Efficacy of autologous cortico-cancellous bone graft and platelet-rich plasma with or without Bio-Oss in bone regeneration for unilateral alveolar cleft defects: A randomized controlled trial.

Introduction: Alveolar cleft grafting is crucial in cleft lip and palate rehabilitation, promoting maxillary continuity and facilitating dental development. While autologous bone grafts are the gold standard, combining them with platelet-rich plasma (PRP) and xenografts like Bio-Oss has the potential to enhance bone regeneration and long-term stability. This study aimed to evaluate the synergistic effects of combining autologous cortico-cancellous bone grafts, PRP, and Bio-Oss in alveolar cleft repair.

Materials and methods: Twenty patients (aged 8-25 years) with unilateral cleft lip and palate were randomly divided into two groups. Group A received autologous cortico-cancellous bone grafts combined with PRP, while Group B received the same grafts with PRP and Bio-Oss. Bone density, pain, and wound healing were assessed at various intervals up to one year postoperatively. Data were analysed using repeated measures ANOVA and Bonferroni post hoc tests.

Results: Group B demonstrated significantly higher bone density (1028.5 ± 45.2 HU) at six months and one year compared to Group A (P < 0.05). Bone resorption occurred in both groups within the first three months, but Group B showed greater bone regeneration. No significant differences were noted in wound healing between the groups, though two patients in Group B experienced secondary healing due to infection.

Conclusion: The combination of autologous bone grafts, PRP, and Bio-Oss may enhance bone regeneration and stability in alveolar cleft repair. Further studies are needed to validate these findings and optimize clinical protocols.