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RecruitingNCT04234971Updated Feb 19, 2026

Cost Effectiveness in Alveolar Bone Grafting in Patients With Cleft Lip and Palate

A Phase 4 interventional study of Intervention group (DBM/BMP) and Control group(autologous ICBG) in Cleft Lip and Palate, sponsored by The University of Texas Health Science Center, Houston. Recruiting at 1 site in United States. Open to participants aged 6 Years to 15 Years. Per ClinicalTrials.gov, last updated 2026-02-19.

Sponsored by The University of Texas Health Science Center, Houston · Phase 4, Interventional, and Health services research

From the registry’s dates

  • Started Jun 2021; still recruiting 5 years 4 months later.
Phase
Phase 4
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
6 Years to 15 Years
Sex
All
01

Study summary

The purpose of this trial is to evaluate if the use of Bone Morphogenic Protein(BMP)/Demineralized Bone Matrix (DBM) versus the use of autologous Iliac Crest Bone Graft (ICBG) will result in an increase in total cost effectiveness for patients undergoing alveolar bone graft (ABG) for Cleft Lip and Palate (CLP) and to see if patients who are treated with DBM/BMP will have reduced post-operative pain scores,reduced operative times,and similar rates of bone healing compared to conventional ICBG.

02

Conditions studied

  • Cleft Lip and Palate

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Keywords

  • alveolar bone graft
  • Bone Morphogenic Protein
  • Demineralized Bone Matrix
  • cleft lip
03

In context

Cleft Lip

168 studies on the registry are indexed under Cleft Lip; 51 are open to participants now.

This study's planned enrollment of 40 is above the median of 30 across 116 interventional studies indexed under Cleft Lip.

Browse Cleft Lip studies →

Lead sponsor

The University of Texas Health Science Center, Houston is the lead sponsor of 897 studies on the registry; 214 are open to participants now.

Of its 173 completed or terminated interventional studies of FDA-regulated products, 142 (82%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
6 Years to 15 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patient with CLP(unilateral or bilateral)
  • Radiographically evident open bone defect of the alveolus
  • Dentition evaluated by orthodontist and cleared for ABG surgery

Exclusion criteria

Exclusion Criteria:

  • Patients without CLP
  • Previous failed repair of alveolar cleft
  • Patients who have previously undergone successful ABG
  • Patients without an alveolar defect
  • Patients whose parents refuse to consent to randomization
  • Patients who have a syndromic CLP
05

Study design

Phase
Phase 4
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Intervention group (DBM/BMP)

    Patient undergoes Alveolar bone graft with DBM/BMP

    Drug: Intervention group (DBM/BMP)

  • Active comparator
    Control group(autologous ICBG)

    Patient undergoes Alveolar Bone Graft with Iliac Crest Bone graft.

    Drug: Control group(autologous ICBG)

Interventions

  • DrugIntervention group (DBM/BMP)

    All patients will undergo a standard procedure for exposure of the cleft alveolar defect and closure of all oronasal fistulae. After induction of general anesthesia, the patient will be intubated with an oral ray tube and prepped and draped in sterile fashion. Pre-operative antibiotics will be given to cover oral flora (i.e. Unasyn or clindamycin if penicillin allergy exists). The intra-oral space will be exposed and the nasal floor and palatal mucosa will be primarily closed to create a water-tight space for the graft. The integrity of the nasal floor mucosa will be tested using methylene blue dye. Following closure of the fistula, the alveolar bone graft will be performed. For the treatment group, 10cc of crushed DBM will be mixed with the micro-sized sponge of rh-BMP-2 (Infuse Bone Graft, Medronic, Minneapolis, MN). The sponge and DBM will then be packed into the defect to completely fill the bony space (FIGURE 3). The anterior mucosa will then be closed.

  • DrugControl group(autologous ICBG)

    The patient will be induced with anesthesia, prepped, and draped. The intra-oral space will be exposed and the nasal floor and palatal mucosa will be primarily closed to create a water-tight space for the graft. The integrity of the nasal floor mucosa will be tested using methylene blue dye. Following closure of the fistula, the alveolar bone graft will be performed.In the control group, the ICBG will be harvested percutaneously using the Accumed bone graft harvesting system. Briefly, an incision will be made in iliac crest and drill bit inserted. Multiple passes of the drill be used to harvest as much autograft bone as possible from the cancellous region of the iliac crest.Following harvest, fibrin glue will be instilled for hemostasis and a Ropivicaine On-Q pain pump inserted for post-operative pain control. The harvest bone graft will be packed into the alveolar defect in a similar fashion and the mucosa closed anteriorly.

06

What researchers measure

Primary outcomes

  1. Health system costs per successful bone graft.

    Health system costs will be reported as the total sum of all costs including incremental surgeon time costs, hospital costs, revision costs, and additional outpatient costs for clinic or ER visits. Bone graft success be defined as no need for a repeat bone graft, as well as by assessment by blinded orthodontist evaluations of the Post op Cone beam computed tomography(CBCT).

    Time frame: One year post graft

Secondary outcomes

  1. Graft Success

    Graft success as indicated by number of patients that did not have exposure of graft as assessed by post op CBCT

    Time frame: 3 months post graft

  2. Infection

    Graft success as indicated by number of patients that had no graft infection as assessed by post op CBCT

    Time frame: 3 months post graft

  3. Fistula Recurrence

    Graft success as indicated by number of patients that had no recurrence of oronasal fistula as assessed by post op CBCT

    Time frame: 3 months post graft

  4. Rate of Revision ABG

    Graft success as indicated by number of patients that had no no need for repeat bone graft as assessed by post op CBCT

    Time frame: 3 months post graft

  5. Operative Time

    Total time for operation

    Time frame: 1 day

  6. Anesthesia Time

    total time of anesthesia

    Time frame: 1 day

  7. Post Operative Pain Scores

    Change in pain as assessed by the numeric Rating Scale(NRS) for pain. The NRS total score ranges form 0(no hurt) to 10(hurts worst)

    Time frame: 1 week post operatively

  8. Pain Medication Usage

    Total dose of post-operative narcotics used

    Time frame: 1 week post operatively

  9. Post Op Fever

    Number of patients with the post operative complication fever

    Time frame: 3 months

  10. Drainage from Fistula

    Number of patients with the post operative complication drainage from donor site or alveolar site

    Time frame: 3 months

  11. Post Op ER Visits

    Number of patients with the post operative complication ER or primary care visits

    Time frame: 3 months.

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Jun 2021 (actual). Primary completion is estimated for Jan 2028, 78 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 15, 2020
First posted
Jan 21, 2020
StartActual
Jun 14, 2021
Primary completionEst.
Jan 1, 2028
CompletionEst.
Jan 1, 2028
Last update
Feb 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04234971
Responsible party
Matthew Greives (Assistant Professor, The University of Texas Health Science Center, Houston) — Principal investigator
First posted
Jan 21, 2020
Start date
Jun 14, 2021
Primary completion
Jan 1, 2028 (estimated)
Completion
Jan 1, 2028 (estimated)
Last update
Feb 19, 2026

Study contacts

Matthew Greives, MD
Contact
Matthew.R.Greives@uth.tmc.edu
(713) 500-7275
Tien Do, DO
Contact
Tien.Do@uth.tmc.edu
Matthew Greives, MD
principal investigator · The University of Texas Health Science Center, Houston

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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