术前正畸对完全性唇腭裂牙槽突植骨疗效的影响

目的　探讨牙槽突植骨术前正畸治疗对于完全性唇腭裂牙槽突植骨长期疗效的影响。方法　选择牙弓狭窄、上颌前牙舌倾或扭转 ,可以伴有前牙反 \ ,牙槽突植骨手术不易进行的完全性唇腭裂患者 16例 ,男 9例 ,女 7例。其中单侧完全性唇腭裂 10例 ,双侧完全性唇腭裂 6例 ,共有裂隙 2 2侧 ,患者年龄 8～ 2 2岁。在牙槽突植骨前进行正畸治疗 ,植骨术后定期拍摄上颌体腔片或上颌前部咬合片 ,观察植骨疗效 ,手术后观察期为 0 5～ 4年。牙槽骨高度的评价采用Bergland标准进行。结果　术前正畸 ,特别是通过开展狭窄的上牙弓 ,能够使因存在错畸形而不易进行牙槽突植骨的唇腭裂患者顺利完成手术 ,牙槽突植骨的临床成功率达 86 %。结论　对于上牙弓狭窄 ,错畸形严重的完全性唇腭裂患者 ,应该在植骨手术前进行正畸治疗。

The effect of pre-surgical orthodontics on secondary alveolar bone grafting in the patients with complete cleft lip and palate

Objective To examine the effect of pre-surgical orthodontics on the outcome of the secondary alveolar bone grafting in the patients with complete cleft lip and palate.Methods Sixteen complete cleft lip and palate patients (9 males and 7 females) with collapsed upper arch or severe mal-positioned upper incisors were selected. The cleft was not easily grafted because of the poor access. The total cleft sites were 22 (10 patients with UCLP and 6 patients with BCLP). The age range of the patients was from 8 to 22 years. Pre-surgical orthodontic treatment was mainly to expand the collapsed upper arch and correct the mal-positioned upper incisors. After the secondary alveolar bone grafting,the patients were followed up and anterior occlusal radiograph/intraoral panograph were taken regularly. The observation period was from 6 months to 4 years. Bergland criteria were used to evaluate the interdental septal height.Results Upper arch expansion and the correction of the mal-positioned upper incisors done by the orthodontic treatment made the bone grafting procedure easier. The clinically successful rate reached 86%.Conclusion The severe upper arch collapse and mal-positioned upper incisors in the patients with complete cleft lip and palate should be corrected orthodontically before the secondary alveolar bone grafting.