Assessment of Periosteal Free Grafts versus Platelet Rich Fibrin asan Adjunct to Alveolar Cleft Grafting
Mahmoud Yehia Abdul Aziz;
Abstract
This study attempted to investigate the effect PFG on the clinical outcomes of ACG regarding soft tissue healing, recurrence of ONF and preservation of the grafted bone compared to PRF.
The study included 10 patients with BCLP. Following split-mouth design, the two sides of alveolar cleft were randomly divided into two groups. The first group received PFG covering the anterior iliac cancellous particulate bone graft while the second group the graft was covered with PRF.
Assessment of the results was based on both clinical and radiological evaluation. The clinical evaluation addressed the healing of tissues around the graft, the recurrence of ONF, and the presence of any clinical signs of infection including any purulent discharge. The radiological evaluation was depending on pre and post-operativeCBCT scans. The post-operative scans were performed immediate postoperatively, at 6 and 12 months respectively. Mimics Ver.19 software was used for volumetric assessment of the alveolar grafts.
Normal soft tissue healing was evident in all patients except in nine sides. Those patients suffered from wound dehiscence, five sides of them experienced recurrence of ONF. PRF showed better clinical outcomes in decreasing the incidence of ONF recurrence.
Radiographically, comparison between the two groups regarding the volume at six and 12 months postoperative showed no significant statistical difference.
In the sample included, the overall success rate in our study according to the studied parameters was:
• Prevention of ONF recurrence = 58%
• Graft volume preservation in Rt-PFG = 47.78% while in Lt-PRF was 52.30%
• Tooth eruption within the graft was only 30%
From the results of this study,it could be concluded that:
1. The effect of both PFG and PRFdid not prove to have a positive volumetric effect on bone grafts used in ACG although it provided significant support to the healing of soft tissues around the alveolar cleft.
2. Pre-existing ONF can be considered as a pre-determinant factor for wound dehiscence and recurrence of ONF following ACG. Therefore, every effort should be done to decrease its occurrence by using valuable adjuncts.
The study included 10 patients with BCLP. Following split-mouth design, the two sides of alveolar cleft were randomly divided into two groups. The first group received PFG covering the anterior iliac cancellous particulate bone graft while the second group the graft was covered with PRF.
Assessment of the results was based on both clinical and radiological evaluation. The clinical evaluation addressed the healing of tissues around the graft, the recurrence of ONF, and the presence of any clinical signs of infection including any purulent discharge. The radiological evaluation was depending on pre and post-operativeCBCT scans. The post-operative scans were performed immediate postoperatively, at 6 and 12 months respectively. Mimics Ver.19 software was used for volumetric assessment of the alveolar grafts.
Normal soft tissue healing was evident in all patients except in nine sides. Those patients suffered from wound dehiscence, five sides of them experienced recurrence of ONF. PRF showed better clinical outcomes in decreasing the incidence of ONF recurrence.
Radiographically, comparison between the two groups regarding the volume at six and 12 months postoperative showed no significant statistical difference.
In the sample included, the overall success rate in our study according to the studied parameters was:
• Prevention of ONF recurrence = 58%
• Graft volume preservation in Rt-PFG = 47.78% while in Lt-PRF was 52.30%
• Tooth eruption within the graft was only 30%
From the results of this study,it could be concluded that:
1. The effect of both PFG and PRFdid not prove to have a positive volumetric effect on bone grafts used in ACG although it provided significant support to the healing of soft tissues around the alveolar cleft.
2. Pre-existing ONF can be considered as a pre-determinant factor for wound dehiscence and recurrence of ONF following ACG. Therefore, every effort should be done to decrease its occurrence by using valuable adjuncts.
Other data
| Title | Assessment of Periosteal Free Grafts versus Platelet Rich Fibrin asan Adjunct to Alveolar Cleft Grafting | Other Titles | تقييم الرقع السمحاقية الحرة مقابل الليفين الغني بالصفيحات الدموية كعامل مساعد لترقيع الشق السنخي | Authors | Mahmoud Yehia Abdul Aziz | Issue Date | 2017 |
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