Drommer R B, Musgrove B
University Hospital of Heidelberg.
Curr Opin Dent. 1991 Jun;1(3):282-6.
Improved management techniques of secondary cleft palate deformities are steadily evolving. The year's literature under review focuses mostly on the various methods available for establishing a complete and stable dental arch. Bone from the mandibular symphysis seems to offer a more reliable source of autogenous bone than do other sites, although if the residual cleft is large, this site may not provide sufficient bone. The optimum time to graft the alveolus appears to be after the incisors have erupted, but before the canine root has fully formed and the crown broken through the mucosa. Mucoperiosteal flaps give better long-term results than do mucosal flaps. Long-term stability of the alveolar segments may be achieved with extended bridges, and the use of rigid internal fixation may offer better three dimensional stability of the maxilla following advancement and inferior repositioning. Pharyngeal flaps have a detrimental effect on stability of the maxilla after advancement, although they may have a beneficial effect on velopharyngeal function after maxillary surgery.
继发性腭裂畸形的改良管理技术正在不断发展。本年度综述文献主要聚焦于建立完整且稳定牙弓的各种可用方法。与其他部位相比，下颌联合处的骨似乎能提供更可靠的自体骨来源，不过如果残余腭裂较大，该部位可能无法提供足够的骨。移植牙槽骨的最佳时机似乎是在切牙萌出后，但在犬牙根完全形成且牙冠穿透黏膜之前。黏骨膜瓣比黏膜瓣能带来更好的长期效果。使用延长桥接可实现牙槽节段的长期稳定性，而在推进和向下复位后，采用坚固内固定可能会使上颌骨获得更好的三维稳定性。咽瓣对推进后上颌骨的稳定性有不利影响，尽管它对上颌手术后的腭咽功能可能有有益作用。
