Tang Kun-Lun, He Xiao-Ling, Chen Dan
Department of Stomatology,Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology. Chengdu 610091, Sichuan Province, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2024 Aug;33(4):426-431.
To evaluate the effect of bone nail and artificial periosteum combined with iliac cancellous bone grafting in repairing cleft lip and palate with alveolar cleft during dental replacement.
The clinical data of 82 children with cleft lip and palate with alveolar cleft during dental replacement period were retrospectively analyzed from January 2020 to December 2023, and were divided into control group (iliac cancellous bone grafting alone, n=42) and experimental group (combined iliac cancellous bone grafting with bone nail and artificial periosteum, n=40) according to the operation method. The viable bone volume in bone graft area, absorption rate of whole bone graft and different bone graft areas, success rate of bone graft, survival rate of bone graft and complications were compared between the two groups. SPSS 25.0 software package was used for statistical analysis.
The surviving bone volume in the bone graft area was significantly larger in the experimental group 3 and 9 months after operation(P＜0.05). There was no significant difference in viable bone volume in bone graft area between the two groups 9 months and 3 months after surgery (P＞0.05). The bone graft absorptivity of the experimental group was significantly lower than that of the control group 3, 9 months and 3-9 months after surgery(P＜0.05), and there was no significant difference between the two groups at 3, 9 months after surgery(P＞0.05). The absorption rate of bone graft in 1/2 area of nasal cavity, 1/2 area of alveolar ridge, 1/2 area of lip and 1/2 area of palate in the experimental group was significantly lower than that in the control group 3 and 9 months after operation(P＜0.05). The absorptivity of bone graft in 1/2 area of alveolar ridge was significantly higher than that in 1/2 area of nasal cavity, and the absorptivity of bone graft in 1/2 area of palatal side was significantly higher than that in 1/2 area of lip in both groups (P＜0.05). The success rate and survival rate of bone grafting in the experimental group were significantly higher than those in the control group(P＜0.05). The complication rate of the experimental group was significantly lower than that of the control group (P＜0.05).
Bone nail and artificial periosteum combined with iliac cancellous bone graft can effectively repair cleft lip and palate with alveolar cleft during dental replacement, reduce bone absorption rate and complications, and improve bone formation effect. Meanwhile, postoperative bone mass absorption mainly occurs within 3 months after surgery, and mainly occurs in the alveolar crest area and palatine area.
评估骨钉和人工骨膜联合髂骨松质骨移植在牙列替换期修复唇腭裂伴牙槽嵴裂的效果。
回顾性分析2020年1月至2023年12月期间82例牙列替换期唇腭裂伴牙槽嵴裂患儿的临床资料，根据手术方法分为对照组（单纯髂骨松质骨移植，n = 42）和试验组（髂骨松质骨移植联合骨钉和人工骨膜，n = 40）。比较两组植骨区存活骨体积、全植骨及不同植骨区的吸收率、植骨成功率、骨移植存活率及并发症。采用SPSS 25.0软件包进行统计分析。
试验组术后3个月和9个月植骨区存活骨体积明显更大（P＜0.05）。术后9个月与3个月两组植骨区存活骨体积差异无统计学意义（P＞0.05）。试验组术后3个月、9个月及3 - 9个月植骨吸收率明显低于对照组（P＜0.05），术后3个月和9个月两组差异无统计学意义（P＞0.05）。试验组术后3个月和9个月鼻腔1/2区、牙槽嵴1/2区、唇1/2区及腭1/2区的植骨吸收率明显低于对照组（P＜0.05）。两组牙槽嵴1/2区植骨吸收率明显高于鼻腔1/2区，腭侧1/2区植骨吸收率明显高于唇1/2区（P＜0.05）。试验组植骨成功率和存活率明显高于对照组（P＜0.05）。试验组并发症发生率明显低于对照组（P＜0.05）。
骨钉和人工骨膜联合髂骨松质骨移植可有效修复牙列替换期唇腭裂伴牙槽嵴裂，降低骨吸收率和并发症，提高骨形成效果。同时，术后骨量吸收主要发生在术后3个月内，主要发生在牙槽嵴区和腭区。
