Rychlik Dariusz, Wójcicki Piotr
Clinic of Plastic Surgery, Wrocław Medical University, and Department of Plastic Surgery, Specialist Medical Center, Polanica Zdrój, Poland.
J Craniofac Surg. 2012 Jan;23(1):118-23. doi: 10.1097/SCS.0b013e318240faa0.
Secondary osteoplasty by means of autogenic spongy bone grafting is the most common procedure used in the reconstruction of the continuity of the maxillary alveolar process. The aim of the study was to analyze retrospectively the effect of certain factors on the course of the bone graft healing process in patients with unilateral complete clefts of the lip, alveolar process, and palate. The investigations involved 62 children aged 8 to 14 years (mean age, 11 years) with unilateral complete cleft of the lip, alveolar process, and palate operated on at the Clinic of Plastic Surgery in Polanica Zdrój from November 2007 to April 2009. All the procedures consisted in the reconstruction of the maxillary alveolar process by means of autogenic spongy bone grafting from the iliac bone. The analysis was performed on the basis of computed tomography scans presenting maxillary alveolar processes in the horizontal cross-sectional planes performed on the second or third postoperative day and after 6 months. They were used as the basis for the measurement of the volume and density (condensation) of the bone graft, the surface of its adhesion to the maxillary alveolar bone, and the volume and density of the healed bone. The following correlation coefficients were determined: between the adhesion surface of the bone to the alveolar bone and the volume of the healed bone, between the adhesion surface of the bone to the alveolar bone and the density of the healed bone, and between the density of the graft and the volume of the healed bone. Increasing the surface of the graft adhesion to the bone ridges of the alveolar cleft contributes to increased volume of the healed bone and slows down the increase in its density (on 6-month follow-up). Crushing of the bone graft increases its resorption and reduces volume of the healed bone.
通过自体松质骨移植进行二期骨成形术是上颌牙槽突连续性重建中最常用的手术方法。本研究的目的是回顾性分析某些因素对单侧唇、牙槽突和腭裂患者骨移植愈合过程的影响。研究对象为2007年11月至2009年4月在波兰尼察-兹德鲁伊整形外科诊所接受手术的62例8至14岁（平均年龄11岁）单侧唇、牙槽突和腭裂儿童。所有手术均采用从髂骨取出自体松质骨移植来重建上颌牙槽突。分析基于术后第二天和6个月时在上颌牙槽突水平横断面上进行的计算机断层扫描。这些扫描图像用于测量骨移植的体积和密度（骨密度）、其与上颌牙槽骨的粘连面积以及愈合骨的体积和密度。确定了以下相关系数：骨与牙槽骨的粘连面积与愈合骨体积之间的关系、骨与牙槽骨的粘连面积与愈合骨密度之间的关系以及移植骨密度与愈合骨体积之间的关系。增加移植骨与牙槽裂骨嵴的粘连面积有助于增加愈合骨的体积，并减缓其密度的增加（在6个月随访时）。骨移植的粉碎会增加其吸收并减少愈合骨的体积。
