Evaluation of the viability of the transplanted bone glaft for alveolar cleft using blood flow measurement and SPECT

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The purpose of this study was to assess the condition and viability of the autogenous particulate marrow and cancellous bone grafted for alveolar cleft. In this investigation, unsuccessful cases that showed marked bone resorption on CT images obtained 1 month after the operation were evaluated. The viability of bone grafts was documented by means of bone scintigraphy and MRI.1. On the scintigrams and MRI obtained 3 months after the operation, there was no evidence of acute inflammation in the operated alveolus. The scintigrams revealed the decreased uptake at the cleft region and the increased uptake at the adjacent alveolus of the cleft. The decreased uptake of the cleft area gradually became wider and clearer until 14 months after the operation. On the other hand, the increased uptake at the adjacent alveolus of the cleft still partially remained at 14 months after the operation.2. On T1-weighted MRI obtained 3 months after the operation of some cases, the grafted bone showed partially hyper intensity similar to the fatty tissues. This area extended to the adjacent alveolus on the MRI obtained 14 months after the operation.3. From these findings we suggest that scintigraphy may be useful to evaluate postoperative avascular necrosis in the alveolar cleft, and that MRI may be useful in assessing the fatty marrow maturation of the bone bridge.