Tache Ana, Mommaerts Maurice Yves
Department of Oral and Maxillofacial Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium.
Ann Maxillofac Surg. 2022 Jan-Jun;12(1):17-21. doi: 10.4103/ams.ams_70_22. Epub 2022 Aug 16.
Bony reconstruction of the alveolar process and its adjacent platform largely represents the final step in surgical achievement of functionality and aesthetics in cleft patients. Throughout the years, the success of this procedure has been investigated. The aim of this study was to assess the success rate of autogenous mid-secondary alveolar bone grafting in this setting.
A retrospective cohort study was performed. All cleft patients receiving secondary alveolar bone grafts between 1990 and 2020 were reviewed. Criteria for assessing success were long-term preservation of alveolar bone stock, ability of spontaneous or orthodontic-guided eruption and periodontal health of permanent lateral incisors and canine teeth, absence of exposed root structures of neighbouring teeth, absence of fistula and successful placement of implants. Failure of alveolar bone grafts was indicated by radiographically demonstrable total or near-total graft loss requiring reintervention.
A number of 124 patients were included and grouped as those primarily operated following our (two-staged palatoplasty) protocol and those receiving cheilorhinoplasty and palatoplasty (one-staged) at other centres. Given the limited cohort size, no complex statistical analysis was performed. In the first group of 64 patients 12 experienced complications (Veau III, eight/36; Veau IV, four/18). In the second group of 60 patients, 12 experienced complications (Veau III, six/37; Veau IV, six/17).
Our surgical protocol using anterior iliac bone grafts for secondary alveolar reconstruction achieved good results, comparing favourably with previous literature.
牙槽突及其相邻平台的骨重建在很大程度上代表了腭裂患者手术实现功能和美观的最后一步。多年来，人们一直在研究该手术的成功率。本研究的目的是评估在这种情况下自体中期牙槽骨移植的成功率。
进行了一项回顾性队列研究。对1990年至2020年间所有接受二期牙槽骨移植的腭裂患者进行了回顾。评估成功的标准包括牙槽骨量的长期保存、恒牙侧切牙和尖牙自发或正畸引导萌出的能力以及牙周健康状况、相邻牙齿无暴露的牙根结构、无瘘管以及种植体成功植入。牙槽骨移植失败表现为影像学上可显示的全部或几乎全部移植骨丢失，需要再次干预。
纳入了124例患者，并分为主要按照我们的方案（两阶段腭裂修复术）进行一期手术的患者以及在其他中心接受唇鼻整形术和腭裂修复术（一期手术）的患者。鉴于队列规模有限，未进行复杂的统计分析。在第一组64例患者中，12例出现并发症（韦氏III型，8例/36例；韦氏IV型，4例/18例）。在第二组60例患者中，12例出现并发症（韦氏III型，6例/37例；韦氏IV型，6例/17例）。
我们使用髂骨前部移植进行二期牙槽重建的手术方案取得了良好的效果，与以往文献相比具有优势。
