 2020. Results Of 73 eligible articles, 15 were included. Some inductive factors along with iliac crest bone decreased bone reabsorption, preserved the generated bone height/width, and reduced the required autologous bone graft volume. Bone morphogenetic protein (BMP2) as an autologous bone graft substitute, demonstrated satisfactory alveolar defect healing, by avoiding autograft use. Many materials did not yield better outcomes than did autologous grafts; however, hydroxyapatite and collagen complex, hydroxyapatite agarose composite gel, acellular dermal matrix film, fibrin glue, platelet-rich plasma, and deproteinized bovine bone showed similar bone healing outcomes, being an alternative alveolar defect treatment. Conclusions BMP2, as an osteoinductive factor along with a synthetic matrix, yields satisfactory bone healing and avoids the need for autologous bone grafts. However, high-quality RCTs are necessary to determine the most effective and safe concentration and protocol of BMP2 utilization as a substitute for the autologous iliac crest bone grafting.
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Affiliation(s)
- Catalina Colorado Osorio
- Unit of Integral Management of Craniofacial Anomalies (UMIMC), School of Dentistry, Universidad El Bosque, Colombia
| | - Lina María Escobar
- Unit of Integral Management of Craniofacial Anomalies (UMIMC), School of Dentistry, Universidad El Bosque, Colombia
| | - María Clara González
- Unit of Integral Management of Craniofacial Anomalies (UMIMC), School of Dentistry, Universidad El Bosque, Colombia
| | - Luis Fernamdo Gamboa
- Unit of Integral Management of Craniofacial Anomalies (UMIMC), School of Dentistry, Universidad El Bosque, Colombia
| | - Leandro Chambrone
- Unit of Integral Management of Craniofacial Anomalies (UMIMC), School of Dentistry, Universidad El Bosque, Colombia.,Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Colombia
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Grassia V, Nucci L, Marra PM, Isola G, Itro A, Perillo L. Long-Term Outcomes of Nonextraction Treatment in a Patient with Severe Mandibular Crowding. Case Rep Dent 2020; 2020:1376472. [PMID: 32850153 PMCID: PMC7439177 DOI: 10.1155/2020/1376472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To describe a clinical case with a severe mandibular crowding treated without extraction and showing a long-term outcome. METHODS A 14-year-old boy in permanent dentition showed a class I molar and cuspid relationship, a severe deep bite of 8 mm, a constricted V-shaped upper arch with moderate crowding, and a severe crowding of about 12 mm in the lower arch. The panoramic X-ray showed an impacted upper right canine. The treatment started with the placement of a transpalatal bar and 0.022 × 0.028 in standard edgewise appliances in the upper arch and a lip bumper bonded on the second lower molars. Initial leveling of the teeth was accomplished with light Australian round wires. Finishing was then performed with rectangular wires. The phase with fixed appliances lasted 2 years and 9 months, and the patient was motivated and cooperative throughout the treatment, although with poor oral hygiene. The patient was treated without extractions. RESULTS The space was gained with the first and second upper molar derotations using the transpalatal bar and the gingival lip bumper in the lower arch. The upper right canine was well positioned, and the maxillary arch form was improved. The severe lower crowding was completely corrected, and a good overbite was achieved. CONCLUSION A conservative, nonextraction treatment approach for this patient with class I malocclusion with severe mandibular crowding was effective, and the results have remained stable after a long-term follow-up (10 years).
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Affiliation(s)
- Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paola Martina Marra
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Italy
| | - Angelo Itro
- Complex Operative Unit of Stomatological Surgery in Developmental Age, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Abstract
PURPOSE OF REVIEW Infants of women with diabetes are at risk for specific morbidities including congenital anomalies, abnormalities of fetal growth, neonatal hypoglycemia, electrolyte abnormalities, polycythemia, hyperbilirubinemia, and respiratory distress syndrome. Recent studies have shed light on long-term outcomes of these infants and presented advances in treatment. The purpose of this review is to outline the most common neonatal morbidities affecting infants of women with diabetes, the pathophysiology and prevalence of these conditions, and contemporary approaches to treatment. RECENT FINDINGS Recent investigative findings have led to advances in treatment approaches for these infants, particularly regarding risks of neonatal hypoglycemia. Optimizing maternal glycemic control during pregnancy is imperative to improving infant outcomes. However, on a population level, maternal diabetes still poses significant risks to the infant. Timely and appropriate treatment of infants of women with diabetes is imperative to decrease short- and long-term morbidity.
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Affiliation(s)
- Sydney Peters
- Tufts University, 419 Boston Avenue, Medford, MA, USA
| | - Chloe Andrews
- Department of Newborn Medicine, Brigham & Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Sarbattama Sen
- Department of Newborn Medicine, Brigham & Women's Hospital, 75 Francis St, Boston, MA, USA.
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
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Ravlyk L, Alawami S, Al-Jewair T. Secondary Alveolar Bone Graft Using Recombinant Human Bone Morphogenetic Protein-2 (rh-BMP2) May Be as Efficacious as Autologous Grafting in Unilateral Cleft Lip and Palate Patients. J Evid Based Dent Pract 2020; 20:101417. [PMID: 32473802 DOI: 10.1016/j.jebdp.2020.101417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Secondary alveolar bone grafting using autologous versus alloplastic material in the treatment of cleft lip and palate patients: systematic review and meta-analysis. Scalzone A, Flores-Mir C, Carozza D, d'Apuzzo F, Grassia V, Perillo L. Prog Orthod 2019;20(6):1-10. SOURCE OF FUNDING The authors received no financial support for this study. TYPE OF STUDY/DESIGN Systematic review and meta-analysis.
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Isola G. Current Evidence of Natural Agents in Oral and Periodontal Health. Nutrients 2020; 12:585. [PMID: 32102287 PMCID: PMC7071353 DOI: 10.3390/nu12020585] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 02/07/2023] Open
Abstract
Oral and periodontal diseases, chewing disorders, and many destructive inflammatory diseases of the supporting tissues of the teeth are usually caused by an imbalance between host defense and environmental factors like smoking, poor nutrition, and a high percentage of periodontopathogenic bacteria. For these reasons, it is important also to focus attention on plaque control and also on improving host resistance through smoking and stress reduction, and a healthy diet. During the last decades, the importance of micronutrients has been extensively reviewed, and it was concluded that the prevention and treatment of periodontitis should include correct daily nutrition and a correct balance between antioxidants, probiotics, natural agents, vitamin D, and calcium. Recently, there has been growing interest in the literature on the impact of nutraceutical dietary aliments on oral and general health. This Special Issue provides a current and thoughtful perspective on the relationship of diet and natural agents on oral and periodontal diseases through a correct clinical approach with the last and most important evidence that may determine good oral conditions and high quality of life.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Unit of Oral Surgery and Periodontology, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy
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Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate. J Clin Med 2020; 9:jcm9020576. [PMID: 32093231 PMCID: PMC7074030 DOI: 10.3390/jcm9020576] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 11/28/2022] Open
Abstract
Secondary alveolar bone grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual alveolar bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual bone defect volume in both groups did not show significant difference (SABG 0.12 cm3 vs. EGPP at 0.14 cm3, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.
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Paiva KBS, Maas CS, dos Santos PM, Granjeiro JM, Letra A. Extracellular Matrix Composition and Remodeling: Current Perspectives on Secondary Palate Formation, Cleft Lip/Palate, and Palatal Reconstruction. Front Cell Dev Biol 2019; 7:340. [PMID: 31921852 PMCID: PMC6923686 DOI: 10.3389/fcell.2019.00340] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022] Open
Abstract
Craniofacial development comprises a complex process in humans in which failures or disturbances frequently lead to congenital anomalies. Cleft lip with/without palate (CL/P) is a common congenital anomaly that occurs due to variations in craniofacial development genes, and may occur as part of a syndrome, or more commonly in isolated forms (non-syndromic). The etiology of CL/P is multifactorial with genes, environmental factors, and their potential interactions contributing to the condition. Rehabilitation of CL/P patients requires a multidisciplinary team to perform the multiple surgical, dental, and psychological interventions required throughout the patient's life. Despite progress, lip/palatal reconstruction is still a major treatment challenge. Genetic mutations and polymorphisms in several genes, including extracellular matrix (ECM) genes, soluble factors, and enzymes responsible for ECM remodeling (e.g., metalloproteinases), have been suggested to play a role in the etiology of CL/P; hence, these may be considered likely targets for the development of new preventive and/or therapeutic strategies. In this context, investigations are being conducted on new therapeutic approaches based on tissue bioengineering, associating stem cells with biomaterials, signaling molecules, and innovative technologies. In this review, we discuss the role of genes involved in ECM composition and remodeling during secondary palate formation and pathogenesis and genetic etiology of CL/P. We also discuss potential therapeutic approaches using bioactive molecules and principles of tissue bioengineering for state-of-the-art CL/P repair and palatal reconstruction.
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Affiliation(s)
- Katiúcia Batista Silva Paiva
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Clara Soeiro Maas
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Pâmella Monique dos Santos
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - José Mauro Granjeiro
- Clinical Research Laboratory in Dentistry, Federal Fluminense University, Niterói, Brazil
- Directory of Life Sciences Applied Metrology, National Institute of Metrology, Quality and Technology, Duque de Caxias, Brazil
| | - Ariadne Letra
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston, TX, United States
- Pediatric Research Center, UTHealth McGovern Medical School, Houston, TX, United States
- Department of Diagnostic and Biomedical Sciences, UTHealth School of Dentistry at Houston, Houston, TX, United States
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