Secondary alveolar bone grafting in cleft lip and palate: A comparative analysis of donor site morbidity in different age groups

J Craniomaxillofac Surg. 2019 Jan;47(1):165-169. doi: 10.1016/j.jcms.2018.11.006. Epub 2018 Nov 12.

Abstract

Introduction: There is no consensus regarding the optimal timing for secondary alveolar bone grafting for clefts defects. We aimed to investigate the potential correlation between the age of patients during surgery, donor site symptoms, surgical time and hospitalization following this procedure.

Material and methods: The outcome of 195 consecutive alveolar bone grafting procedures among different age groups (mean: 7.1 years; range 1.8-40.5) was retrospectively assessed based on a chart review and purpose-prepared report forms. The association between age, gender and hospitalization following bone harvesting was tested by Spearman rank correlation, while relationships (i.e. between age and pain) were evaluated by logistic regression.

Results: The most frequent donor site complaints included: pain equal to or exceeding that of the recipient site (93%) and gait disturbances (92.5%) immediately after the procedure. Chronic complaints included: iliac contour alteration (40.1%), unsightly scar (23%) and recurring discomfort (2.1%). Statistical analysis showed no correlation between donor site symptoms, their duration or hospitalization time following surgery at different ages, except a higher incidence of significant pain immediately after bone harvesting in older females (r = 0.268; p = 0.030).

Conclusion: Alveolar bone grafting at an earlier age does not increase donor site symptoms, surgical duration or hospitalization following surgery.

Keywords: Alveolar bone grafting; Autogenous bone harvesting; Cleft lip and palate; Cleft treatment protocol; Donor site morbidity; Iliac crest.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Alveolar Bone Grafting / adverse effects*
  • Alveolar Bone Grafting / methods*
  • Bone Transplantation / methods
  • Child
  • Child, Preschool
  • Cleft Lip / physiopathology*
  • Cleft Lip / surgery*
  • Cleft Palate / surgery
  • Cohort Studies
  • Female
  • Hospitalization
  • Humans
  • Ilium
  • Infant
  • Length of Stay
  • Male
  • Postoperative Complications*
  • Retrospective Studies
  • Time Factors
  • Tissue Donors
  • Treatment Outcome
  • Young Adult