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混合牙列期应用双髂骨皮质骨松质骨板移植技术行牙槽裂整复

Alveolar Cleft Reconstruction Using Double Iliac Corticocancellous Bone Plates Grafting Technique in Mixed Dentition Phase.

机构信息

Oral and Maxillofacial Surgery Department, Faculty of Dentistry, 110152Cairo University, Cairo, Egypt.

出版信息

Cleft Palate Craniofac J. 2022 Oct;59(10):1222-1227. doi: 10.1177/10556656211042160. Epub 2021 Sep 24.

Abstract

OBJECTIVE

The primary goal of maxillary alveolar cleft reconstruction in patients with cleft lip/palate at the phase of mixed dentition is to build bone in the cleft area which in turn allows closure of the oronasal fistula, establishes arch continuity, and improve maxillary stability. This study aimed to evaluate the double iliac corticocancellous bone plates grafting technique for initial alveolar cleft grafting.

DESIGN

This prospective study was conducted on 12 consecutive patients with unilateral complete alveolar cleft and previous cleft lip and palate corrective surgery.

INTERVENTION

For all patients, the iliac crest graft was harvested and cut into 2 cortical bone plates and adapted labially and palatally. Both plates were fixed with screws then the gap between the 2 plates was filled with cancellous bone. The grafted side was compared to the contralateral side 9 months postoperatively regarding labio-palatal alveolar width and bone density, while the 9 months postoperative graft height was compared to the immediate postoperative height using computed tomography scans.

RESULTS

All grafted sides showed similarity to the contralateral sides regarding both alveolar width and bone density with minimal crestal bone resorption.

CONCLUSION

The double iliac corticocancellous bone plate grafting technique seems to be a reliable method for alveolar cleft reconstruction with adequate bone quality and contour.

摘要

目的

唇腭裂患者混合牙列期上颌牙槽裂重建的主要目标是在裂隙区域构建骨组织,从而关闭口鼻瘘,建立牙弓连续性,并增强上颌稳定性。本研究旨在评估双髂嵴皮质骨松质骨板移植技术在初次牙槽裂植骨中的应用。

设计

本前瞻性研究纳入了 12 例单侧完全性牙槽裂且曾行唇腭裂矫正手术的连续患者。

干预措施

所有患者均采集髂嵴移植物,切成 2 块皮质骨板并适配于唇侧和腭侧。用螺钉固定两块板,然后用松质骨填充两块板之间的间隙。术后 9 个月,比较移植侧与对侧的唇腭侧牙槽宽度和骨密度,同时使用计算机断层扫描比较术后 9 个月的移植高度与即刻术后高度。

结果

所有移植侧在牙槽宽度和骨密度方面均与对侧相似,仅有轻微的牙槽嵴骨吸收。

结论

双髂嵴皮质骨松质骨板移植技术似乎是一种可靠的牙槽裂重建方法,可获得充足的骨质量和轮廓。

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