Jansma J, Raghoebar G M, Batenburg R H, Stellingsma C, van Oort R P
University Hospital Groningen, The Netherlands.
Cleft Palate Craniofac J. 1999 Jan;36(1):67-72. doi: 10.1597/1545-1569_1999_036_0067_bgocla_2.3.co_2.
Fixation of a prosthesis or single tooth replacement using osseointegrated implants has the potential to overcome functional and psychological inconveniences that many patients experience from such appliances. However, the dimensions of the recipient site are relatively often inadequate for implant placement. This study assessed grafting of this site with autogenous bone as a solution for the latter problem.
Ten cleft lip and palate patients had bone grafts; six had iliac crest grafts to the maxillary sinus floor (31 implants), and four had chin bone grafts to the local defect in the anterior maxilla (six implants). Implants were inserted during the grafting procedure (one patient) or after 3 months (nine patients).
No inflammation of the bone grafts or the maxillary sinus occurred. One implant was lost during the healing phase. Four single tooth restorations, one fixed bridge, and five implant-supported overdentures were made. During the follow-up, which was 47 months (range, 28 to 65 months) in the anterior maxilla group and 56 months (range, 28 to 68 months) in the posterior maxilla group, no loss of implants was observed, and all prosthetic appliances functioned well.
It is concluded that bone grafting followed by placement of dental implants can serve as a reliable alternative for conventional prosthetic rehabilitation of cleft patients.
使用骨结合种植体进行假体固定或单颗牙齿替换，有可能克服许多患者使用此类修复体时所经历的功能和心理不便。然而，受体部位的尺寸相对常常不足以植入种植体。本研究评估了使用自体骨移植该部位作为解决后一问题的方法。
10例唇腭裂患者接受了骨移植；6例患者接受了上颌窦底髂嵴骨移植（31颗种植体），4例患者接受了上颌前部局部缺损的颏骨移植（6颗种植体）。在骨移植过程中（1例患者）或3个月后（9例患者）植入种植体。
骨移植部位或上颌窦均未发生炎症。在愈合阶段有1颗种植体丢失。制作了4个单颗牙齿修复体、1个固定桥和5个种植体支持的覆盖义齿。在上颌前部组随访47个月（范围28至65个月），上颌后部组随访56个月（范围28至68个月）期间，未观察到种植体丢失，所有修复体功能良好。
得出结论，骨移植后植入牙种植体可作为腭裂患者传统修复康复的可靠替代方法。
