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目的观察单侧完全性唇腭裂患者牙槽突裂植骨术后,阻生前牙牵引助萌效果,并分析其成败原因。方法选取2002—2012年大连大学附属口腔医院大连市口腔医院诊治的8例二期植骨成功的替牙期单侧完全性唇腭裂伴牙槽突裂患者,其中男5例,女3例,年龄(10.5±2.6)岁。均有尖牙或侧切牙阻萌,其中侧切牙阻萌2例、尖牙阻萌6例。采用直丝弓矫治技术,在牙列排齐整平并开大阻生前牙间隙后与外科配合进行闭合式牵引助萌,同时进行矫治结果分析。结果 6例牵引成功,平均疗程(22.5±4.5)个月,牵引时间(从手术开窗到牙齿破龈)平均(6.5±3.5)个月;牵引到位的牙齿与邻牙邻接关系良好,牙合关系稳定,但与对侧正常萌出前牙相比,牙龈形态略不同。其余2例(1例阻生侧切牙、1例阻生尖牙)牵引失败。结论对于唇腭裂伴牙槽嵴裂植骨术后出现前牙阻萌患者,应在矫治中及时进行牵引助萌。植骨时间、成功率、阻生尖牙萌出角度及与邻牙关系、助萌手术对阻生牙影响等均直接关系到牵引助萌的成败。
Objective To observe the effect of anastomotic traction assisted by alveolar cleft grafting after unilateral cleft lip and palate, and analyze the causes of its success. Methods Eight patients with secondary complete cleft lip and palate cleft lip and palate with alveolar cleft successfully treated in Dalian Stomatological Hospital affiliated to Dalian University Stomatology Hospital from 2002 to 2012 were selected. There were 5 males and 3 females, Age (10.5 ± 2.6) years old. Fusiform or lateral incisors were adorable, including lateral incisors and adorable in 2 cases, canine adorable in 6 cases. The use of straight wire arch correction techniques, dentition alignment and open a large anterior interosseous gap with the surgery with a closed traction to help Meng, while correction results. Results The traction was successful in 6 cases (22.5 ± 4.5) months and the mean traction time (from the window of operation to the gingival recess) was (6.5 ± 3.5) months. Tooth traction was in good relationship with the adjacent teeth, The relationship is stable, but compared with the normal eruption of the opposite side of the teeth, the gingival form slightly different. The remaining two cases (1 case of incisor incisors, 1 case of incisors) failed to pull traction. Conclusion For cleft lip and palate with alveolar cleft grafting after the emergence of anterior teeth resistance Meng patients should be in the treatment of timely traction to help Meng. The success rate of grafting, the success rate, the eruption angle of impacted canines, the relationship with the adjacent teeth and the influence of adorable surgery on the impacted teeth are all directly related to the success or failure of traction adolescence.