Reduction of bone resorption by the application of fibrin glue in the reconstruction of the alveolar cleft.
A major complication in 30% to 75% of cases of surgical treatment of alveolar cleft is resorption of the bone graft. A treatment alternative is the application of fibrin glue, which has the capacity to favor the integration of the graft. The main objective of the study was to evaluate if the use of the fibrin glue reduces bone resorption when it is applied locally. The authors designed a randomized clinical trial. Patients were divided into two groups: group 1, fibrin glue; and group 2, control. Pre- and postoperative graft volume, bone density, bone quality (Lekholm and Zarb, and Norton and Gamble classifications), and postoperative complications were evaluated. The follow-up for all patients was 3 months after discharge. Twenty-seven patients were surgically treated, 13 in group 1 and 14 in group 2. Group 1 had increased graft volume compared with group 2 (64.32 cm v 21.70 cm; P < 0.0001). Bone density was higher in group 1 than in group 2 (396.57 v 245.68; P > 0.076). Bone quality was type 1, 2 and 3 and 4 in group 1. Resorption in group 2 was 62.26%; in group 1, it was 29.72% (P > 0.081). The observed complications were infection and dehiscence of sutures (P > 0.537). The authors conclude that the fibrin glue significantly diminishes bone resorption, allowing improved graft integration and quality.
Segura-Castillo
José L
JL
Medical Research Unit in Clinical Epidemiology, Jalisco, Mexico. jluissegura@yahoo.com
Aguirre-Camacho
Humberto
H
González-Ojeda
Alejandro
A
Michel-Perez
Jorge
J
D000293:Adolescent; D000539:Alveolar Process / Q000002:abnormalities*; D000543:Alveoloplasty / Q000379:methods*; D015519:Bone Density / Q000187:drug effects; D001862:Bone Resorption / Q000517:prevention & control*; D016025:Bone Transplantation / Q000473:pathology*; D002648:Child; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D008297:Male; D016037:Single-Blind Method; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013537:Sutures / Q000009:adverse effects; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives