Abstract: Objective: This study aimed to establish a therapeutic schedule according to the morphologic characteristics of 129 residual alveolar clefts before alveolar bone grafting (ABG). Methods: Information of each patient was collected including the position of teeth near the clefts, the width of cleft, the relationship of cleft segments and the presence of palatal fistula. All patients were divided into two groups according to the evaluation results, one group eligible for ABG on time, and the other group for whom ABG had to be delayed. Results: 45 patients (34.9%) belonged to the on-time ABG group, while 84 patients (65.1%) belonged to the delayed-ABG group. 51 patients（39.5%）required pre-ABG orthodontic treatment; 44 patients (34.1%) required extraction before the ABG; and 11 patients (8.5%) required surgical procedures to obstruct the large palatal fistula. Conclusion: Right timing is necessary for ABG because morphologic characteristics of the cleft would have a strong impact on the success rate.

Key words: alveolar bone grafting, cleft lip and palate, orthodontic treatment

摘要： 目的：分析研究牙槽突裂牙颌特性，制定相应的治疗计划。方法：口腔颌面外科医师与正畸科医师共同会诊，记录129例患者的临床检查结果（牙位，咬合关系，有无多生牙、畸形牙、残根残冠，尖牙的萌出情况，牙弓形态，裂隙的宽窄等），分析影像学资料及牙颌模型，制定手术或手术前治疗计划。结果：可按期植骨组为45例（34.9%），延期植骨组为84例（65.1%）。在延期植骨组中，51例患者（39.5%）需要术前正畸，44例患者（34.1%）需要术前拔牙，11例患者（8.5%）需要术前修复较大的腭部穿孔。按期植骨组中：单侧唇裂伴牙槽突裂患者（unilateral cleft lip and alveolus，UCLA）最多，其次为双侧唇腭裂伴牙槽突裂患者（bilateral cleft lip and palate，BCLP），然后是单侧唇腭裂伴牙槽突裂患者（unilateral cleft lip and palate，UCLP）。而需要术前正畸干预的延期植骨组中，患者数量比较BCLP> UCLP >UCLA；需要拔牙的延期植骨患者数量UCLP> BCLP >UCLA；需要修复硬腭前部瘘口的患者数量BCLP> UCLP。结论：除年龄因素外，牙槽突裂患者的牙颌特性对手术的成功率有重大影响，也应作为选择治疗时机的重要参考。

关键词: 牙槽突裂植骨术；  , 唇腭裂；  , 正畸

CLC Number: 

• R782.13