Alveolar Bone Grafting for Cleft Lip and Palate | Dr. Daniel Gould

Dr. Daniel Gould co-authored this study published in Plastic and Reconstructive Surgery, comparing two approaches to secondary alveolar bone grafting in patients with cleft lip and palate.

Traditionally, reconstruction of an alveolar cleft involves harvesting bone from the iliac crest of the pelvis. While effective, this approach requires a second surgical site and can contribute to additional discomfort, operative time, and recovery considerations.

The researchers evaluated recombinant human bone morphogenetic protein-2 combined with a demineralized bone matrix as an alternative to traditional iliac crest bone grafting. The study reviewed 501 procedures performed in 414 patients over a 12-year period, comparing surgical complications, cleft closure, and canine tooth eruption between the two approaches.

The findings showed similar rates of repeat surgery for alveolar cleft repair between the groups, as well as comparable canine eruption through the grafted area. The alternative grafting approach was not associated with an increase in serious adverse events, although localized swelling and minor wound separation were reported and generally resolved without intervention.

The research supports continued exploration of regenerative and tissue-engineering approaches in reconstructive surgery, particularly when they may reduce the need to harvest a patient's own bone while maintaining effective clinical outcomes.