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International Journal of Oral and... Jan 2024This study aimed to evaluate the effectiveness of autologous platelet derivatives (APD), specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), combined... (Meta-Analysis)
Meta-Analysis Review
This study aimed to evaluate the effectiveness of autologous platelet derivatives (APD), specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), combined with autogenous iliac crest bone grafts in secondary alveoloplasty for patients with cleft lip and palate. Electronic databases, relevant journals, and reference lists of included studies were searched until July 2022. Best-evidence synthesis was performed to draw conclusions. After the search strategies, 12 randomized controlled trials were included that provided data on six outcomes: newly formed bone, mean bone loss in height and width, bone density, functionality, and postoperative complications. Two authors independently assessed the risk of bias, and the certainty of evidence was assessed using the GRADE approach. The pooled results suggest that there is uncertainty as to whether the combination of APDs with autogenous iliac crest bone grafts improves the percentage of newly formed bone, as the certainty of the evidence was assessed as very low. It may slightly improve the functionality of patients (with low certainty of the evidence) and probably slightly reduces the incidence of postoperative complications (with moderate certainty of evidence). Further randomized clinical trials with standardized methodologies are required to validate these findings.
Topics: Humans; Cleft Lip; Alveoloplasty; Cleft Palate; Bone Transplantation; Postoperative Complications
PubMed: 37730524
DOI: 10.1016/j.ijom.2023.08.008 -
Clinical Oral Investigations Jun 2011The alveolar cleft in patients with clefts of lip, alveolus and palate (CLAP) is usually reconstructed with an autologous bone graft. Harvesting of autologous bone... (Review)
Review
Reconstruction of the alveolar cleft: can growth factor-aided tissue engineering replace autologous bone grafting? A literature review and systematic review of results obtained with bone morphogenetic protein-2.
The alveolar cleft in patients with clefts of lip, alveolus and palate (CLAP) is usually reconstructed with an autologous bone graft. Harvesting of autologous bone grafts is associated with more or less donor site morbidity. Donor site morbidity could be eliminated if bone is fabricated by growth factor-aided tissue engineering. The objective of this review was to provide an oversight on the current state of the art in growth factor-aided tissue engineering with regard to reconstruction of the alveolar cleft in CLAP. Medline, Embase and Central databases were searched for articles on bone morphogenetic protein 2 (BMP-2), bone morphogenetic protein 7, transforming growth factor beta, platelet-derived growth factor, insulin-like growth factor, fibroblast growth factor, vascular endothelial growth factor and platelet-rich plasma for the reconstruction of the alveolar cleft in CLAP. Two-hundred ninety-one unique search results were found. Three articles met our selection criteria. These three selected articles compared BMP-2-aided bone tissue engineering with iliac crest bone grafting by clinical and radiographic examinations. Bone quantity appeared comparable between the two methods in patients treated during the stage of mixed dentition, whereas bone quantity appeared superior in the BMP-2 group in skeletally mature patients. Favourable results with BMP-2-aided bone tissue engineering have been reported for the reconstruction of the alveolar cleft in CLAP. More studies are necessary to assess the quality of bone. Advantages are shortening of the operation time, absence of donor site morbidity, shorter hospital stay and reduction of overall cost.
Topics: Alveolar Process; Alveoloplasty; Bone Density; Bone Morphogenetic Protein 2; Bone Morphogenetic Proteins; Bone Transplantation; Cleft Lip; Cleft Palate; Collagen Type I; Humans; Mesoderm; Osteogenesis; Recombinant Proteins; Tissue Engineering; Tissue Scaffolds; Transforming Growth Factor beta
PubMed: 21465220
DOI: 10.1007/s00784-011-0547-6 -
Clinical Oral Implants Research Aug 2011To assess, based on the existing literature, the benefit of socket preservation therapies in patients with a tooth extraction in the anterior or premolar region as... (Review)
Review
OBJECTIVE
To assess, based on the existing literature, the benefit of socket preservation therapies in patients with a tooth extraction in the anterior or premolar region as compared with no additional treatment with respect to bone level.
MATERIAL AND METHODS
MEDLINE-PubMed and the Cochrane Central Register of controlled trials (CENTRAL) were searched till June 2010 for appropriate studies, which reported data concerning the dimensional changes in alveolar height and width after tooth extraction with or without additional treatment like bonefillers, collagen, growth factors or membranes.
RESULTS
Independent screening of the titles and abstracts of 1918 MEDLINE-PubMed and 163 Cochrane papers resulted in nine publications that met the eligibility criteria. In natural healing after extraction, a reduction in width ranging between 2.6 and 4.6 mm and in height between 0.4 and 3.9 mm was observed. With respect to socket preservation, the freeze-dried bone allograft group performed best with a gain in height, however, concurrent with a loss in width of 1.2 mm.
CONCLUSION
Data concerning socket preservation therapies in humans are scarce, which does not allow any firm conclusions. Socket preservation may aid in reducing the bone dimensional changes following tooth extraction. However, they do not prevent bone resorption because, depending on the technique, on the basis of the included papers one may still expect a loss in width and in height.
Topics: Alveolar Bone Loss; Alveolar Process; Alveoloplasty; Bone Substitutes; Bone Transplantation; Collagen; Humans; Intercellular Signaling Peptides and Proteins; Membranes, Artificial; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 21091540
DOI: 10.1111/j.1600-0501.2010.02064.x