📖 ABSTRACT/OVERVIEW
Secondary alveolar bone grafting (SABG) at the cleft alveolus is performed to facilitate canine eruption, provide bony support for adjacent teeth, close oronasal fistulae, and enable later implant placement. The microstructural quality of regenerate bone in the grafted cleft site determines the long-term success of dental rehabilitation and implant osseointegration. Comprehensive micro-CT and histomorphometric characterization of alveolar regenerate bone quality in Nigerian cleft patients has not previously been reported. This PhD study analyzes the microstructural characteristics of bone cores harvested from the secondary graft site at the time of canine exposure surgery, typically performed 12 to 18 months after SABG, in 40 cleft patients managed at LUTH Lagos, UCH Ibadan, and National Orthopaedic Hospital Enugu. Micro-computed tomography analysis quantified bone volume fraction (BV/TV), trabecular thickness, trabecular number, and cortical porosity. Histomorphometric analysis evaluated osteocyte lacunar density, remodeling surface, and marrow adiposity. Outcomes were correlated with graft source (anterior iliac crest versus mandibular symphysis), patient age at grafting, timing of canine eruption, and nutritional biomarkers at the time of grafting. Results reveal significantly higher BV/TV and trabecular number in iliac crest-derived grafts compared to mandibular symphysis grafts at 12-month analysis. Nutritional markers, specifically serum 25-hydroxyvitamin D, were positively correlated with regenerate bone volume. Patients grafted before 11 years of age demonstrated superior microstructural outcomes. The study provides the first African micro-CT dataset for cleft alveolar bone graft quality and informs optimized graft site selection and perioperative nutrition protocols. Keywords: alveolar bone grafting, cleft palate, micro-CT, histomorphometry, bone quality.
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