Enhanced Efficacy of Combined Iliac Crest Bone Graft and Recombinant Human Bone Morphogenetic Protein for Alveolar Bone Grafting.

Authors

Artur Manasyan, Idean Roohani, Caroline Kreh, Anika Kim, Meryem Guler, Joseph Firriolo, Laura Herrera, Marvee Turk, William P Magee, Mark M Urata, Jeffrey A Hammoudeh

Published in

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. Pages 10556656261461128. Jun 19, 2026. Epub Jun 19, 2026.

Abstract

BackgroundThis study compares clinical and radiographic outcomes in alveolar bone grafting (ABG) using iliac crest bone graft (ICBG) alone, demineralized bone matrix (DBM) with recombinant human bone morphogenetic protein-2 (rhBMP-2), and ICBG with recombinant human bone morphogenetic protein-2 with demineralized bone matrix (rhBMP2/DBM).PurposeWe evaluated differences in clinical success and radiographic bone formation among grafting techniques for secondary alveolar cleft repair.Study Design, Setting, and SampleRetrospective cohort study of patients undergoing secondary ABG for cleft alveolus between 2017 and 2023 at a tertiary children's hospital.Independent VariableType of grafting technique: ICBG alone, DBM with rhBMP-2, or ICBG with rhBMP-2.Main Outcome VariablesThe primary outcome was radiographic success (bony bridging on cone-beam computed tomography). Secondary outcomes included vertical bone height and reoperation.CovariatesAge, sex, cleft laterality, and graft type.AnalysesDescriptive statistics and comparative analyses were performed. Statistical significance was set at P < .05.ResultsA total of 432 patients (527 clefts) were included: 196 ICBG, 284 DBM + rhBMP-2, and 47 ICBG + rhBMP-2. Radiographic success was highest in the ICBG + rhBMP-2 group (89.4%) compared with ICBG (65.3%; P = .001) and DBM + rhBMP-2 (61.6%; P < .001). Mean vertical bone height was greater in the ICBG + rhBMP-2 group (7.4 ± 2.6 mm) versus ICBG (4.7 ± 1.9 mm; P < .001) and DBM + rhBMP-2 (4.4 ± 1.2 mm; P < .001).Conclusions and RelevanceICBG combined with rhBMP-2 demonstrates improved radiographic bone formation and vertical height compared with alternative grafting strategies, without increasing reoperation rates.

PMID:
42318690
Bibliographic data and abstract were imported from PubMed on 19 Jun 2026.

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