Touzet-Roumazeille Sandrine, Vi-Fane Brigitte, Kadlub Natacha, Genin Michaël, Dissaux Caroline, Raoul Gwenaël, Ferri Joël, Vazquez Marie-Paule, Picard Arnaud
Université Lille Nord de France, UDSL, F-59000, Lille, France; Oral and Maxillofacial Department, Roger Salengro Hospital, University Hospital of Lille, F-59000, Lille, France; INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, F-59000, Lille, France.
APHP, Hôpital Necker-Enfants Malades, Service de chirurgie maxillo-faciale, F-75015, Paris, France; Centre de référence des malformations de la face et de la cavité buccale, F-75015, Paris, France; Université Paris VII, Faculté de Médecine Diderot, F-75006, Paris, France.
J Craniomaxillofac Surg. 2015 Jul;43(6):950-5. doi: 10.1016/j.jcms.2015.03.027. Epub 2015 Apr 9.
Primary alveolar cleft repair has two main purposes: to restore normal morphology and normal function. Gingivoperiosteoplasty with bone grafting in mixed dentition has been a well-established procedure. We hypothesized that 1) performance of this surgery in deciduous dentition would provide favorable bone graft osseointegration, and 2) would improve the support of incisor teeth eruption, thereby avoiding maxillary growth disturbances. We conducted a retrospective study of clinical and tridimensional radiological data for 73 patients with alveolar clefts (with or without lip and palate clefts) who underwent gingivoperiosteoplasty with iliac bone graft in deciduous dentition. Pre- and post-operative Cone Beam Computed Tomography (CBCT) comparison allowed evaluation of the ratio between bone graft volume and initial cleft volume (BGV/ICV ratio), and measurement of central incisor teeth movements. This series of 73 patients included 44 males and 29 females, with a mean age of 5.5 years. Few complications were observed. Post-operative CBCT was performed at 7.4 months. The mean BGV/ICV ratio was 0.62. Axial rotation was significantly improved post-operatively (p = 0.004). Gingivoperiosteoplasty with iliac bone graft is safe when performed in deciduous dentition and results in a sufficient bone graft volume to support lateral incisor eruption and upper central incisor tooth position improvement.
原发性牙槽嵴裂修复有两个主要目的:恢复正常形态和正常功能。在混合牙列期进行带骨移植的牙龈骨膜成形术是一种成熟的手术方法。我们推测:1)在乳牙列期进行该手术能使骨移植获得良好的骨整合;2)能改善切牙萌出的支持情况,从而避免上颌生长紊乱。我们对73例牙槽嵴裂(伴或不伴唇腭裂)患者进行了一项回顾性研究,这些患者在乳牙列期接受了髂骨移植的牙龈骨膜成形术。通过术前和术后锥形束计算机断层扫描(CBCT)对比,评估骨移植体积与初始裂隙体积之比(BGV/ICV比),并测量中切牙的移动情况。这73例患者包括44名男性和29名女性,平均年龄5.5岁。观察到的并发症很少。术后CBCT在7.4个月时进行。平均BGV/ICV比为0.62。术后轴向旋转明显改善(p = 0.004)。在乳牙列期进行髂骨移植的牙龈骨膜成形术是安全的,并且能产生足够的骨移植体积以支持侧切牙萌出和改善上颌中切牙位置。
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