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Clinical Evaluation of Bioabsorbable Mesh for Secondary Bone Grafts in the Alveolar Cleft

Tatsuo Shirota*,Hiroshi Ogura,Maiko Suzuki,Ayako Akizuki,Takaaki Kamatani,Seiji Kondo,Tetsutaro Yamaguchi

Purpose: This study investigates whether a poly-L-lactic acid (PLLA)-polyglycolic acid (PGA) mesh-type bone joining material (PLLA-PGA mesh), a bioabsorbable osteosynthetic material, can replace titanium mesh for secondary bone grafts in the alveolar cleft.

Methods: The subjects were 6 patients who underwent secondary bone grafting in the alveolar cleft using the PLLA-PGA mesh and 6 patients treated with titanium mesh. Intraoral X-ray images and dental small-field CT (3DX) were taken over a period of 6 months postoperatively. Analysis of Covariance (ANCOVA) was performed for two objective variables obtained from CT images namely the vertical height of the bony bridge and the labial-lingual thickness. A generalized linear model was also used to analyze a discrete objective variable, i.e., the score for the bony bridge height obtained from the occlusal X-ray image. In these analyses, the five explanatory variables used were mesh type, sex, age, grafted bone mass, and width of the alveolar cleft measured on the CT image.

Results: No significant factors were observed among the 5 explanatory variables with regard to influence on bony bridge thickness. Mesh type was the only significant factor influencing bony bridge height, and the height was greater when using PLLA-PGA mesh than when using titanium mesh. However, there were no significant factors influencing alveolar crest height on occlusal X-ray images.

Conclusions: There were no marked differences in bony bridge morphology in the alveolar cleft area between the PLLA-PGA and titanium mesh groups.