论文部分内容阅读
腭裂的牙槽突裂造成局部外形缺陷、口鼻腔瘘和牙齿排列不齐等畸形,其修复非常重要。手术时间宜在9～11岁混合牙列期,行自体松质骨移植术,不应采用人工骨植入,因它不能为牙的移动提供适合的基质,反可影响牙的正常萌出。但对于牙已萌出的成年人,则不妨应用羟基磷灰石人工骨代替自体骨,以免另行取骨增加手术痛苦,我们经临床实践,取得了良好疗效。临床资料腭裂术后遗牙槽突裂,口鼻瘘,裂隙两侧牙齿均已错位萌出,年龄在18岁以上患者。本组共12例,男8例,女4例。年龄20～26岁。单侧牙槽突裂9例,双侧3例。方法手术在局麻下进行,沿齿槽突裂隙及相邻两侧龈缘切开剥离粘骨膜,显示齿槽突问裂隙,向裂隙的两侧及患侧鼻底区域在骨膜下分离,将适量的羟基磷灰石颗粒置入齿槽突问裂隙、患侧鼻底及鼻翼部剥起的骨膜下充填,严密相互缝合唇腭侧的各粘骨膜瓣。疗效本组病例均Ⅰ期愈合。10例随访2～12月,口鼻瘘封闭严密,恢复了齿槽突的连续性以及鼻翼基底和上唇应有的骨性支撑。双侧上齿槽突裂术前可摇动的前颌,术后完全稳固。患侧上唇及鼻翼部凹陷消失,与健侧基本对称,
Cleft lip cleft palate caused by local shape defects, mouth and nose fistula and missing teeth and other malformations, the repair is very important. The operative time should be mixed dentition in the age of 9 to 11 years, autologous cancellous bone transplantation should not be used artificial bone implantation, because it can not provide a suitable matrix for the movement of teeth, but can affect the normal eruption of teeth. But for the teeth have erupted adults, may wish to use hydroxyapatite artificial bone instead of autologous bone, in order to avoid additional bone surgery to increase the pain, we have clinical practice, and achieved good results. Clinical data cleft palate after alveolar cleft, mouth fistula, the teeth on both sides of the fracture have been dislocation eruption, age over 18 years of age patients. This group a total of 12 cases, 8 males and 4 females. Age 20 ~ 26 years old. One-sided alveolar cleft in 9 cases, bilateral in 3 cases. Methods The operation was performed under local anesthesia. The periosteum was separated along the alveolar cleft and the adjacent gingival margins, and the periosteum was dislocated to both sides of the fissure and the parietal nasal area. The appropriate amount of hydroxyapatite particles into the crenada fissure fissure, ipsilateral nasal and nasal wing stripping periosteal filling, close to each other lip mucoperiosteal flap. The efficacy of this group of patients were healed. 10 cases were followed up from December to December, the mouth and nose fistula closed tightly and restored the continuity of the alveolar process and the bony support of the base of the nose and upper lip. Both sides of the alveolar cleft preoperative shakable forearm, completely solid postoperatively. Ipsilateral upper lip and nasal wing dent disappeared, and the contralateral basic symmetry,