Comparative evaluation of surgical treatment of congenital alveolar cleft in children

Objectives. To study the effectiveness of the modified autologous bone grafting method in treatment of the maxillary alveolar process defects. Material and methods. The study was conducted in the Maxillofacial Surgery Department of the OIUCH (Osh Interregional United Clinical Hospital). Sixty patients with congenital clefts of the maxillary alveolar process aged 11 to 13 years were included. Patients were divided into two groups: the first (main) and the second (comparison). Results. The use of the method modified by the authors gives a favorable treatment result in defects in the alveolar process due to the placement of the cortical plate at the base of the nose and the isolation of the nasal microflora. The modified method effectiveness is confirmed by the results of clinical, radiological, and bone density assessments. Recovery was 1.5 times faster compared with the traditional method. X-ray examination after 12 months found the formation of mature bone tissue in all the 30 (100%) group 1 patients, which was also confirmed by the mean densitometry indicators (1812±12.9 M/S). In group 2, the bone density values did not reach those of the first group (p<0.05). In the long term, six months after the intervention, the results of bone grafting of the alveolar process were considered good in 28 (93.4%) patients, in whom bone density values in the defect area exceeded the initial 1746±12.2M/S, and satisfactory in 2 (6.6%) patients with the values reaching 1654±11.9 M/S. No unsatisfactory results were observed in the main group. In the comparison group, there were 18 (60.0%) patients with good results, with the density indicators of 1468±11.8 M/S, 10 (33.3%) patients with satisfactory results (1279±12.0 M/S), and 2 (6.7%) patients with unsatisfactory results, whose density values were equal to zero (p<0.05). Thus, the proportion of complications in group 2 was much higher compared with the first group. No complications were observed in the first group. Conclusions. The use of autologous iliac bone graft provides good outcomes in the treatment of the maxillary alveolar process defects. With this technique, the defect can be completely replaced after 12 months with minimal complications. Key words: autologous bone grafting, alveolar process, graft, mucoperiosteal flap, iliac bone, mucosa Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study