Evaluation of the Efficacy of Platelet Rich Fibrin with Bone Graft in the Reconstruction of Unilateral Alveolar Cleft

Main Article Content

Enas Abdulsattar Abdulmaged
Mohammed Oday Falih

Keywords

bone graft, alveolar cleft, alloplastic material, autogenous bone graft, platelet rich fibrin.

Abstract

Background: Alveolar cleft grafting aims to stabilize and restore the continuity of the maxillary arch, provide support for tooth eruption, eliminate oronasal fistulas, and improve the aesthetic outcome. Alveolar cleft reconstruction using alloplastic material has been proposed as a way to speed up surgery, provide a significant amount of bone, and eliminate the requirement for a donor site. Platelet-rich fibrin (PRF), consider an abundant source of autologous cytokines and growth factors, that enable bone regeneration and soft tissue maturation.


Patients and Methods: This research was performed at the Department of Oral and Maxillofacial Surgery at Al-Wasity Teaching Hospital in Iraq, from (November 2020 and June 2022). Twenty patients with a unilateral alveolar cleft, aged 7 to 13, were involved in this study. Two equal groups of patients were created; group I contained ten patients; alveolar cleft reconstructed by the alloplastic bone substitute (QualyBone BCP) with platelet rich fibrin (PRF). While group II contained ten patients, was grafted with an alloplastic bone substitute (QualyBone BCP) only. Cone-beam computerized tomography was used to assess how PRF affects bone healing, as well as the height, density, and bone continuity in both groups.


Results: Six months postoperatively, the height and density of bone growth show a significant difference between the two groups. At the same time interval, the new bone formation in group I was denser and higher than in group II. also, good bone continuity was observed in all patients.


Conclusion: platelet rich fibrin effect on vascularization and regeneration of bony defects. Also, preserve the bone height and increased bone density in a six months period.

Abstract 278 | pdf Downloads 80 PDF Downloads 173 XML Downloads 31 HTML Downloads 26

References

1. Zhang D, Chu F, Yang Y, Xia L, Zeng D, Uludağ H, Zhang X, Qian Y, Jiang X: Orthodontic Tooth Movement in Al¬veolar Cleft Repaired with a Tissue Engineering Bone: An Experimental Study in Dogs. Tissue Eng Part A 17:1313- 1325, 2011.
2. Kim J, Jeong W. Secondary bone grafting for alveolar clefts: surgical timing, graft materials, and evaluation methods. Archives of Craniofacial Surgery. 2022 Apr;23(2):53.
3. Kang NH. Current methods for the treatment of alveolar cleft. Archives of plastic surgery. 2017 May;44(3):188.
4. Skoog T. The use of periosteum and Surgicel® for bone restoration in congenital clefts of the maxilla: A clinical report and experimental investigation. Scandinavian Journal of Plastic and Reconstructive Surgery. 1967 Jan 1;1(2):113-30.
5. Yılmaza S, Kılıçb AR, Kelesc A, Efeoğlud E. Reconstruction of an alveolar cleft for orthodontic tooth movement. American Journal of Orthodontics and Dentofacial Orthopedics. 2000 Feb 1;117(2):156-63.
6. Kyung H, Kang N. Management of alveolar cleft. Arch Craniofac Surg 2015; 16: 49-52.
7. Wallender A, Stone J. Bone Graft and Reconstruction of the Cleft Maxilla: Alveolar Bone Graft and Midface Distraction. Atlas of the Oral and Maxillofacial Surgery Clinics of North America. 2022 Mar 1;30(1):37-44.
8. Turvey TA, Vig K, Moriarty J, Hoke J. Delayed bone grafting in the cleft maxilla and palate: a retrospective multidisciplinary analysis. American journal of orthodontics. 1984 Sep 1;86(3):244-56.
9. Ma’amon AR, Telfah H. Secondary alveolar bone grafting: the dilemma of donor site selection and morbidity. British Journal of Oral and Maxillofacial Surgery. 2008 Dec 1;46(8):665-70.
10. Silva Filho OG, Ozawa TO, Bachega C, Bachega MA. Reconstruction of the alveolar cleft with allogenous bone graft: Clinical considerations. Dental Press Journal of Orthodontics. 2013 Dec;18(6):138-47.
11. Bajaj AK, Wongworawat AA, Punjabi A. Management of alveolar clefts. Journal of Craniofacial Surgery. 2003 Nov 1;14(6):840-6.
12. Reis CH, Buchaim RL, Pomini KT, Hamzé AL, Zattiti IV, Duarte MA, Alcalde MP, Barraviera B, Ferreira Júnior RS, Pontes FM, Grandini CR. Effects of a Biocomplex Formed by Two Scaffold Biomaterials, Hydroxyapatite/Tricalcium Phosphate Ceramic and Fibrin Biopolymer, with Photobiomodulation, on Bone Repair. Polymers. 2022 May 19;14(10):2075.
13. Kökdere NN, Baykul T, Findik Y. The use of platelet-rich fibrin (PRF) and PRF-mixed particulated autogenous bone graft in the treatment of bone defects: An experimental and histomorphometrical study. Dental research journal. 2015 Sep;12(5):418.
14. Naik B, Karunakar P, Jayadev M, Marshal VR. Role of Platelet rich fibrin in wound healing: A critical review. Journal of conservative dentistry: JCD. 2013 Jul;16(4):284.
15. Pavlovic V, Ciric M, Jovanovic V, Trandafilovic M, Stojanovic P. Platelet-rich fibrin: Basics of biological actions and protocol modifications. Open Medicine. 2021 Jan 1;16(1):446-54.
16. Al-Ashmawy MM, Ali HE, Baiomy AA. Effect of platelet-rich fibrin on the regeneration capacity of bone marrow aspirate in alveolar cleft grafting (clinical and radiographic study). Dentistry. 2017;7(428):2161-1122.
17. Haugen HJ, Lyngstadaas SP, Rossi F, Perale G. Bone grafts: which is the ideal biomaterial?. Journal of Clinical Periodontology. 2019 Jun;46:92-102.
18. Conway JC, Taub PJ, Kling R, Oberoi K, Doucette J, Jabs EW. Ten-year experience of more than 35,000 orofacial clefts in Africa. BMC pediatrics. 2015 Dec;15(1):1-9.
19. Dalkýz M, Ozcan A, Yapar M, Gökay N, Yüncü M. Evaluation of the effects of different biomaterials on bone defects. Implant dentistry. 2000 Jan 1;9(3):226-35.
20. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006 Mar 1;101(3):e45-50.
21. Simonpieri, A., Del Corso, M., Vervelle, A., Jimbo, R., Inchingolo, F., Sammartino, G. and M Dohan Ehrenfest, D., 2012. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery. Current pharmaceutical biotechnology, 13(7), pp.1231-1256.
22. Karayürek F, Kadiroğlu ET, Nergiz Y, Akçay NC, Tunik S, Kanay BE, Uysal E. Combining platelet rich fibrin with different bone graft materials: An experimental study on the histopathological and immunohistochemical aspects of bone healing. Journal of Cranio-Maxillofacial Surgery. 2019 May 1;47(5):815-25.
23. Nacopoulos C, Dontas I, Lelovas P, Galanos A, Vesalas AM, Raptou P, Mastoris M, Chronopoulos E, Papaioannou N. Enhancement of bone regeneration with the combination of platelet-rich fibrin and synthetic graft. Journal of Craniofacial Surgery. 2014 Nov 1;25(6):2164-8.