Lee C, Crepeau R J, Williams H B, Schwartz S
Cleft Palate Unit, Montreal Children's Hospital, Canada.
Plast Reconstr Surg. 1995 Dec;96(7):1534-8.
Alveolar cleft bone grafts customarily have been evaluated by one-dimensional dental radiographic measurements. Based on the dental radiograph, remarkable successes with just a single bone graft have been reported in the literature. At the Montreal Children's Hospital, the experience with 101 alveolar bone grafts in 62 cleft lip and palate patients was retrospectively reviewed to determine (1) the precision of dental radiographs at evaluating the clinical outcome, (2) the effect of dental maturation on alveolar bone grafts, and (3) the effect of augmentation bone grafts. The dental radiograph significantly overestimated the number of clefts that could be managed orthodontically (p < 0.01, McNemar's test) and thus poorly prognosticated the ability to achieve bony obliteration of the alveolar cleft and orthodontic closure of the dental gap. Bone grafts performed during the preeruptive canine dentition yielded significantly better results (p < 0.05, chi-squared test). With each subsequent augmentation bone-graft procedure performed, there existed a trend toward improved dental arch stability and radiographic and clinical outcomes.
牙槽嵴裂植骨通常通过一维牙科X线测量进行评估。基于牙科X线片，文献中报道了仅一次植骨就取得显著成功的案例。在蒙特利尔儿童医院，对62例唇腭裂患者的101例牙槽嵴植骨经验进行了回顾性研究，以确定：（1）牙科X线片评估临床结果的准确性；（2）牙齿成熟度对牙槽嵴植骨的影响；（3）植骨增量的影响。牙科X线片显著高估了正畸治疗可处理的腭裂数量（p<0.01，McNemar检验），因此对实现牙槽嵴裂骨愈合和牙间隙正畸关闭的能力预后不佳。在犬齿萌出前进行的植骨效果显著更好（p<0.05，卡方检验）。随着每次后续的植骨增量手术，牙弓稳定性以及X线和临床结果都有改善的趋势。
