3D-computed tomography assessment reveals a negative correlation between donor-site iliac cancellous bone density and bone density at the recipient site in secondary alveolar bone grafting.

BACKGROUND

Autologous iliac bone grafting is the gold standard for secondary alveolar bone grafting (SABG) in alveolar cleft patients. While multiple factors affect osteogenesis, the influence of donor-site bone density (BD) on outcomes remains poorly characterized.

METHODS

In this retrospective, exploratory pilot study, 20 patients with unilateral alveolar clefts undergoing SABG (2023-2024) were analyzed. Donor-site iliac cancellous BD (ICBD) was quantified using Hounsfield Units (HU) from preoperative Computed Tomography (CT). Postoperative osteogenesis volume (OV), osteogenesis rate (OR), and the osteogenic area BD (OABD) were calculated via three-dimensional (3D) reconstruction and Boolean operations on pre- and postoperative (6-month) CT scans.

RESULTS

A significant strong negative correlation was found between ICBD and OABD (ρ = -0.6436, p = 0.0022), indicating that lower donor-site ICBD correlated with higher BD in the osteogenic alveolar bone. No significant correlations were observed between ICBD and OV (p = 0.7252) OR (p = 0.3494).

CONCLUSION

In this pilot study, lower-density iliac cancellous bone was associated with superior bone density at the graft site. These preliminary findings suggest that preoperative assessment of ICBD may be a useful indicator, but further prospective studies are needed to confirm its clinical utility.