Comparison of iliac crest versus mandible for alveolar bone grafting

Abstract

Introduction: Alveolar bone grafting in patients of cleft lip or palate has become a well established procedure. This procedure has a number of advantages namely, stabilization of the maxillary arch, facilitation of the eruption of maxillary canine and sometimes lateral incisor, providing bony support to the teeth adjacent to the cleft, facilitation of closure of oro-nasal fistula and helping raise the alar base of nose. The objective of this study was to compare the iliac crest bone with that of the mandibular symphysis for the reconstruction of alveolar clefts.

Material and Methods: 102 patients were selected ranging in age between 8 to 13 years. Iliac crest was selected as donor site in 58 cases and mandible in 44 cases. Post operative observation period was 12 months. An independent t-test was used to compare the treatment abilities of the two groups.

Results: The independent t-test showed a statistically insignificant difference (p-value > 0.05) in the treatment abilities of the two groups. Results of both groups were comparable in most respects regarding pain and paraesthesia. Mandibular reconstruction was superior in regard to reduced morbidity, no gait disturbance, reduced hospitalization time and intraoral scar. On the other hand, reduced operating time, as two operating teams working at a same time, was observed in iliac crest graft cases.

Conclusions: The choice of ileac crest versus mandible for alveolar bone grafting depends on the choice of the operator. Reduced hospitization along with early healing are amongst the benefits of mandibular reconstruction.