Alveolar cleft defect closure with iliac bone graft, rhBMP-2 and rhBMP-2 with zygoma shavings: Comparative study

AIM: To present the outcome measures of the use of iliac bone graft, rhBMP-2 and rhBMP-2 with zygoma shavings in alveolar cleft defect closure. MATERIALS AND METHODS: Retrospective analysis of details of treated alveolar defect cases (5-10 years during January 2008–December 2010) from records with 4 months follow-up in accordance with the inclusion criteria. PREDICTOR VARIABLES: Type of graft used (iliac crest graft/rhBMP-2/rhBMP-2 with zygoma shaving). OUTCOME VARIABLES: Duration of the operation, blood loss, postoperative drugs used, donor site morbidity, efficiency of bone deposition (radiologically) at 4 months. STATISTICS: Descriptive statistics, one-way ANOVA. P < 0.05 was taken as significant. RESULTS: Forty two cases met the inclusion criteria. Mean efficiency of bone deposition was 89.97 ± 4.79%. Mean efficiency of bone formation in rhBMP-2 (n=13), rhBMP-2 with zygoma shavings (n=9) and iliac crest graft (n=20) was 89.42%, 95.38% and 87.91%, respectively (P=0.000). Drugs usage and postoperative morbidity differed significantly between groups (P < 0.05). CONCLUSION: The use of rhBMP-2 evades the need for additional surgery and overcomes the postoperative morbidity that is associated with the conventional iliac grafting technique. The rhBMP-2 with zygoma shavings showed maximum benefits.