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骨裂289例。移植时的平均年龄为11岁11个月，从7岁到33岁不等。我们对接受骨移植超过1.5年的患者进行了临床和影像学评价。实验结果如下：我们看到较好的骨桥裂，牙槽骨高度，和正常牙龈的植牙区，在年轻的年龄组。此外，我们也有一些病例只需要正畸治疗来做牙合，而在年轻的年龄组中，根吸收的牙齿较少。2 .大多数牙槽骨contour@was在移植物上移动的病例，植骨后在新骨组织中有正畸牙的运动，无需假体治疗。虽然我们不能否认上颌生长抑制的可能性，但我们可以简化骨移植后腭裂患者全牙康复的管理。双侧唇腭裂伴骨桥或牙根吸收不良的发生率最高。这一结果被认为是由于移植物体积不足以填补骨缺损造成的。综上所述，在不影响髂骨生长的情况下，自体颗粒松质骨移植治疗牙槽骨裂应在较年轻时进行，但也有例外。宽牙槽裂或双侧唇腭裂的病例。适当的移植年龄可能会稍晚一些，因为需要从髂骨上取下静脉或松质骨片。

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.