齿槽裂修复方法的研究进展

目的探讨齿槽裂修复治疗的目的、方法以及治疗时机的选择。方法查阅1950年至2006年有关齿槽裂修复的文献,归纳文献中报道的不同方法,并评价其各自的优缺点。结果齿槽裂修复的主要目的:关闭口鼻瘘;建立稳定、连续的上颌骨牙弓;为牙齿萌出提供基础;为上唇和鼻底提供稳定支架。主要治疗方法:植骨术;牵引成骨技术;组织工程骨和生长因子应用;引导骨再生技术。患者最佳的手术治疗时机是9~11岁时混合牙列期。结论在9~11岁混合牙列期手术,以髂骨松质骨为移植材料被认为是修复齿槽裂的主要手段。牵引成骨技术、组织工程技术和引导骨再生技术,将是齿槽裂修复的新方向。

Advancement in the methods for reconstructing alveolar cleft

Objective To investigate the outcome, methods and healing time for reconstructing alveolar cleft. Methods The literatures describing the reconstruction of alveolar cleft were extensively reviewed. The outcome, methods and healing timing of reconstructing alveolar cleft as reported in literatures were summ arized. Advantages and disadvantages of different reconstructive methods and healing time were evaluated. Results The outcomes for reconstructing alveolar clefts included: elimination of oronasal fistulae; stabilizing the maxillary arch; providing a foundation for tooth eruption; providing support for alar base and upper lip. The methods included: bone grafting; osteogenesis distraction; application of tissue-engineered bone and growth factors; guided bone regeneration. The interval between patients ages of 9 and 12 years during the period of mixed dentition was the best time for treatment. Conclusion Iliac cancellous bone grafting performed between the ages of 9 and 12 years during the period of mixed dentition is the gold standard for the reconstruction of alveolar cleft. Osteogenesis distraction and tissue-engineered bone as well as guided bone regeneration are new approaches for the reconstruction of alveolar cleft.