The use of autologous tooth bone graft in alveolar cleft reconstruction
Würsching Tamás
KÁROLY RÁCZ CONSERVATIVE MEDICINE PROGRAM
Dr. Fekete Andrea
SE Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika előadóterme
2026-06-12 10:00:00
Gyermekkori betegségek klinikuma, élettana és prevenciója
Dr. Szabó Attila
Dr. Németh Zsolt és Dr. Nagy Krisztián
Dr. Lendvai Dávid
Dr. Seres László
Dr. Zima Endre
Dr. Szamosi Tamás
Dr. Dános Kornél
The two studies this thesis is based upon examine autogenous tooth bone as a graft for secondary alveolar bone grafting in patients with unilateral cleft lip and palate.
The first pilot study details the operative concept on a small cohort of seven patients: extracted deciduous and supernumerary teeth were processed into particulate ATB graft. Mixing it with fibrin sealant inside a 3D-printed mold based on virtual surgical planning yielded a “sticky” block that improved handling and fit. Soft-tissue closure employed the split-thickness papilla curtain flap, which shifts keratinized gingiva over the graft and moves the suture line away from the grafted zone. Patients were discharged on the first postoperative day, and early healing was uneventful with favourable soft-tissue conditions. Three-month radiographic outcomes based on CBCT subtraction analysis showed that planned graft volume averaged 1.14 ± 0.36 cm³ and measured hard-tissue gain averaged 0.65 ± 0.26 cm³ (≈60% realization). Morphological similarity between planned and achieved grafts was moderate (mean DSC: 0.43 ± 0.20; mean HD: 1.83 ± 0.77 mm), with a consistent trend toward buccal displacement and insufficient palatal/nasal fill.
The second, retrospective cohort study by Würsching et al., included 21 patients exhibiting UCLP treated with either ICBG (n=11) or ATB (n=10). Outcomes were assessed on long-term CBCT (mean follow-up was 30 ± 13 months) using the grading system published by Stasiak et al. Key findings were, that bone on the cleft side remained significantly less than the contralateral non-cleft side in both groups (ATB p=0.002; iliac crest p=0.005), yet there was no significant difference between the two groups on the cleft side (Mann–Whitney U=47.5, p=0.617). At least 60% of cases in each group achieved moderate or good outcomes on Stasiak grading. On average, approximately 5 teeth provided sufficient ATB volume for unilateral defects. To sum up, the data support that ATB is a feasible alternative to iliac crest for unilateral alveolar cleft reconstruction, delivering short- and long-term CBCT outcomes comparable to iliac crest, while avoiding donor-site morbidity, although neither material fully restores the cleft to the contralateral healthy side.
