Craniofacial and Special Care Orthodontics, Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA, USA.
School of Dentistry, University of California, San Francisco, CA, USA.
Cleft Palate Craniofac J. 2024 May;61(5):791-800. doi: 10.1177/10556656221143945. Epub 2023 Feb 7.
The purpose is to evaluate outcomes of alveolar bone grafting based on the pre-grafting orthodontic preparation methods.
Retrospective analysis of individuals with unilateral cleft lip and palate.
28 individuals with non-syndromic UCLP from two craniofacial centers, 14 individuals each from XXXX and XXXX.
The alignment group underwent maxillary expansion with incisors alignment while the non-alignment group underwent only maxillary expansion for presurgical orthodontic preparation.
Initial and post-surgical CBCT scans were compared to observe changes in angulation of the incisor adjacent to the cleft site, alveolar bony root coverage, and bone graft outcomes.
In the alignment group, the buccolingual rotation decreased by 32.35 degrees ( = .0002), the anteroposterior inclination increased by 14.01 degrees ( = .0004), and the mesiodistal angulation decreased by 17.88 degrees ( = .0001). Alveolar bony coverage did not change after bone graft in both groups, and no difference was observed between the groups. Chelsea scale showed satisfactory bone graft outcome (category A, C) in 12 cases (85.71%) in the alignment group and 11 cases (78.51%) in the non-alignment group. The volumetric measurement showed the alignment group had better bone fill of 69.85% versus 51.45% in the non-alignment group ( = .0495).
Alveolar bony coverage on the tooth adjacent to cleft sites did not change with alveolar bone grafting surgery in either of the alignment and non-alignment group. Presurgical orthodontic alignment does not induce root exposure nor poorer bone grafting outcome.
评估基于预移植正畸准备方法的牙槽骨移植的结果。
对单侧唇腭裂个体的回顾性分析。
来自两个颅面中心的 28 名非综合征性 UCLP 个体，XXXX 和 XXXX 各 14 名。
对齐组接受上颌扩张和切牙对齐，而非对齐组仅接受上颌扩张进行术前正畸准备。
比较初始和术后 CBCT 扫描，观察裂隙侧邻牙的切牙角度变化、牙槽骨根覆盖和骨移植结果。
在对齐组中，颊舌向旋转减少了 32.35 度（ = .0002），前向后倾斜增加了 14.01 度（ = .0004），近远中角度减少了 17.88 度（ = .0001）。两组骨移植后牙槽骨覆盖均无变化，两组间无差异。切尔西量表显示，对齐组 12 例（85.71%）和非对齐组 11 例（78.51%）的骨移植结果良好（A 类、C 类）。体积测量显示，对齐组的骨填充量更好，为 69.85%，而非对齐组为 51.45%（ = .0495）。
在对齐组和非对齐组中，牙槽骨移植手术均未导致裂隙侧邻牙牙槽骨覆盖发生变化。术前正畸对齐不会导致牙根暴露或骨移植效果较差。
