Bioactive glass 45S5 ceramic for alveolar cleft reconstruction, about 58 cases.

BACKGROUND: Secondary alveolar bone grafting in patients with clefts lip and palate is usually performed with iliac crest bone harvesting, however using bone substitute allow to avoid harvesting morbidity. The purpose of our study was to assess if the use of a bioactive glass ceramic is an acceptable alternative to iliac crest bone harvesting in alveolar clefts treatment. METHODS: A prospective study including all patients who have benefited of alveolar grafting by GlassBONE (Noraker, France), a synthetic resorbable bioactive glass 45S5 ceramic was conducted. The patients underwent clinical assessments and imaging check-up by dental panoramic radiography and CBCT. RESULTS: Fifty-eight graftings were performed. The mean age at the time of the graft was 7.6 years. Hospitalization, social eviction and antalgic consumption were reduced. Bone continuity was achieved in 63.8% of the cases. Bilateral cleft and dental agenesia increased grafting failure. In the subgroup of 25 patients with isolated unilateral cleft without dental agenesis, 80% had bone continuity at one year. We noted 10.3% of alveolar fistula recurrence. CONCLUSION: The use of GlassBONE in alveolar grafts simplifies the surgery procedure and the postoperative management, and ensures satisfactory mucosal healing, tooth eruption and bone continuity in two thirds of the followed grafts.