正畸牙移入牙槽突裂患者植骨区的牙CT评价

目的应用牙CT评价正畸牙移入牙槽突裂患者植骨区后牙槽骨的形态变化。方法对3位牙槽突裂患者在植骨前后和正畸治疗后行牙槽突裂裂隙区的三维牙CT检查,分析正畸牙移入植骨区域后,正畸牙位置及牙槽骨的形态变化。结果牙槽突裂植骨术后,正畸牙可以顺利移入植入骨区域,正畸牙的牙根尖位置发生明显的位移,牙槽骨会随正畸牙的移动发生塑形改变,而不仅仅是牙齿在牙槽骨内的移动。结论牙槽突裂植骨及正畸治疗有益于重建牙弓的完整性。     

CT在唇腭裂二期牙槽突植骨疗效评价中的应用

目的 探讨唇腭裂二期牙槽突植骨后牙槽骨三维结构,以确保唇腭裂牙槽突植骨术后正畸 治疗的顺利进行。方法 选择唇腭裂二期牙槽突植骨术后半年以上的唇腭裂患者７名,病人的唇腭类型 分别为：单侧完全性唇腭裂６人,双侧完全性唇腭裂１人,牙槽突裂隙为８侧。病人的平均年龄为１５岁, 年龄范围 １１岁至 ２６岁。ＣＴ扫描平面与　面平行,从眶下缘至牙冠的根 １／３,每 ２毫米扫一层并进行三维 重建。结果ＣＴ可以真正反映唇腭裂牙槽突植骨部位的三维结构,能够发现唇腭侧存在的骨骼缺陷,有 利于唇腭裂序列治疗的顺利进行。结论 唇腭裂牙槽突植骨后,正畸治疗前采用ＣＴ这一先进手段进行 裂隙部位牙槽骨高度的三维评价,对于牙槽突植骨后正畸治疗及唇腭裂序列治疗具有十分重要的意义, 使牙槽突植骨的评价进入了三维时代。     

正畸辅助水平向牵张成骨治疗牙槽突裂的临床探讨

目的探讨正畸辅助水平向牵张成骨治疗牙槽突裂的临床效果。方法单侧完全性牙槽突裂患者3例,缺损区域远中节段性截骨,保留其血液供应形成一含牙及种植支抗的骨运送盘,牵引骨运送盘向裂隙侧移动,运用牵张成骨的原理修复牙槽骨缺损。结果牙槽骨软硬组织缺损区完全闭合,牵张区新骨形成良好,支抗牙无明显松动及移位,牙髓活力测试正常,种植支抗稳定无松脱。结论采用正畸辅助水平向牵张成骨修复牙槽突裂临床可行。     

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。     

牙槽突裂的裂隙特点及正畸治疗对唇腭裂患者牙槽突植骨术的影响

牙槽突裂是位于唇腭裂患者上颌牙弓处的骨缺损,常发生于侧切牙与尖牙之间。由于先天性裂隙、早期手术治疗所致瘢痕挛缩及唇肌压迫等原因,患者多并发严重的上颌骨横向发育障碍。牙槽突植骨术作为唇腭裂序列治疗中的重要步骤,是修补上颌骨裂隙和矫正上颌横向发育不足的有效手段。众多临床实践及研究发现,正畸治疗的时机选择与牙槽突植骨术的成功率及预后效果密不可分,同时,牙槽突裂的裂隙特点对牙槽突植骨术产生的影响也不可忽视。本文就牙槽突裂的裂隙特点与正畸治疗时机对牙槽突植骨术成功率及预后的影响两方面进行综述,以期为唇腭裂患者临床治疗方案的选择及实验研究的设计提供一定的依据。     

影像学在评价牙槽突裂二期植骨术疗效中的应用

牙槽突裂二期植骨术的目的是稳定上颌牙弓,对裂隙区邻牙提供骨支持和诱导尖牙的萌出等,是唇腭裂序列治疗中的重要组成部分。裂隙部位的植骨量影响正畸治疗中邻近牙齿的萌出、移动和牙槽嵴突度、形态的重塑以及后续治疗计划的制定。影像学检查观察植骨区骨质情况,是评价唇腭裂牙槽突植骨疗效最重要的方法之一。笔者就牙槽突植骨区骨质情况影像学评价方法进行综述。     

牙槽突裂治疗方法的研究进展

牙槽突裂整复术现已成为唇腭裂序列治疗的重要环节,上颌骨裂隙骨移植在20世纪初就已提出,但至今,对牙槽突裂的治疗方法仍存在许多争议,本文就牙槽突裂整复术的手术时机、植入物选择、手术方法、术前术后正畸干预等方面的研究进展作一综述。     

完全性唇腭裂婴儿术前正畸治疗的临床研究

目的 观察术前鼻-牙槽突矫治器(PNAM)在完全性唇腭裂婴儿术前矫治中的作用.方法 采用术前鼻-牙槽突矫治器对45例非综合征性完全性唇腭裂患儿(平均年龄为18.33 d)进行唇裂术前正畸治疗,测量治疗前后的鼻小柱倾斜度、鼻小柱长度、鼻孔宽度、鼻孔高度和牙槽骨裂隙宽度,并用SPSS 10.0软件进行统计分析.结果 经PN...     

单侧完全性唇腭裂伴牙槽嵴裂患者植骨术后尖牙的牵引助萌

单侧完全性唇腭裂患者常伴有牙槽嵴裂,而裂隙侧的尖牙多发生阻生,即使在适当的年龄做了牙槽嵴植骨术,也常会出现尖牙阻生。本文介绍一例单侧完全性唇腭裂伴牙槽嵴裂患者经过术前扩弓治疗后进行牙槽突裂植骨,植骨术后正畸治疗完成尖牙牵引助萌。     

唇腭裂牙槽植骨术前正畸对植骨疗效的影响

目的探讨牙槽突植骨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、上颌后牙舌倾或扭转并伴有前牙反、牙槽植骨手术不宜进行的完全性腭裂患者11例,男7例,女4例,患者年龄范围8-22岁,进行牙槽植骨术前正畸治疗.术后定期拍摄上颌体腔片/上颌前部咬合片,术后观察时间0.5-3年,牙槽骨高度的评价采用Bergland标准进行.结果11例完全性唇腭裂的病人,经过牙槽植骨术前正畸后,上颌牙弓开展明显,后牙反由于牙弓开展而减小或解除,磨牙间距明显增加.前牙扭转和舌倾明显改善,为牙槽二期植骨术创造了良好的条件.牙槽突植骨的临床成功率为88%.结论对于牙弓狭窄,错畸形严重的唇腭裂患者,应该在植骨术前进行正畸治疗,提高牙槽突植骨的疗效.     

Facio-lingual width of the alveolar base

Importance is attached to assessment of anterior facio-lingual maxillary and mandibular apical base widths in determining limits to incisor root movements. There is absence of similar assessment of facio-lingual base widths for premolars and molars. The aims of this paper are two-fold: to determine the strength of associations between the facio-lingual widths of the anterior and buccal alveolar apical bases, and to determine if an association might exist between the posterior alveolar base width and specific lateral cephalometric measurements. Comparative measurements were made on 40 adult Thai skulls and their companion mandibles using lateral cephalometric radiographs, linear tomography, and direct measurements of the dento-alveolar and basal structures. Wide variation was found in facio-lingual widths of the alveolar bases. No significant correlations were found between the facio-lingual widths of the anterior and posterior alveolar bases in the maxillae and mandible. Significant inverse correlations were found between the alveolar base widths at the mandibular incisors and the FP-MP and PP-MP angles, and between maxillary incisor base widths and the gonial angle. Importantly, no cephalometric indicators were found to predict posterior alveolar base widths. There is a need to continue to search for assessment indicators.     

Primary repair of the alveolar cleft

Nasoalveolar fistula and oropharyngeal fistula of the anterior palatal region are very commonly seen in cases when there are concomitant clefts of the lip and the palate. Absence of adequate tissue in that region complicates the treatment and necessitates new tissue transfers from near or distant tissues. Today, the techniques used for correcting cleft lip cannot successfully solve these 2 problems. In this study, we describe a technique that depends on the principle of using the lip mucosal tissues that remains during the Tennison cleft lip correction technique, with a flap designation, to correct the tissue defect of the cleft between the foramen incisivum and lip and the alveolar region. Twenty-two patients (13 boys and 9 girls), with ages ranging from 3 to 53 months (mean, 24 mo), with unilateral cleft lip and palate underwent surgery with this new technique. In all these patients, clefts in the anterior palatal and alveolar regions were successfully corrected. Fistula was observed in none of these patients in these regions. Through this method, clefts in the anterior palatal and alveolar regions can be corrected during repair of cleft lips.     

Endosseous alveolar distractor (LEAD™) in the management of residual alveolar ridge resorption

Background  

Lack of sufficient alveolar bone height or width is one of the most frequent problems in the dental rehabilitation of the edentulous patient.     

Correction of postsurgical alveolar ridge defect with vertical alveolar distraction of the onlay block graft

ABSTRACT: Alveolar bone augmentation for dental implant rehabilitation is one of the greatest challenges for oral and maxillofacial surgeons. Bringing out an inadequate quantity of vertical bone during augmentation compromises correct implant positioning and the resulting prosthetic restoration. Alveolar distraction osteogenesis is now generally used in correcting alveolar ridge atrophy due to trauma, congenital defects, or periodontal defects. Onlay block grafting is a suitable method for restoring the alveolar bony defects. However, it sometimes can become a complicated procedure to repair the horizontal defect accompanying a vertical defect using only bone blocks. This clinical report presents a successful reconstruction of a severe anterior mandibular alveolar bony defect as a result of impacted teeth extraction and periodontal problem in a 50-year-old healthy female patient. The defect was reconstructed with symphysis graft and platelet-rich fibrin in the first step. Vertical alveolar distraction was performed on the grafted site to maintain the suitable bony height 3 months later. Grafted bony segment distraction and the treatment options in similar cases were also discussed in this clinical report among with the literature.     

Arteriographic assessment of patency of the inferior alveolar artery and its relevance to alveolar atrophy

Patency of the inferior alveolar artery was investigated on 84 patients who had undergone selective external carotid angiography with digital subtraction. Patency of the artery was lost earlier in males than females, but the presence or absence of teeth did not appear to affect the outcome. The artery was visualized less well on patients with medical conditions that may predispose to early or excessive atherosclerotic disease.