Department of Oral and Maxillofacial Surgery, General Hospital Balingen, Tuebinger Str. 30, 72336 Balingen, Germany.
J Craniomaxillofac Surg. 2009 Dec;37(8):429-33. doi: 10.1016/j.jcms.2009.07.009. Epub 2009 Aug 18.
The results of primary bone grafting in terms of initial cleft width, existence or absence of a lateral incisor and scar formation in the donor area are compared.
After primary osteoplasty with calvarian bone at an average age of 24 months (4-56 months) radiographic assessment was carried out in 31 patients with 40 alveolar clefts. The bone formation in the grafted area was assessed using dental radiographs taken at 66 months on average (13-114 months) after primary bone grafting. According to the Abyholm classification patients were assigned to 4 groups (indices I-IV) with indices I and II being rated as a success.
We observed success (indices I and II) in 76% and poor results (index IV) in 14%. The causes for the poor results were an alveolar cleft width of 11-12 mm in three cases, an extraction of a decayed deciduous tooth 17 months after bone grafting in one case and a traumatic transplant loss in another case. The non-existence of a lateral incisor and a broad cleft are related to poor results.
Based on the results presented, primary bone grafting using calvarial bone seems to be a promising alternative in bridging narrow alveolar defects. This method allows early intervention at an age in which children do not recognize themselves as cleft patients. The preservation of the deciduous teeth is equally important regarding their functional stimulus for bone development.
比较初次植骨在初始裂隙宽度、侧切牙存在与否和供区瘢痕形成方面的结果。
对 31 例 40 例牙槽裂患者于 24 月龄（4-56 月龄）行颅骨骨形成术，平均于术后 66 个月（13-114 个月）行口腔曲面断层片评估。根据 Abyholm 分类将患者分为 4 组（指数 I-IV），指数 I 和 II 被评为成功。
我们观察到 76%的成功率（指数 I 和 II）和 14%的不良结果（指数 IV）。3 例不良结果的原因是牙槽裂宽度为 11-12mm，1 例于植骨后 17 个月发生龋齿拔除，1 例创伤性移植丢失。侧切牙缺失和裂隙较宽与不良结果有关。
基于目前的结果，使用颅骨骨的初次植骨似乎是一种有前途的方法，可以桥接狭窄的牙槽裂。这种方法可以在儿童还没有意识到自己是唇腭裂患者的年龄进行早期干预。保存乳牙对骨发育的功能性刺激同样重要。
