Jabbari Fatima, Reiser Erika, Thor Andreas, Hakelius Malin, Nowinski Daniel
a Department of Surgical Sciences, Oral and Maxillofacial Surgery , Uppsala University , Uppsala , Sweden ;
b Department of Surgical Sciences, Plastic Surgery , Uppsala University , Uppsala , Sweden.
Ups J Med Sci. 2016;121(1):33-7. doi: 10.3109/03009734.2015.1134733. Epub 2016 Feb 29.
Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained before bone grafting. Alveolar bone height was evaluated with the Modified Bergland Index (mBI) at 1 and 10-year follow-up. Results Anterior cleft width correlated positively with enamel hypoplasia and rotation of the central incisor adjacent to the cleft. There was, however, no correlation between initial cleft width and alveolar bone height at either 1 or 10 years follow-up. Conclusions Wider clefts did not seem to have an impact on the success of secondary alveolar bone grafting but appeared to be associated with a higher degree of some dental anomalies. This finding may have implications for patient counseling and treatment planning.
目的 确定单侧唇腭裂患者初始腭裂大小与牙齿异常之间的相关性，以及牙槽骨植骨的效果。方法 从瑞典乌普萨拉大学医院唇腭裂 - 颅面中心纳入67例连续的非综合征性单侧完全性唇腭裂（UCLP）患者。所有患者均由同一位外科医生进行手术，并按照乌普萨拉方案进行治疗，包括：3个月时进行唇成形术，6个月时进行软腭关闭，2岁时关闭硬腭残留裂隙，以及在恒牙尖牙萌出前进行二期牙槽骨植骨（SABG）。在初次唇成形术时获取的石膏模型上测量腭裂大小。在植骨前获取的X线片和石膏模型上记录牙齿异常情况。在1年和10年随访时用改良伯格伦德指数（mBI）评估牙槽骨高度。结果 前腭裂宽度与釉质发育不全以及裂隙相邻的中切牙旋转呈正相关。然而，在1年或10年随访时，初始腭裂宽度与牙槽骨高度之间均无相关性。结论 较宽的腭裂似乎对二期牙槽骨植骨的成功与否没有影响，但似乎与某些牙齿异常的程度较高有关。这一发现可能对患者咨询和治疗计划有影响。
