| Purpose:The clinical effects of different concentrations of iliac bone autografts combined with platelet-rich plasma(PRP)to reconstruct alveolar clefts of different defect sizes were analyzed.Method:From January 2020 to September 2022,a retrospective case-control research study was carried out on 40 individuals who had a unilateral alveolar cleft who complied with the selection requirements.Group A:Autogenous iliac bone graft(0.5-1.0cm~3medium defect size);Group B:PRP combined with autogenous iliac bone graft(0.5-1.0cm~3medium defect size,3 times concentrated platelet concentration);Group C:PRP combined with autogenous iliac bone graft(0.5-1.0cm~3medium defect size,5 times concentrated platelet concentration);Group D:PRP combined with autogenous iliac bone graft(0-0.5cm~3low defect size,3times concentrated platelet concentration).There were no significant differences in gender,age,body mass index,alveolar cleft defect size,tooth eruption,orthodontic treatment and other general data among the four groups(P>0.05),indicating comparability.Preoperative CBCT photography was performed in all the four groups.The percentage of postoperative bone formation volume,postoperative bone density changes,treatment costs and adverse reactions were recorded and compared between the two groups.Visual analog scale(VAS)was used to evaluate the improvement of patients’pain.Results:All the operations in the four groups were successfully completed,no complications occurred in the donor area,the surgical incision healed in stageⅠ,and no infection occurred.One patient in group A experienced obvious local swelling following surgery,and one other patients experienced worsening pain the following day.Although there was local swelling and pain in one case,postoperative pain and swelling were not readily apparent in group B,but all of them experienced relief following symptomatic treatment.In groups C and D,postoperative pain and swelling were not immediately apparen.In a comparison of groups with different concentrations of PRP,bone Bridges were formed in all patients at 6-month follow-up.There was statistical significance in BMD changes among the three groups(S=11.04,P=0.01),and BMD changes in groups B and C were significantly better than those in group A(P<0.05).The three groups’bone formation rates were statistically significant(S=5.50,P=0.01),and group B and group C’s rates were significantly higher than those of group A’s(P<0.05).Group B and C had significantly lower VAS scores than group A(P<0.05),and there treatment costs height than goup A(P<0.05),in contrast.In a comparison of different alveolar cleft defect sizes,bone Bridges were formed in all patients at 6-month follow-up.Between the two groups,there was no significant different in bone mineral density(T=11.04,P=0.19).There was statistical significance in bone formation rate between the two groups,and the bone formation rate in group B was significantly better than that in group D(T=3.51,P=0.01).At the same time,VAS score and treatment cost of group B were not significantly different from that of group A(P>0.05).Conclusion:In the treatment of alveolar cleft with the same defect size,PRP combined with autograft was significantly superior to that of autograft alone in terms of new bone volume formation rate,bone density change value and VAS score.These results also indicated that 3-5 times the concentration of PRP could induce bone formation and reduce bone resorption after alveolar bone grafting.Meanwhile,the defect size of alveolar cleft may be related to the rate of bone formation,and smaller defects can better resist bone resorption. |
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