Secondary Alveolar Bone Grafting in the Mixed Dentition Phase: Patients of Younger Age Associated With Enhanced Osteogenesis and Midfacial Skeletal Symmetry.

Abstract

Introduction: Alveolar bone grafting during the mixed dentition period is a common treatment, but the optimal surgical timing remains unclear. This study aims to evaluate how age influences the outcomes of secondary alveolar cleft repair, focusing on bone formation and midfacial symmetry.

Materials and methods: This study retrospectively analyzed patients who underwent autologous iliac cancellous bone grafting for alveolar cleft repair from January 2019 to August 2023. Preoperative and 1-year postoperative skull CT data were used to measure osteogenesis rate and midface bony structures, with statistical analysis conducted using R.

Results: A total of 68 patients aged 8 to 12 years were included in the study, with no significant differences in baseline data. Autologous iliac bone grafting for alveolar cleft repair resulted in significant improvements in the symmetry of the midfacial skeletal structure, with younger patients showing more pronounced improvements. Univariate linear regression analysis revealed a linear relationship between age and osteogenesis rate, which was further confirmed by multiple linear regression analysis. Age was identified as the most significant factor influencing the osteogenesis rate (β=-0.037, P=0.003), while the deviation of the nasal septum was also found to significantly affect the osteogenesis rate (β=0.004, P=0.009).

Conclusions: Age significantly impacts the outcomes of alveolar cleft repair using autologous iliac cancellous bone grafting. Younger patients have better bone formation and facial symmetry improvements, suggesting that earlier surgery may be more beneficial. Preoperative nasal septal deviation assessment is also essential for optimizing surgical planning.