Mitsugi Masaharu, Ito Osamu, Alcalde Rafael E
Department of Oral and Maxillofacial Surgery and Plastic Surgery, Kagawa Prefectural Central Hospital, Kagawa, Japan.
Br J Plast Surg. 2005 Jul;58(5):619-25. doi: 10.1016/j.bjps.2005.02.020.
Secondary autogenous cancellous bone grafting is a widely used method for the treatment of alveolar clefts and oronasal fistulae. However, failure of iliac bone grafting sometimes occurs due to inadequate covering with the surrounding soft tissue and marked scar formation, inappropriate patient age, or large clefts. For alveolar clefts, we developed a method consisting of alveolar bone transportation, closure of the alveolar cleft, and/or grafting of new bone. Transport distraction osteogenesis along the curve of the dental arch is ideal. Alveolar bone was transported in the planned direction using a ready-made bone-borne distractor in combination with an orthodontic arch wire for transport guidance. This method allows simultaneous correction of nasal septal deviation and also correction of maxillary arch deformities and malocclusion since, the dental arch is expanded without donor sacrifice. This method can be regarded as tissue engineering to expand bone tissue. This method can be safely performed not only in patients undergoing initial treatment for alveolar clefts but also in patients in whom bone grafting has failed. Since 1997, we have performed this method in 22 patients and obtained good results.
二期自体松质骨移植是治疗牙槽嵴裂和口鼻瘘的一种广泛应用的方法。然而，髂骨移植有时会失败，原因包括周围软组织覆盖不足和明显的瘢痕形成、患者年龄不合适或裂隙较大。对于牙槽嵴裂，我们开发了一种方法，包括牙槽骨牵张成骨、牙槽嵴裂关闭和/或新骨移植。沿牙弓曲线进行牵张成骨是理想的。使用现成的骨支持式牵张器结合正畸弓丝进行牵引引导，将牙槽骨按计划方向牵张。这种方法可以同时矫正鼻中隔偏曲，还可以矫正上颌牙弓畸形和错牙合，因为在不牺牲供体的情况下扩大了牙弓。这种方法可被视为扩大骨组织的组织工程学方法。这种方法不仅可以安全地应用于牙槽嵴裂初始治疗的患者，也可以应用于骨移植失败的患者。自1997年以来，我们已对22例患者实施了该方法，并取得了良好的效果。
