Corre P, Khonsari R-H, Laure B, Elamrani K, Weiss P, Mercier J-M
Clinique de chirurgie maxillo-faciale et de stomatologie, centre hospitalier universitaire de Nantes, France.
Rev Stomatol Chir Maxillofac. 2012 Apr;113(2):131-5. doi: 10.1016/j.stomax.2011.12.012. Epub 2012 Feb 4.
Bone substitutes are rarely used in the reconstruction of cleft lip and palate. The graft material of choice is cancellous bone, harvested in the hip or tibia. Tibial harvesting may lead to postoperative morbidity, or even complications. This has lead surgeons to develop alternative solution. We present a secondary alveolar bone grafting technique using synthetic calcium phosphate ceramics.
A patient presenting with a complete unilateral cleft lip and palate was treated by alveolar bone grafting at the age of nine years, using a mixture of autologous bone, harvested on the operative field, and particles of biphasic calcium phosphate (BCP); the graft was included in a platelet rich plasma (PRP) gel. The patient was followed up for eight years after the procedure. No sign of early or late infection was observed. At the end of facial growth, the cuspid had erupted correctly in a safe periodontal environment. Sequential X-rays showed complete filling of the initial bone defect, progressive resorption of ceramics, and spontaneous eruption of the cuspid.
In this long-term follow-up report, the use of BCP mixed with autologous bone did not interfere with dental eruption or maxilla growth. A second bone-harvesting site was thus avoided. BCP could be a suitable alternative to autologous bone graft for secondary alveoloplasty.
骨替代物很少用于唇腭裂修复。首选的移植材料是取自髋部或胫骨的松质骨。取自胫骨可能会导致术后发病，甚至出现并发症。这促使外科医生寻求替代解决方案。我们介绍一种使用合成磷酸钙陶瓷的二期牙槽骨移植技术。
一名患有完全性单侧唇腭裂的患者在9岁时接受了牙槽骨移植治疗，使用的是术中取自术野的自体骨与双相磷酸钙（BCP）颗粒的混合物；移植材料被置于富血小板血浆（PRP）凝胶中。术后对该患者进行了8年随访。未观察到早期或晚期感染迹象。在面部生长结束时，尖牙在安全的牙周环境中正常萌出。系列X线片显示最初的骨缺损完全填充，陶瓷逐渐吸收，尖牙自然萌出。
在这份长期随访报告中，使用BCP与自体骨混合并未干扰牙齿萌出或上颌骨生长。因此避免了第二个取骨部位。BCP可能是二期牙槽成形术中自体骨移植的合适替代品。
