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A meta‑analysis of alveolar bone grafting using bone substitutes in cleft lip and palate patients

Indri Lakhsmi Putria*, Pascalis Fabianb, Citrawati Dyah Kencono Wunguc

aDepartment of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine,Airlangga University, Surabaya, Indonesia, bPlastic Reconstructive and Aesthetic Surgery Unit, Airlangga Universitas Hospital, Surabaya, Indonesia, cDepartment of Physiology and Medical Biochemistry, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
 

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

 

Abstract
 
In individuals with cleft lip and palate (CLP), an alveolar bone graft (ABG) is carried out for alveolar cleft closure. Several sources for ABG include autologous bone, xenologous bone, and alloplastic substitutes. Autologous bone has been the preferred source for ABG. Alloplastic substitutes might serve as an alternative. This study aimed to compare the outcomes between autologous and alloplastic as sources for ABG. This study made use of eight web databases. Randomized control trials (RCTs) and non‑RCTs were included. CLP patients with alveolar cleft with imaging studies, computed tomography (CT scan) and/or cone beam CT scan, and bone graft volume within 6–12 months postintervention were selected. Bone graft volume within 6–12 months postintervention was assessed. Three studies met the inclusion criteria. After 6–12 months of follow‑up, there were no statistically significant differences in bone graft volume between autologous and alloplastic bone grafts (fixed‑effect model estimate value = 0.21; confidence interval − 0.301–0.730; P = 0.414). The limitations include small research sample sizes, a high likelihood of bias among included studies, and different alloplastic materials from each included study. Autologous and alloplastic bone grafts showed similar effectiveness in alveolar bone grafting. Further clinical trial studies with bigger sample sizes and similar interventions are needed as evidence for future reviews.
 
Keywords: Alveolar bone grafting, Bone substitutes, Bone transplantation, Cleft lip with or without cleft palate, Medical care

 

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