Jensen J, Sindet-Pedersen S, Enemark H
Department of Oral and Maxillofacial Surgery, Royal Dental College, Aarhus University and Aarhus University Hospital, Denmark.
J Oral Maxillofac Surg. 1998 Apr;56(4):460-6; discussion 467. doi: 10.1016/s0278-2391(98)90713-3.
This study evaluates a treatment regimen for reconstruction of residual maxillary alveolar cleft defects consisting of mandibular bone grafting and immediate implant installation.
Sixteen cleft patients (five female and 11 male) had residual cleft defects of the alveolar ridge reconstructed with bone grafts from the mandibular symphyseal region. The bone graft was pretapped at the donor site before fixation in the residual ridge with Brånemark implants. Twenty implants were installed according to this concept. The period of observation ranged from 36 to 69 months, with a mean of 48 months after implant installation.
Five patients developed wound dehiscenses that resulted in total or partial bone graft sequestration. Two implants were lost, one due to sequestration and the other due to mobility at the abutment procedure; 18 implants were still well functioning at the end of the observation period. However, all patients showed significant periimplant bone resorption after this one-stage treatment.
Because of the observed complication rate, the one-stage procedure may not be optimal for reconstructing residual cleft defects.
本研究评估一种用于重建上颌残余牙槽嵴裂缺损的治疗方案，该方案包括下颌骨移植和即刻种植体植入。
16例腭裂患者（5例女性，11例男性），采用下颌骨联合部的骨移植重建牙槽嵴的残余腭裂缺损。在供区将骨移植块预攻丝，然后用布伦马克种植体固定于残余牙槽嵴。按照这一理念植入了20枚种植体。观察期为种植体植入后36至69个月，平均48个月。
5例患者出现伤口裂开，导致全部或部分骨移植块坏死。2枚种植体丢失，1枚因骨移植块坏死，另1枚在基台操作时因松动而丢失；在观察期末，18枚种植体仍功能良好。然而，在这一阶段治疗后，所有患者均出现明显的种植体周围骨吸收。
鉴于观察到的并发症发生率，一期手术可能并非重建残余腭裂缺损的最佳选择。
