Mandibular Symphysis Bone for Alveolar Grafting: 3D Outcomes and Donor Site Regeneration in Patients With Unilateral Cleft Lip and Alveolus.
Authors
Affiliations (6)
Affiliations (6)
- Department of Postgraduation, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil.
- Department of Oral and Maxillofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil.
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
- Hospital for Rehabilitation of Craniofacial Anomalies and Bauru School of Medicine, University of São Paulo, Bauru, Brazil.
- Department of Orthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
- Department of Orthodontics and Facial Orthopedics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil.
Abstract
ObjectiveThe mandibular symphysis is a donor site for alveolar bone grafting (ABG) in patients with cleft lip and/or palate, offering reduced morbidity. This prospective study evaluated ABG outcomes and donor site regeneration using artificial intelligence (AI)-powered 3-dimensional (3D) tools.DesignProspective study.SettingTertiary-level craniofacial hospital.Patients, ParticipantsTwenty-one patients with cleft lip and alveolus (mean age 12.1 ± 3.2 years), and without syndromes.InterventionsAlveolar bone grafting was performed using mandibular symphysis bone by an experienced surgeon at a single center.Main Outcome MeasuresPre- and one-year postoperative cone-beam computed tomography scans were analyzed using AI-powered 3D tools to assess alveolar bone defect and bone bridge formation in terms of thickness, mediolateral extension, and height. Donor site regeneration was evaluated by shape correspondence analysis comparing pre- and postharvesting morphology. Pulp vitality, mental nerve sensory disturbances, and length of hospital stay were recorded.ResultsAt one-year follow-up, cleft defects were reduced to near-zero in all dimensions. The bone bridge reached mean values of 11.6 ± 3.4 mm buccopalatally, 20.7 ± 2.7 mm mediolaterally, and 14.6 ± 4.2 mm vertically. Donor site regeneration was highly favorable, requiring 2.73 ± 1.3 mm of residual bone formation. All patients were discharged within 24 h, with minimal discomfort and no complications.ConclusionThese findings confirm mandibular symphysis bone as a reliable graft source and support the clinical value of AI-powered 3D approach.