Purpose: To evaluate the effect of bone nail and artificial periosteum combined with iliac cancellous bone grafting in repairing cleft lip and palate with alveolar cleft during dental replacement.
Methods: The clinical data of 82 children with cleft lip and palate with alveolar cleft during dental replacement period were retrospectively analyzed from January 2020 to December 2023, and were divided into control group (iliac cancellous bone grafting alone, n=42) and experimental group (combined iliac cancellous bone grafting with bone nail and artificial periosteum, n=40) according to the operation method. The viable bone volume in bone graft area, absorption rate of whole bone graft and different bone graft areas, success rate of bone graft, survival rate of bone graft and complications were compared between the two groups. SPSS 25.0 software package was used for statistical analysis.
Results: The surviving bone volume in the bone graft area was significantly larger in the experimental group 3 and 9 months after operation(P＜0.05). There was no significant difference in viable bone volume in bone graft area between the two groups 9 months and 3 months after surgery (P＞0.05). The bone graft absorptivity of the experimental group was significantly lower than that of the control group 3, 9 months and 3-9 months after surgery(P＜0.05), and there was no significant difference between the two groups at 3, 9 months after surgery(P＞0.05). The absorption rate of bone graft in 1/2 area of nasal cavity, 1/2 area of alveolar ridge, 1/2 area of lip and 1/2 area of palate in the experimental group was significantly lower than that in the control group 3 and 9 months after operation(P＜0.05). The absorptivity of bone graft in 1/2 area of alveolar ridge was significantly higher than that in 1/2 area of nasal cavity, and the absorptivity of bone graft in 1/2 area of palatal side was significantly higher than that in 1/2 area of lip in both groups (P＜0.05). The success rate and survival rate of bone grafting in the experimental group were significantly higher than those in the control group(P＜0.05). The complication rate of the experimental group was significantly lower than that of the control group (P＜0.05).
Conclusions: Bone nail and artificial periosteum combined with iliac cancellous bone graft can effectively repair cleft lip and palate with alveolar cleft during dental replacement, reduce bone absorption rate and complications, and improve bone formation effect. Meanwhile, postoperative bone mass absorption mainly occurs within 3 months after surgery, and mainly occurs in the alveolar crest area and palatine area.