Cleft Alveolar Bone Grafting Using Mandibular Symphyseal Bone Graft and Resorbable Collagen Membrane: A CBCT-Based 3-Dimensional Morphometric Analysis.

Abstract

ObjectiveIliac cancellous bone graft has been regarded as the gold standard for secondary alveolar bone grafting (SABG); however, it is associated with a high resorption rate and donor-site morbidity. This study aimed to evaluate the radiographic outcomes of SABG using a mandibular symphyseal bone graft combined with a double-layer resorbable collagen membrane through standardized 3-dimensional cone-beam computed tomography (CBCT)-based morphometric assessment.DesignRetrospective study.SettingPatients with unilateral cleft lip/palate (UCLP) or bilateral CL/P (BCLP) who underwent SABG at a single center.Patients and InterventionEighteen patients with UCLP/BCLP who underwent SABG using a mandibular symphyseal bone graft and a double-layer resorbable collagen membrane between 2022 and 2025.Main Outcome MeasuresPreoperative and 1.5-year postoperative CBCT-based 3-dimensional linear morphometric measurements, including cleft width reduction and postoperative bone bridge thickness.ResultsAt 1.5 years postoperatively, cleft width significantly reduced at all measurement levels (P < .001). The mean postoperative bone bridge thickness was 5.97 ± 2.02 mm at the mid-root level and 6.62 ± 2.50 mm at the apical level.ConclusionsMandibular symphyseal bone grafting combined with a double-layer resorbable collagen membrane yielded favorable radiographic outcomes, with substantial reduction of alveolar cleft defects and satisfactory bone bridge formation in this retrospective cohort. This technique may be a viable treatment option for selected patients. However, prospective controlled studies with larger cohorts and longer follow-up are needed to confirm its comparative effectiveness and long-term stability.