Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil.
Department of Maxillofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil.
Am J Orthod Dentofacial Orthop. 2020 Nov;158(5):731-737. doi: 10.1016/j.ajodo.2019.10.021. Epub 2020 Sep 16.
Our objective was to evaluate the effects of bone-anchored maxillary protraction (BAMP) on the status of the secondary alveolar bone graft in patients with unilateral complete cleft lip and palate (UCLP).
The experimental group (EG) comprised 26 patients with UCLP, mean age of 11.9 years, submitted to secondary alveolar bone grafting (SABG) with recombinant bone morphogenetic protein, and BAMP therapy, using miniplate-borne Class III intermaxillary elastics. Cone beam computed tomography (CBCT) examinations were taken 6 months after SABG and before BAMP (T1) and after 18 months of BAMP therapy (T2). The control group (CG) was composed of 24 patients with UCLP submitted only to SABG with recombinant bone morphogenetic protein or autogenous bone from iliac crest without BAMP therapy, matched by initial age and sex with the EG. In the CG, CBCT examinations were performed 6 months (T1) and 12 months (T2) after SABG surgery. CBCT axial sections were analyzed using Garib scores in both time points. Intra- and intergroup comparisons were performed using Wilcoxon and Mann-Whitney tests, respectively (P <0.05).
No intergroup differences were found at T1 and T2. The EG showed significant improvement of graft status from T1 to T2 at the cervical and middle levels of the alveolar cleft. No significant interphase differences were found for graft scores in the CG.
Despite loads of intermaxillary elastics applied to the maxilla, no harm to the grafted alveolar bone was observed after BAMP therapy in patients with UCLP.
我们的目的是评估骨锚定上颌骨牵引（BAMP）对单侧完全性唇腭裂（UCLP）患者的二次牙槽骨移植（SABG）状况的影响。
实验组（EG）包括 26 例 UCLP 患者，平均年龄 11.9 岁，接受了二次牙槽骨移植（SABG）和重组骨形态发生蛋白，并使用微型板载 III 类颌间弹性体进行 BAMP 治疗。在 SABG 后 6 个月（T1）和 BAMP 治疗前（T2），对患者进行了锥形束 CT（CBCT）检查。对照组（CG）由 24 例 UCLP 患者组成，他们仅接受了 SABG 和重组骨形态发生蛋白或自体髂骨移植，与 EG 按初始年龄和性别相匹配，没有接受 BAMP 治疗。在 CG 中，在 SABG 手术后 6 个月（T1）和 12 个月（T2）进行了 CBCT 检查。在两个时间点，使用 Garib 评分对 CBCT 轴位片进行分析。使用 Wilcoxon 和 Mann-Whitney 检验分别进行组内和组间比较（P<0.05）。
在 T1 和 T2 时，组间无差异。EG 在牙槽裂的颈部和中部水平，从 T1 到 T2，移植体状况有显著改善。在 CG 中，移植体评分在各相中无显著差异。
尽管上颌骨施加了颌间弹性体的负荷，但在 UCLP 患者中，BAMP 治疗后未观察到对移植牙槽骨的损害。
