16h50 Alveolar cleft reconstruction utilizing a particulate autogenous tooth graft – long term results of a case series

Background: During secondary alveolar cleft grafting, the use of autogenous cancellous bone harvested from the iliac crest is still considered the gold standard. Due to the risk of donor-site morbidity and excessive graft resorption, alternative grafting materials (e.g. intraoral bone, xenografts) are being tested.

Methods/Description: Autogenous tooth bone graft (ATB) is a novel material derived from extracted teeth. ATB has successfully been used in pre-prosthetic and periodontal surgery for hard-tissue reconstruction. Seven patients with unilateral cleft lip and palate were treated with ATB, using their own deciduous teeth for grafting. Cone-beam computed tomography (CBCT) scans were taken prior to the surgery for preoperative planning. Control scans were taken at 3 months and 2 years after the operation to assess graft integration, graft stability, and the volume of the newly formed hard tissues.

Results: Our preliminary results showed that ATB integration was favorable after 3 months of healing, with no adverse effects or excessive resorption of the graft. Hard-tissue gain, as measured at the 3-month follow-up, averaged 0.65 cm3 ± 0.26 cm3 , which meant 59.92 ± 24.35 % of the planned graft volume. The early positive results were also confirmed by the 2 year postoperative scans, where the graft was mostly replaced by bone, and showed no interference with tooth eruption.

Conclusions: The use of ATB might be a feasible alternative for autologous bone during alveolar cleft grafting. However, studies using a large sampler size are required to derive further conclusions.