Discussion
bone loss ratio rate, alveolar defects, alveolar cleft, infection, oronasal fistula, Alveolar cleft, cleft
GRAFT LOSS, RECURRENCE, DEHISCENCE, INFECTION, SECONDARY, COMPLICATIONS, ERUPTION
The surgical procedures of alveolar cleft reconstruction are controversial regarding the time, grafting materials, and surgical technique. Alveolar cleft grafting is performed at various ages, but secondary grafting, performed between the ages of 8 and 12 years (mixed dentition), is the most suitable and advantageous. The grafting in this age range gives a housing for canine eruption and allow the alignment of adjacent teeth [All patients involved in these study were unilaterally clefted with no significant difference regarding the cleft volum between the two groups to control the cofounders as the bone formation and the graft resorption ratio affected according to the cleft severity and cleft size [Multiple graft material sources are used for cleft reconstruction, including autogenous bone grafts and allogenic and alloplastic grafts. There was a desire to develop an alternative graft material that could offer the benefits of bone graft with fewer complications and minimal graft loss rate in addition to improving the outcomes [The BMAC is a source of MSCs, concentrated mononuclear cells (MNCs), platelet, cytokines, and growth factors which have anabolic and anti-inflammatory effects on the recipient tissue related to bone regeneration [Pelegrine et al. [The present study showed no dehiscence, infection, or oronasal fistula recurrence in all patients in the BMAC group. This finding aligns with Elhadidi et al. [In this study, an autogenous particulate iliac graft was used as it has osteogenic, osteoinductive, and osteoconductive properties [Regarding the bone volume, there was a significant difference between the mean of BV of the intervention and placebo groups after six months (Concerning bone density, the present study reported a statistically significant difference in the BD parameters between the two groups after six months and 12 months (Relating to the bone loss ratio rate, there was a significant difference between the intervention and control groups (Regarding the previous study, cleft severity, defect size, and patient age would affect the study outcomes. Accordingly, there were attempts to control the different cofounders in the current study as the eligible patients’ age were 8–12 years with unilateral alveolar cleft and no difference regarding the volum between the two groups and this was considered as a point of study strength.The current study had a number of limitations. Only unilateral alveolar defects were involved in the analysis. As the local conditions and resorption rate differed between bilateral and unilateral clefts, the reconstruction of the bone may be different. In addition, the present study did not include patients with variable defect volumes, which would have allowed subgroup analysis and shed light on the graft behavior in different defect volumes.