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2008 Annual Meeting Abstracts


ACELLULAR DERMAL MATRIX IN ALVEOLAR BONE GRAFTING: A NOVEL STRATEGY FOR IMPROVED OUTCOMES
Julio A. Clavijo-Alvarez, MD, PhD, Lisa Vecchione, DMD, MDS, Chatan Irwin, MS, Gary DeCesare, MD, Darren M. Smith, MD, Joseph E. Losee, MD.
University of Pittsburgh, Pittsburgh, PA, USA.

ACELLULAR DERMAL MATRIX IN ALVEOLAR BONE GRAFTING: A NOVEL STRATEGY FOR IMPROVED OUTCOMES
BACKGROUND & PURPOSE: Secondary alveolar bone grafting (ABG) remains the standard for alveolar cleft repair. Compromised oral or nasal closure may impede healing and result in graft failure or persistent fistulae. Incorporating acellular dermal matrix (ADM) into these repairs may protect the bone graft during mucosal healing by providing an additional layer of soft tissue coverage.
METHODS: A retrospective review of ABG’s supplemented with ADM at our cleft-craniofacial center was performed. A complete alveolar cleft and minimum 3 months follow-up were required for inclusion. Healing, mucosal breakdown, and exposed/lost graft were documented. Periapical radiographs were analyzed for postoperative alveolar bone according to the Chelsea scale and canine eruption through the graft site.
RESULTS: Thirty-six patients were included. Demographics are depicted in table 1. Minor mucosal delay with bone exposure was present in 50% of the cases treated in the control group (10 of 20). ADM exposure occurred in 37.5% of the experimental group (6 of 16) no significant differences between groups (p=0.45); however, bone graft exposure occurred in 30% of the cases (6 of 20) in the control group and in 0 of 16 cases in the ADM group (p≤ 0.016). Complete mucosal healing time averaged 4 weeks in the control group (SD=2.71; range: 2 - 11). The ABD group healing time averaged 5 weeks (SD=3.82; range: 1 - 14) No significant differences between groups were found.
CONCLUSIONS: Incorporating ADM into ABG has significantly protect alveolar bone grafts during healing. Further studies are underway to determine the functional impact by measuring alveolar bone engraftment and canine eruption.
ParameterControlADM
Total patients2016
Gender (Female/male)9/114/12
Veau Class III15 (75%)8 (50%)
Veau Class IV5 (25%)8 (50%)
Mean age at ABG12 ± 2.57 years (9-20)11 ± 2.14 years (9-17)

Table 1.