Factors Associated with The Revision of Alveolar Bone Grafting Using Iliac Crest Bone Grafts in Patients with Cleft Lip and Palate

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Published: Oct 31, 2024
Keywords:
Alveolar cleft Alveolar bone graft Iliac crest bone graft

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Supon Kamkaew
Resident of residency training program in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University.
Wilawan Weraarchakul
Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University.
Pipop Sutthiprapaporn
Division of Orthodontics, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University.
Siripong Sittisomwong
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University.

Abstract

Alveolar bone grafting with iliac crest bone grafts is a common corrective procedure for maxillary abnormalities in patients with cleft lip and palate. Despite its widespread use, the need for surgical revisions persists. This retrospective case-control study analyzed data from the past 12 years (2010-2021), including 30 cases requiring revision and 30 controls without such need. We examined the influence of gender, presence of oronasal fistulas, and alveolar cleft characteristics-specifically, the type and size of the cleft. Measurements were taken at three anatomic levels: cervical, middle, and apex of the tooth root, using intraoral radiographs. Results from multiple logistic regression analysis, controlling for confounding variables, showed statistically significant associations (p<0.05) with the need for revision. Notably, females were 4.82 times more likely than males to require revision (95% CI: 1.06–21.85), and the presence of an oronasal fistula increased the likelihood of repeat surgery by 8.14 times (95% CI: 1.86-35.59). Furthermore, each millimeter increase in the size of the alveolar cleft at the root apex was associated with a 1.62 times higher chance of requiring additional surgery (95% CI: 1.14-2.32). These findings underscore the importance of meticulous patient preparation and targeted surgical planning to address oronasal fistulas and cleft size, necessitating close collaboration among surgeons and orthodontists to reduce the frequency of revisions and improve post-operative outcomes.

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1.
Kamkaew S, Weraarchakul W, Sutthiprapaporn P, Sittisomwong S. Factors Associated with The Revision of Alveolar Bone Grafting Using Iliac Crest Bone Grafts in Patients with Cleft Lip and Palate. Khon Kaen Dent J [Internet]. 2024 Oct. 31 [cited 2024 Nov. 20];27(3):20-34. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/270362
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Vol. 27 No. 3 (2024): Sep-Dec (in press)
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Articles
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บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการลงตีพิมพ์ในวิทยาสารทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นถือเป็นลิขสิทธิ์เฉพาะของคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่น หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด ๆ จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษร จากคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นก่อนเท่านั้น

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