自体髂骨移植修复牙槽突裂的临床研究

Clinical approach by autologous ilium grafting to alveolar cleft repair

目的探讨自体髂骨移植在牙槽突畸形修复中的效果。方法23例唇腭裂术后成人牙槽突裂患者采用自体髂骨移植修复。将髂骨松质骨填充牙槽突裂间隙内，用髂骨皮质骨骨片恢复梨状孔底缘外形，单皮质钛钉固定。术前及术后对CT影像进行比较分析，评价临床效果。结果应用Bergland分级评价，临床成功率（I～Ⅱ级）为69．6％，临床失败率（Ⅲ、Ⅳ级）为30．4％。其中5例移植骨外露，经碘仿油纱加压后，创面Ⅱ期愈合。2例基本无连续骨桥，再次出现口鼻瘘孔。其余创面均I期愈合。结论自体髂骨移植可以有效修复牙槽突裂。

Objective To evaluate the clinical approach by autologous ilium grafting to repairing alveolar cleft. Methods Twenty- three adult alveolar cleft patients were performed autologous ilium grafting for repair of alveolar cleft. We cut an iliac cortical bone fit for the sharp of pyriform aperture to cover on the alveolar cleft. The iliac spongy bone was put into the alveolar cleft with tender pressure. Finally the Iliac cortical bone was fixed with titanium screws. Results Based on Bergland＇ s criteria, the clinical success rate was 69.9% （ I - II ） and failure rate was 30.4% （Ⅲ, Ⅳ ）. Conclusion Autologous ilium grafting is an effective method to the repair of alveolar cleft.