Randomized Controlled Trial Comparing Resorption Rates of Mandibular Cortical and Iliac Cancellous Bone Grafts in Alveolar Cleft Repair.
Xuefei Pang, Xinran Zhao, Zuyin Yu et al.
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In 30 seconds
This randomized controlled trial compared mandibular cortical bone (MCB) with iliac cancellous bone (ICB) for secondary alveolar cleft grafting in patients with unilateral clefts. Among 28 participants, six-month bone resorption was lower with MCB than ICB (45.20 ± 29.81% vs 74.87 ± 18.48%; P = 0.005). MCB was also associated with longer surgery and greater costs, while hospital stay was shorter; intraoperative bleeding did not differ significantly. The findings indicate better short-term graft retention with MCB in this study, alongside trade-offs in operative time and cost.
Key findings
- At six months, bone resorption was 45.20 ± 29.81% with MCB and 74.87 ± 18.48% with ICB (P = 0.005).
- MCB was associated with significantly greater costs (P < 0.001) and longer surgery (P = 0.026), but a shorter hospital stay (P < 0.001).
- Intraoperative bleeding did not differ significantly between graft groups; two adverse events were reported in the MCB group.
Why it matters
Graft resorption affects the short-term radiographic outcome of secondary alveolar cleft repair. This trial provides a direct randomized comparison suggesting that mandibular cortical grafts may retain more bone at six months than iliac cancellous grafts, while also highlighting differences in operative burden and cost. These competing outcomes are relevant when evaluating graft options.
What to keep in mind
The trial included only 28 patients and assessed the primary resorption outcome at six months, limiting the precision and duration of the evidence.