口腔医学研究

口腔医学研究 ›› 2026, Vol. 42 ›› Issue (1): 30-34.DOI: 10.13701/j.cnki.kqyxyj.2026.01.006

• 口腔颌面外科学研究 • 上一篇    下一篇

术前裂隙管理对青少年期牙槽突裂植骨修复效果影响的回顾性研究

肖寅, 程家龙, 习伟宏*   

  1. 南昌大学附属口腔医院口腔颌面外科,口腔疾病江西省重点实验室,江西省口腔疾病临床医学研究中心 江西 南昌 330006
  • 收稿日期:2025-06-03 出版日期:2026-01-28 发布日期:2026-01-23
  • 通讯作者: *习伟宏,E-mail:xwh1975@163.com
  • 作者简介:肖寅(1989~ ),男,江西吉安人,主治医师,硕士,研究方向:牙槽突裂植骨修复。
  • 基金资助:
    江西省卫生健康委科技计划(编号:202410284)

Retrospective Study on Impact of Preoperative Cleft Management on Outcomes of Alveolar Cleft Bone Grafting in Adolescents

XIAO Yin, CHENG Jialong, XI Weihong*   

  1. Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanchang University, Key Laboratory of Oral Biomedicine of Jiangxi Province, Nanchang 330006, China
  • Received:2025-06-03 Online:2026-01-28 Published:2026-01-23

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摘要： 目的: 分析术前裂隙管理措施对青少年期牙槽突裂植骨修复效果的影响。方法: 回顾性分析110例就诊于南昌大学附属口腔医院行髂骨松质骨植骨修复的单侧完全性牙槽突裂患者。根据采取的裂隙管理措施分组:术前正畸、术前拔牙、术中拔牙组和无措施组,收集术前、术后3个月以上的锥体束CT(cone beam CT,CBCT),采用Padwa三维评价量表进行术后成骨效果的评价,并比较各组的术后伤口裂开率、术后伤口感染率。结果: 术前正畸组、术前拔牙组、术中拔牙分组和无措施组临床成功率分别为97.2%、86.4%、90.5%、90.3%,4组之间差异无统计学意义(P=0.438)。术中拔牙组的患者术后伤口裂开率(P=0.237)、伤口感染率(P=0.482)均高于其他3组,且仅有36.8%的病例是Ⅰ类手术结果,低于其他3组(P=0.303)。结论: 青少年期牙槽突裂植骨术前可以采用术前正畸、术前拔牙两种措施进行裂隙管理。植骨术中同期进行拔牙操作,可能对临床效果产生负面影响。

关键词: 术前裂隙管理, 牙槽骨突裂, 髂骨松质骨, 锥体束CT

Abstract: Objective: To analyze the impact of preoperative cleft management measures on the outcomes of alveolar cleft bone grafting in adolescents. Methods: A retrospective analysis was conducted on 110 patients with unilateral complete alveolar cleft who underwent cancellous iliac bone grafting at the Affiliated Stomatology Hospital of Nanchang University. The patients were divided into four groups based on the cleft management measures adopted: preoperative orthodontics group, preoperative extraction group, intraoperative extraction group, and no intervention group. Cone-beam computed tomography (CBCT) was collected both preoperatively and at least 3 months postoperatively. The postoperative osteogenesis outcomes were evaluated using the Padwa three-dimensional assessment scale, and the postoperative wound dehiscence rate and infection rate were compared among the groups. Results: The clinical success rates of the preoperative orthodontics group, preoperative extraction group, intraoperative extraction group, and no intervention group were 97.2%, 86.4%, 90.5%, and 90.3%, respectively. There was no statistically significant difference among the four groups (P=0.438). The intraoperative extraction group had higher postoperative wound dehiscence rate (P=0.237) and infection rate (P=0.482) compared with the other three groups. Only 36.8% of the cases in this group achieved Class Ⅰ surgical outcomes, which was lower than that of the other three groups (P=0.303). Conclusion: Preoperative orthodontics and preoperative extraction are effective cleft management measures for alveolar cleft bone grafting in adolescents. Performing extraction during the bone grafting surgery may have a negative impact on the clinical outcomes.

Key words: preoperative cleft management, alveolar cleft, iliac cancellous bone, cone-beam computed tomography