替牙期牙槽突裂患者行块状髂骨植骨术的初步疗效分析

doi:10.7518/hxkq.2022.03.009

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (3): 303-308.doi: 10.7518/hxkq.2022.03.009

替牙期牙槽突裂患者行块状髂骨植骨术的初步疗效分析

江晓娴(), 茅传青, 赖永圳, 卢萌, 王承勇, 蔡志宇, 陈伟辉()

福建医科大学附属协和医院口腔颌面外科，福州 350001

收稿日期:2021-08-08 修回日期:2022-03-08 出版日期:2022-06-01 发布日期:2022-06-01
通讯作者: 陈伟辉 E-mail:jiangxiaoxian89@163.com;whchen@fjmu.edu.com
作者简介:江晓娴，硕士，E-mail：jiangxiaoxian89@163.com
基金资助:
福建省教育厅中青年教师项目(JAT170225);福建省科技厅引导性项目(2019Y0021)

Preliminary efficacy analysis of block iliac bone grafting in patients with alveolar cleft in mixed dentition

Jiang Xiaoxian(), Mao Chuanqing, Lai Yongzhen, Lu Meng, Wang Chengyong, Cai Zhiyu, Chen Weihui.()

Dept. of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China

Received:2021-08-08 Revised:2022-03-08 Online:2022-06-01 Published:2022-06-01
Contact: Chen Weihui. E-mail:jiangxiaoxian89@163.com;whchen@fjmu.edu.com
Supported by:
Young and Middle-Aged Teacher Project of Fujian Provincial Department of Education(JAT170225);Leading Project of Fujian Science and Technology Department(2019Y0021);Correspondence: Chen Weihui, E-mail: whchen@fjmu.edu.com

摘要/Abstract

摘要： 目的

探究替牙期单侧牙槽突裂患者行块状髂骨移植术的疗效情况。

方法

回顾性研究就诊于福建医科大学附属协和医院口腔颌面外科的采用自体半厚块状髂骨块进行单侧牙槽突裂植骨修复的替牙期患者37例。植骨术后1周、术后6~12个月随访观察，并通过Mimics软件对15例患者（术前恒尖牙未萌出的9~12岁患者）的随访影像资料进行髂骨块的三维重建和体积测量，对比分析髂骨块骨吸收率。

结果

37例患者中，32例植骨成功，5例植骨失败。植骨成功率为86.5%。术前恒尖牙未萌出的9~12岁的15例患者中，有2例在术后6~12个月尖牙自行经植骨区萌出；锥形束CT示移植骨块出现良好的骨性连接，其吸收主要发生在牙槽嵴顶处和腭侧，不同患者之间的骨吸收率差异较大，术后6~12个月的平均骨吸收率为39.0%±13.8%。

结论

对替牙期牙槽突裂患者采用块状髂骨植骨术可获得较好的成骨效果。

关键词: 牙槽突裂, 块状骨, 替牙期, 骨吸收, 锥形束CT

Abstract: Objective

To investigate the efficacy of block iliac bone grafting in patients with unilateral alveolar cleft in mixed dentition.

Methods

A retrospective study was conducted on patients with unilateral alveolar clefts in mixed dentition who were treated in the Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital. All patients underwent unilateral alveolar cleft bone graft repair with autogenous block iliac bone blocks. The healing of bone blocks was analyzed at 1 week and 6-12 months after surgery. Mimics software was used for the three-dimensional reconstruction and volumetric measurement of the iliac bone blocks on the follow-up imaging data of 15 patients aged 9-12 years without the eruption of canines before surgery, and the bone resorption rate of the iliac bone blocks was comparatively analyzed.

Results

In the 37 patients, bone grafting was successful in 32 and failed in five. The success rate of bone grafting was 86.5%. In 15 patients aged 9-12 years without the eruption of canines before surgery, eruption through the bone graft area was observed in two patients 6-12 months after the operation. Cone beam computer tomography showed that the grafted bone block exhibited good bony connections, and its resorption mainly occurred on the crests and palatal sides of the alveolar ridge. Bone resorption rates varied considerably between patients with a mean bone resorption rate of 39.0%±13.8% at 6-12 months after surgery.

Conclusion

For patients in mixed dentition, bone grafting with block iliac bone can achieve better osteogenesis effect.

Key words: alveolar cleft, block bone, mixed dentition, bone resorption, cone beam computer tomography

中图分类号:

R 782.2⁺2

江晓娴, 茅传青, 赖永圳, 卢萌, 王承勇, 蔡志宇, 陈伟辉. 替牙期牙槽突裂患者行块状髂骨植骨术的初步疗效分析[J]. 华西口腔医学杂志, 2022, 40(3): 303-308.

Jiang Xiaoxian, Mao Chuanqing, Lai Yongzhen, Lu Meng, Wang Chengyong, Cai Zhiyu, Chen Weihui.. Preliminary efficacy analysis of block iliac bone grafting in patients with alveolar cleft in mixed dentition[J]. West China Journal of Stomatology, 2022, 40(3): 303-308.

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替牙期牙槽突裂患者行块状髂骨植骨术的初步疗效分析

Preliminary efficacy analysis of block iliac bone grafting in patients with alveolar cleft in mixed dentition

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患者编号	年龄/岁	术后随访时间/月	骨吸收率/%
1	10	11	15.0
2	8	12	33.2
3	10	8	60.8
4	9	12	46.7
5	11	11	25.0
6	9	6	45.2
7	8	6	41.3
8	10	7	68.9
9	12	6	25.9
10	9	6	42.8
11	12	12	28.9
12	12	11	36.5
13	10	10	32.7
14	12	12	46.0
15	11	7	36.8