Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine
Comparison of dental outcomes in patients with nonsyndromic complete unilateral cleft lip and palate who receive secondary alveolar bone grafting before or after emergence of the permanent maxillary canine
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DOI：
10.1016/j.ajodo.2019.11.012
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发表时间：
2020-05-01
影响因子：
3
通讯作者：
Suri, Sunjay
中科院分区：
文献类型：
--
作者：
Vandersluis, Yona R.;Fisher, David M.;Suri, Sunjay
简介：对于完全单侧唇腭裂（CUCLP）患者，可以在裂侧永久尖牙出现之前或之后（分别为CE前和CE后）进行二次牙槽骨移植（SABG）。关于SABG时机相关的牙科结局的争议仍未解决。本研究的目的是评价接受CE前或CE后SABG的CUCLP儿童的牙齿存活率和裂邻牙的特定牙齿结局。研究方法：回顾性分析了21名CE前和23名CE后SABG受试者的上颌尖牙、中切牙和侧切牙，这些受试者患有非综合征CUCLP，所有与唇腭裂相关的手术均由同一名外科医生进行。在7岁时、SABG时和移植后约4年收集口内X线片和临床图表记录。分析牙齿存活率、自发性尖牙萌出、计划的假体置换、牙根发育和牙根吸收。结果：非裂侧的牙体质量优于裂侧。在裂侧，CE前和CE后SABG组的裂邻牙的牙齿存活率无显著差异（P > 0.05）。大多数牙齿在移植后完成了牙根发育，并且在CE SABG前组中的裂侧牙根发育在SABG后似乎加速。趋势显示，CE前SABG组的牙根吸收较少（16.28%; CE后：22.73%; P > 0.05），接受的计划假体置换较少（14.29%; CE后：26.01%; P > 0.05），但需要的犬暴露次数较多（33.33%; CE后：4.55%; P = 0.02）。结论：CE前SABG显示CUCLP患者的牙科结局更好，不良牙科结局少于CE后SABG。
Introduction: For patients with complete unilateral cleft lip and palate (CUCLP), secondary alveolar bone grafting (SABG) can be performed before or after the emergence of the cleft side permanent canine (pre-CE and post-CE, respectively). The controversy regarding dental outcomes related to the timing of SABG remains unsettled. The objective of this study was to evaluate dental survival and specific dental outcomes of cleft-adjacent teeth in children with CUCLP who received either pre-CE or post-CE SABG. Methods: The permanent maxillary canines and the central and lateral incisors of 21 pre-CE and 23 post-CE SABG subjects with nonsyndromic CUCLP and all cleft-related surgeries performed by the same surgeon were analyzed retrospectively. Intraoral radiographs and clinical chart notes were collected at age 7 years, at the time of the SABG, and approximately 4 years after the grafting. Dental survival, spontaneous canine eruption, planned prosthetic replacement, root development, and root resorption were analyzed. Results: Dental outcomes on the noncleft side were better than those on the cleft side. On the cleft side, dental survival of the cleft-adjacent teeth was not significantly different between the pre-CE and post-CE SABG groups (P > 0.05). Most teeth completed root development after grafting, and the cleft side canine root development in the pre-CE SABG group appeared to accelerate after SABG. Trends showed that the pre-CE SABG group suffered less root resorption (16.28%; post-CE: 22.73%; P > 0.05) and received fewer planned prosthetic replacements (14.29%; post-CE: 26.01%; P > 0.05) but required a greater number of canine exposures (33.33%; post-CE: 4.55%; P = 0.02). Conclusions: Pre-CE SABG showed better dental outcomes in patients with CUCLP, with fewer adverse dental outcomes than post-CE SABG.