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二期牙槽骨植骨时拔牙会影响腭裂患者的治疗效果吗?

Does Tooth Removal at the Time of Secondary Alveolar Bone Grafting Influence the Outcome for Cleft Patients?

作者信息

Conville Robert, Zakaria Nor Nadia, Woods Martin, Khoshkhounejad Golfam

机构信息

Evelina Cleft Centre, Guys & St Thomas' Hospital NHS Foundation Trust, London, UK.

Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, UK.

出版信息

Cleft Palate Craniofac J. 2025 Jun 18:10556656251346720. doi: 10.1177/10556656251346720.

Abstract

ObjectiveTo investigate whether tooth removal at the time of secondary alveolar bone grafting (SABG) has any association with the surgical outcome and to assess the overall radiographic outcomes of SABG.DesignSingle-center retrospective cohort study.Tertiary UK cleft service.MethodsAny patient diagnosed with a cleft lip and/or palate aged under 16 years who had a SABG over a 3-year period (January 2021-June 2023) were included in the study. Patients with a craniofacial syndrome or those who had a repeat SABG were excluded. Two trained independent assessors were calibrated to use the Kindelan scoring index. Intra and inter-rater reliability was assessed using kappa statistics at the dichotomous level for the calibrated assessors (success vs failure). Chi-square tests were used to assess any associations ( < .05).ResultsNinety patients and 105 SABG (mean age 10.12 years SD 1.45) were included in the study. The overall success rate of the SABGs included was 85.7%. There were no significant differences in outcomes between those who had tooth extraction at the time of bone grafting ( > .05). There were also no statistically significant association between cleft type and cleft side and graft success.ConclusionsTooth extraction during the time of SABG surgery did not significantly influence its success. The results demonstrated that the SABG success rate was in line with the UK national outcome data.

摘要

目的

探讨二期牙槽骨植骨术(SABG)时拔牙与手术效果之间是否存在关联,并评估SABG的整体影像学效果。

设计

单中心回顾性队列研究。

英国三级腭裂治疗服务。

方法

纳入2021年1月至2023年6月期间接受SABG的16岁以下唇裂和/或腭裂患者。排除患有颅面综合征或接受过重复SABG的患者。两名经过培训的独立评估者接受校准以使用Kindelan评分指数。在校准评估者的二分水平(成功与失败)上,使用kappa统计量评估评分者内和评分者间的可靠性。使用卡方检验评估任何关联(P<0.05)。

结果

90名患者和105例SABG(平均年龄10.12岁,标准差1.45)纳入研究。所纳入的SABG总体成功率为85.7%。骨移植时拔牙者与未拔牙者的手术效果无显著差异(P>0.05)。腭裂类型、腭裂侧别与植骨成功之间也无统计学显著关联。

结论

SABG手术时拔牙对其成功率无显著影响。结果表明,SABG成功率与英国国家结果数据一致。

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