Assessment of Nanocrystalline Hydroxyapatite Versus Autogenous Bone Grafts : A Comparative Clinical Study in Alveolar Cleft Grafting

NCT ID: NCT04693559

Last Updated: 2021-01-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-31

Study Completion Date

2023-03-31

Brief Summary

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This work aims to evaluate Nanocrystalline Hydroxyapatite versus Autogenous bone grafts in alveolar cleft grafting

Detailed Description

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Alveolar cleft is the most common congenital bone defect. Since its introduction in 1972, alveolar bone grafting (ABG) has been widely accepted to correct alveolar bone defect in most cleft centres.The purpose of ABG is to restore the dental arch continuity, stabilize the maxilla, close the oronasal fistulae, facilitate subsequent orthodontic treatment, enhance nasal symmetry, establish better oral hygiene, limit growth disturbances, etc . Autologous bone grafting is the gold standard for treating alveolar clefts, with the iliac crest , bone being the most widely accepted donor site(Tan, Brogan et al. 1996.New bone graft substitutes have been devised in recent decades, such as demineralized bone matrix (DBM), bone morphogenetic proteins (BMPs), calcium phosphate (CP), calcium sulfate (CS), hydroxyapatite (HA), highly purified bovine xenograft, and more, but clinical evidence of their efficacy varies among clinical and experimental studies \[4\] With the advent of new biomaterials, which may include or consist of allogenic bone source such as collagen membranes, hydroxyapatite crystals, tricalcium phosphate powder that has been increased consideration for their placement in the repair of alveolar clefts as well as other dental applications

Conditions

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Alveolar Cleft

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patient will be randomized into to groups according to the surgical procedures performed as follow
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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autogenous iliac bone graft (group A)

autogenous iliac bone graft will be used to fill the alveolar defect

Group Type OTHER

secondary alveolar bone graft

Intervention Type PROCEDURE

Under general anaesthesia, the soft tissue in the gingiva surrounding the alveolar cleft will injected with 0.5% lidocaine with 1:100,000 parts of epinephrine. At the alveolar cleft site, gingival sulcus incisions will made on both the sides of the cleft. The tissue will then elevated beneath the periosteum. The mucosa of the nasal floor and the oral mucosa will dissected. Next, the bone particles will implanted into the bone defect. The cleft site will closed without tension by advancement of the gingival flaps

harvesting of the autogenous bone graft

Intervention Type PROCEDURE

osteotome and then cut into small bone granules. The bone granules will then carefully placed into a syringe and pressed to its densest state by pushing the plunger

Nano crystalline Hydroxyapatite (group B)

Nano crystalline Hydroxyapatite will be used to fill the alveolar defect

Group Type OTHER

secondary alveolar bone graft

Intervention Type PROCEDURE

Under general anaesthesia, the soft tissue in the gingiva surrounding the alveolar cleft will injected with 0.5% lidocaine with 1:100,000 parts of epinephrine. At the alveolar cleft site, gingival sulcus incisions will made on both the sides of the cleft. The tissue will then elevated beneath the periosteum. The mucosa of the nasal floor and the oral mucosa will dissected. Next, the bone particles will implanted into the bone defect. The cleft site will closed without tension by advancement of the gingival flaps

Nanocrystalline Hydroxyapatite

Intervention Type PROCEDURE

Nanocrystalline Hydroxyapatite will be used to fill the alveolar defect

Interventions

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secondary alveolar bone graft

Under general anaesthesia, the soft tissue in the gingiva surrounding the alveolar cleft will injected with 0.5% lidocaine with 1:100,000 parts of epinephrine. At the alveolar cleft site, gingival sulcus incisions will made on both the sides of the cleft. The tissue will then elevated beneath the periosteum. The mucosa of the nasal floor and the oral mucosa will dissected. Next, the bone particles will implanted into the bone defect. The cleft site will closed without tension by advancement of the gingival flaps

Intervention Type PROCEDURE

harvesting of the autogenous bone graft

osteotome and then cut into small bone granules. The bone granules will then carefully placed into a syringe and pressed to its densest state by pushing the plunger

Intervention Type PROCEDURE

Nanocrystalline Hydroxyapatite

Nanocrystalline Hydroxyapatite will be used to fill the alveolar defect

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age (7 - 12 years )
* Non-syndromic CLA or CLP
* More than 6 months of follow-up

Exclusion Criteria

* History of previous alveolar surgery
* History of active infection or underlying disease such as hematologic disorders , neoplasm, and immune deficiency
* Patients who had received primary or tertiary ABG
Minimum Eligible Age

7 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Abdullah Hashim Ahmed

MBBS

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Abdullah Hashim, MBBS

Role: CONTACT

+201148239460

References

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Boyne PJ, Sands NR. Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg. 1972 Feb;30(2):87-92. No abstract available.

Reference Type BACKGROUND
PMID: 4550446 (View on PubMed)

Kyung H, Kang N. Management of Alveolar Cleft. Arch Craniofac Surg. 2015 Aug;16(2):49-52. doi: 10.7181/acfs.2015.16.2.49. Epub 2015 Aug 11.

Reference Type BACKGROUND
PMID: 28913221 (View on PubMed)

Cypher TJ, Grossman JP. Biological principles of bone graft healing. J Foot Ankle Surg. 1996 Sep-Oct;35(5):413-7. doi: 10.1016/s1067-2516(96)80061-5.

Reference Type BACKGROUND
PMID: 8915864 (View on PubMed)

Feinberg SE, Weisbrode SE, Heintschel G. Radiographic and histological analysis of tooth eruption through calcium phosphate ceramics in the cat. Arch Oral Biol. 1989;34(12):975-84. doi: 10.1016/0003-9969(89)90055-1.

Reference Type BACKGROUND
PMID: 2558643 (View on PubMed)

Fernyhough JC, Schimandle JJ, Weigel MC, Edwards CC, Levine AM. Chronic donor site pain complicating bone graft harvesting from the posterior iliac crest for spinal fusion. Spine (Phila Pa 1976). 1992 Dec;17(12):1474-80. doi: 10.1097/00007632-199212000-00006.

Reference Type BACKGROUND
PMID: 1471005 (View on PubMed)

Porter AE, Patel N, Skepper JN, Best SM, Bonfield W. Effect of sintered silicate-substituted hydroxyapatite on remodelling processes at the bone-implant interface. Biomaterials. 2004 Jul;25(16):3303-14. doi: 10.1016/j.biomaterials.2003.10.006.

Reference Type BACKGROUND
PMID: 14980425 (View on PubMed)

Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW. Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res. 1996 Mar;(324):86-97. doi: 10.1097/00003086-199603000-00011.

Reference Type BACKGROUND
PMID: 8595781 (View on PubMed)

Other Identifiers

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AssiutU011270

Identifier Type: -

Identifier Source: org_study_id

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