顎裂部へニ次的早期骨移植術を施行した症例の検討　　術後の骨架橋形成について

DOI 被引用文献2件 参考文献19件

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  • Early secondary bone grafts using autogenous particulate marrow and cancellous bone to augment alveolar clefts Evaluation of bone bridge formation after bone grafting.
  • Evaluation of bone bridge formation after bone grafting
  • 術後の骨架橋形成について

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We have used secondary bone grafting since 1982 to augment alveolar clefts in patients with cleft lip or palate. We performed operations in about 600 patients, using autogenous particulate marrow and cancellous bone harvested from the anterior or posterior iliac crest. The optimal age for bone grafting is between 8 and 11 years, before eruption of the ipsilateral permanent canine.<BR>Since 1993, we have performed bone grafting in patients 5 to 6 years of age. The objective of this procedure was not only to induce eruption of the ipsilateral canine but also to promote eruption of the ipsilateral incisor in a normal position and to enhance prompt remodeling of grafted bone. We clinically and radiographically evaluated the results of bone grafting. We also studied bone bridge formation in the alveolar cleft regions, including the time of formation. Twenty-five patients, (12 boys and 13 girls) were operated on at 5 (4 patients) or 6 (21 patients) years of age. The mean age of the patients was 6 years 3 months. There were 7 cases of unilateral cleft lip and alveolus, 17 of unilateral cleft of the lip and palate, and 1 of bilateral cleft lip and palate.<BR>Bone bridges were formed in the alveolar clefts in 24 of the 25 patients. The clinical and radiographic records obtained for 23 patients showed that bone bridges were formed 3 months after operation on average.<BR>Our study suggested that remodeling of the bone in patients 5 to 6 years of age was prompt and had a good outcome. Future investigations should study whether early secondary bone grafting at the ages of 5 to 6 years affects maxillary growth.

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