Cleft Alveolar Bone Grafting Using Mandibular Symphyseal Bone Graft and Resorbable Collagen Membrane: A CBCT-Based 3-Dimensional Morphometric Analysis.

Factors Related to the Outcomes of Secondary Alveolar Cleft Bone Grafting Using Two-Dimensional Radiographic Analysis: A Retrospective Study.

BackgroundSecondary alveolar bone grafting (SABG) is essential for correcting alveolar defects in patients with cleft lip and palate. While clinical evaluation combined with 2-dimensional (2D) radiography is a practical and cost-effective method for assessing surgical success, inadequate grafting outcomes often necessitate repeat surgeries.ObjectiveTo evaluate the clinical variables influencing SABG outcomes in cleft patients using 2D radiographic images.Materials and MethodsThis retrospective study reviewed data from 63 patients who underwent SABG at the Faculty of Dentistry, Prince of Songkla university between 2013 and 2023. Variables analyzed included age, cleft type/size, surgical techniques, graft materials, and orthodontic timing. Efficacy was assessed via 2D radiographs (18 conventional, 45 digital) using the Chelsea scale for bone bridging and ImageJ software for bone density. Statistical analyses involved Chi-square tests and multiple logistic regression (P < 0.05).ResultsOverall analysis revealed that patient age and cleft type were the only significant predictors of SABG success, with odds ratios of 10.46 and 5.19, respectively. Subgroup analyses indicated that the timing of post-surgical orthodontic movement was the most significant factor in the conventional radiography group, whereas cleft type was the primary determinant in the digital group.ConclusionPatient age and cleft type significantly impact SABG outcomes. Patients aged 10-12 years and those with unilateral cleft deformities exhibit significantly higher success rates compared to other age groups and bilateral deformities.

AI-based three-dimensional assessment of alveolar bone grafting using iliac crest and mandibular symphysis bone combined with L-PRF in unilateral cleft lip and palate

Objectives: This thesis aimed (1) to develop and validate a standardized AI-based 3D workflow for the assessment of alveolar bone grafting (ABG) outcomes and mandibular symphysis (MS) donor-site bone regeneration, and (2) to apply the validated methodology to evaluate the effect of leukocyte-platelet-rich fibrin on alveolar grafting performed with iliac crest (IC) and MS bone. Materials and Methods: Two sequential studies were conducted. First, an AI-powered 3D imaging workflow using automated orientation, segmentation, voxel-based superimposition, and shape correspondence analysis was developed and validated in a sample of 21 patients with cleft lip and alveolus. This workflow was used to assess ABG performed with MS bone, evaluating bone formation at the cleft site and MS donor site bone regeneration. Subsequently, the validated workflow was refined to include volumetric bone quantification and applied in a prospective cohort study of 92 patients with unilateral complete cleft lip and palate who underwent ABG. Patients were allocated in groups according to graft donor site (IC or MS) and the use of L-PRF (with or without). CBCT scans were obtained preoperatively and at a 12-month follow-up. Volumes of maxillary bone formation and MS donor site bone regeneration were assessed using the CBCT scans and 3D models. Shape correspondence analysis was applied to compare pre-and post-harvesting symphyseal morphology. Results: The AI-powered 3D workflow demonstrated feasibility, reproducibility, and clinical applicability for the assessment of ABG outcomes and MS donor site bone regeneration. Volumetric bone formation does not differ significantly regardless to graft source or L-PRF use. No significant main effects of graft type (IC vs MS) or L-PRF use were observed, and no significant interaction between these factors was detected (P > 0.05). MS donor site bone regeneration was high, with a mean regeneration of 92.5 ± 4.8%. Shape correspondence analysis showed a mean residual discrepancy of 2.81 ± 1.99 mm relative to pre-harvesting morphology. All patients were discharged within 24 hours in stable condition, reporting minimal postoperative discomfort and no postoperative complications. Conclusion: The proposed AI-powered 3D imaging workflow is reliable and clinically applicable for assessing ABG outcomes and mandibular symphysis donor site bone regeneration. In this cohort, L-PRF does not significantly influence volumetric bone formation, regardless of graft source, and no interaction between graft type and L-PRF was observed. Bone regeneration at the mandibular symphysis donor site was high, with no permanent complications.

Preoperative 3D Morphological Predictors of Bone Bridge Formation in Secondary Alveolar Bone Grafting: A CBCT Analysis.

PURPOSE To identify independent preoperative three-dimensional (3D) morphological predictors for postoperative bone bridge formation in secondary alveolar bone grafting (SABG) using cone-beam computed tomography (CBCT), and to propose an optimal surgical strategy based on these quantitative indicators. MATERIALS AND METHODS This study evaluated 100 patients who underwent SABG. Preoperative and 6-month postoperative CBCT images were analysed. Patients were categorized into three surgical stages: lateral incisor eruption (Stage 1), canine eruption (Stage 2), and the multi-bracket treatment period (Stage 3). Preoperative cleft dimensions (volume, area and width) and postoperative outcomes (bone bridge thickness, height, and residual defect volume) were measured. Multiple linear regression analysis was performed to identify independent preoperative predictors of surgical success. RESULTS Multivariate analysis revealed that a larger preoperative cleft volume strongly predicted decreased postoperative bone bridge thickness at the mesial aspect (p < 0.001). Furthermore, a larger preoperative cleft area at the root apex was a significant independent predictor of decreased mesial bone bridge thickness (p = 0.019), and a wider preoperative cleft at the midportion strongly predicted decreased bone bridge height (p = 0.001). Volumetric analysis showed that patients in Stage 3 exhibited significantly larger preoperative cleft volumes. Consequently, while the absolute dimensions of the newly formed bone bridges did not differ significantly among the stages, Stage 3 patients were left with significantly larger postoperative residual bone defects. CONCLUSION The preoperative cleft volume, apical cleft area, and middle cleft width evaluated via CBCT are robust independent predictors of SABG outcomes. To minimize postoperative residual dead space and optimise bone filling, surgical intervention is strongly recommended during Stage 1 or 2, prior to the severe morphological expansion of the alveolar cleft.

Long-Term Bone Healing Using Autogenous Tooth Bone Graft Combined with rhBMP-2 after Enucleation of a Large Odontogenic Keratocyst: A Case Report.

Alveolar ridge preservation using an intentionally exposed xenogeneic collagen matrix seal in sockets with varying proportions of vertical bone resorption: a pilot study.

Within the limitations of this study, intentionally exposing the xenogeneic collagen matrix seal yielded comparable outcomes in non-contained and contained sockets, which may reflect the material's ability to reduce the adverse effects of socket-wall resorption.

Membrane-free guided tissue regeneration with enamel matrix derivative and bone graft materials improves 3-dimensional periodontal outcomes in small dogs.

Objective To evaluate the clinical and radiographic outcomes of membrane-free guided tissue regeneration (GTR) using enamel matrix derivative (EMD) with bone grafts in dogs with vertical infrabony periodontal defects. Methods This retrospective study reviewed cases of client-owned dogs that underwent membrane-free GTR using EMD in combination with bone grafts between August 1, 2023, and September 30, 2025. Outcomes were assessed from records and cone-beam computed tomography (CBCT) datasets using 2-D measurements of clinical attachment loss (CAL) and vertical bone defect ratio (VBDR) and 3-D volumetric analysis. Success was defined as CAL improvement (≥ 1 mm) and VBDR reduction (> 10%). Volumetric analysis was used to quantify infrabony defect fill. Results 20 periodontal defects in 16 dogs were included (allograft, n = 10; xenograft, 10). Median follow-up was 7 months (range, 6 to 14 months). All defects met the success criteria. Median CAL decreased from 5.0 mm (range, 3.0 to 8.0 mm) to 2.0 mm (range, 1.0 to 3.0 mm), and median VBDR decreased from 0.42 (range, 0.16 to 0.78) to 0.18 (range, 0.04 to 0.46). Volumetric analysis revealed a median infrabony defect fill of 98.49% (range, 71.86% to 100.00%). Conclusions Membrane-free GTR with EMD was associated with clinically meaningful periodontal improvement and substantial infrabony defect fill in appropriately selected canine patients with vertical infrabony defects. Prospective, controlled studies are warranted to further evaluate its efficacy and indications. Clinical Relevance This membrane-free regenerative approach may provide a practical tooth-preserving treatment option for selected small-breed dogs when conventional barrier-membrane placement is technically challenging.