Study of bone grafting in alveolar cleft and occlusal guidance for cleft palate patients

采用自体颗粒松质骨和髂骨骨髓移植治疗牙槽突裂289例。移植时的平均年龄为11岁11个月，范围为7岁4至33岁。并对移植10例以上的患者进行了临床和影像学评价。五年前。研究结果如下：1.年轻组的牙槽骨高度、植牙区牙龈生长正常，裂骨桥接较好。结论：1.年轻组中有病例仅需正畸治疗就能达到牙咬合，且裂旁牙根吸收较少.大多数病例牙槽骨轮廓在植骨区凹陷，正畸牙在植骨后的新骨组织中移动，未进行修复治疗.虽然我们不能否认上颌骨生长抑制的可能性，但我们可以简化裂骨患者植骨后的全牙修复管理。双侧唇腭裂病例中，伴有骨桥不良或牙根吸收的裂隙发生率最高。作者认为，在不影响髂骨生长的前提下，牙槽突裂内植自体微粒松质骨应尽量年轻化。在广泛的齿槽裂或双侧唇腭裂病例中。移植的合适年龄可能稍晚，因为需要从髂骨中取出Mueb Swe松质骨碎片。

The autogenous particulate cancellous bone and marrow from Iliac bone were transplanted in the alveolar clefts of 289 patients. The average age at the time of transplant was 11 years 11 months, with a range of 7 years 4 maths to 33 years. A clinical and radiographic evaluation of this bone grafting was made to the patients who had underwent transplant more than l. 5 years before. The results were as follows.1. We see better bone bridging of cleft, alveolar bony height, and normal gingival fors on the grafted region among the younger age group. Moreover we had wore cases needed only orthodontic treatment to make a dental occlusim, and less teeth of root resorption adjacents to the cleft in the younger age group.2. Most of the cases, in which alveolar'contour@was iumved on the grafted region, had orthodontic tooth, movement in the new osseous tissue after bone grafting without prosthetic treatment.3. Although we could not denied the possibility of maxillaly growth inhibition, we could simplify the management of a total dental rehabilitation for cleft patients after the bone grafting.4. The frequency of the cleft with unfavorable bone bridging or the root resorption of the tooth was highest in bilateral cleft lip and palate cases. This results were thought to be caused by the insufficient volume of grafts to fill up the bony defects.It is concluded that the autogenous particulate cancellous bone grafting in alveolar cleft should be carried out at younger age as long as it dose not disturbs the growth of Iliac bone with some exceptions. In the cases with wide alveolar cleft or bilateral cleft lip and palate'. the proper age of transplant may be a little later because it is necessary to take mueb swe cancellous bone chips from Iliac bone.