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치조열 골이식
ALVEOLAR CLEFT GRAFT

전상호    (고려대학교 의과대학원 치과학교실 구강악안면외과   ); Padwa, Bonnie L.    (   ); 정영수    (연세대학교 치과대학 구강악안면외과학교실, 구강과학연구소  );
  • 초록

    Bone grafting the alveolar cleft allows for stability and continuity of the dental arch, provides bone for eruption of permanent teeth or placement of dental implants, and gives support to the lateral ala of the nose. Closure of residual oronasal fistula can occur simultaneously. Repair of alveolar clefts can occur at a variety of stages defined as primary, early secondary, secondary, and late. Most centers perform this surgery as secondary bone grafting. Autogenous bone provides osteogenesis, osteoinduction and conduction and is recommended for grafting to the cleft alveolus and several donor sites are available. The surgeon should select the best flap design considering the amount of mucosa available, blood supply and tension-free closure, and the extent of the oronasal communication. The authors provide a comprehensive understanding of alveolar clefts and their repair by reviewing the historical perspective, objectives for treatment, timing, source of graft, presurgical orthodontics, surgical techniques, postoperative care, and complications.


  • 주제어

    Alveolar cleft .   Bone graft .   Oronasal fistula .   Timing .   Flap design.  

  • 참고문헌 (29)

    1. Jolleys A, Robertson NRE : A study of the effects of early bone grafting in complete clefts of the lip and palate: 5 year study. Br J Plast Surg 25 : 229, 1972 
    2. Smahel Z, Mullerova Z, Horak I : Facial development in unilateral cleft lip and palate prior to the eruption of permanent incisors after primary bone grafting and periosteal flap surgery. Acta Chir Plast 38 : 30, 1996 
    3. Suzuki A, Goto K, Nakamura N et al : Cephalometric comparison of craniofacial morphology between primary bone grafted and nongrafted complete unilateral cleft lip and palate adults. Cleft Palate Craniofac J 33 : 429, 1996 
    4. Rosenstein S, Dado D, Kernahan D et al : The case for early bone grafting in cleft lip and palate: a second report. Plast Reconstr Surg 87 : 644, 1991 
    5. Andlin-Sobocki A, Eliasson LA, Paulin G : Periodontal evaluation of teeth in bone grafted regions in patients with unilateral cleft lip and cleft palate. Am J Orthodont Dentofacial Orthop 107 : 144, 1995 
    6. Catone GA, Reimer BL, McNeir D et al : Tibial autogenous cancellous bone as an alternative donor site in maxillofacial surgery: a preliminary report. J Oral Maxillofac Surg 50 : 1258, 1992 
    7. Koole R : Ectomesemchymal mandibular symphysis bone graft: an improvement in alveolar cleft grafting. Cleft Palate Craniofac J 31 : 217, 1994 
    8. Marx R, Carlson ER, Eichstaedt E et al : Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85 : 638, 1998 
    9. Boyne PJ, Sands NR : Combined orthodontic-surgical management of residual palato-alveolar cleft defects. Am J Orthod 70 : 20, 1976 
    10. Eppley BL : Alveolar cleft bone grafting (part I): primary bone grafting. J Oral Maxillofac Surg 54 : 74, 1996 
    11. Collins M, James DR, Mars M : Alveolar bone grafting: a review of 115 patients. Eur J Orthod 20 : 115, 1998 
    12. Santiago PE, Grayson BH, Cutting CB et al : Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J 35 : 77, 1997 
    13. Stassen L : Alveolar bone grafting: how I do it. In: Booth P, Schendel S, Hausamen J, editors. Oral and maxillofacial surgery. New York, Churchill-Livingstone, 1047, 1999 
    14. Pruzansky S : Pre-surgical orthopedics and bone grafting for infants with cleft lip and palate: a dissent. Cleft Palate J 1 : 164, 1964 
    15. Clark J, Zeitler DL : Outcome of alveolar grafting in cleft patients of different ages. J Oral Maxillofac Surg 54(Suppl 3) : 117, 1996 
    16. Hardy SP, Wilke RC, Doyle JF : Advantages of percutaneous hollow needle technique for iliac bone harvest in alveolar cleft grafting. Cleft Palate Craniofac J 36 : 252, 1999 
    17. Kalaaji A, Lilja J, Friede H et al : Bone grafting in the mixed and permanent dentition in cleft lip and palate patients: long-term results and the role of the surgeon's experience. J Craniomaxillofac Surg 24 : 29, 1996 
    18. Posnick J : The staging of cleft lip and palate reconstruction: infancy through adolescence. In: Rose A, Ross A, editors. Craniofacial and Maxillofacial Surgery in Children and Young Adults. Philadelphia, WB Saunders, 785, 2000 
    19. Boyne PJ : Bone grafting in the osseous reconstruction of alveolar and palatal clefts. Oral Maxillofac Surg Clin N Am 3 : 589, 1991 
    20. Zeitler D : Alveolar cleft grafts. In: Fonseca R, editor. Oral and maxillofacial surgery. Philadelphia. WB Saunders, 75, 2000 
    21. Daw Jr JL, Patel PK : Management of alveolar clefts. Clin Plastic Surg 31 : 303, 2004 
    22. Ramstad T, Semb G : The effect of alveolar bone grafting on the prosthodontic/reconstructive treatment of patients with unilateral complete cleft lip and plate. Int J Prosthodont 10 : 156, 1997 
    23. Rudman RA : Prospective evaluation of morbidity associated with iliac crest harvest for alveolar cleft grafting. J Oral Maxillofac Surg 55 : 219, 1997 
    24. Jia YL, James DR, Mars M : Bilateral alveolar bone grafting: a report of 55 consecutively-treated patients. Eur J Orthod 20 : 299, 1998 
    25. Lee C, Crepeau RJ, Williams HB et al : Alveolar cleft bone grafts: results and imprecisions of the dental radiograph. Plast Reconstr Surg 96 : 1534, 1995 
    26. Boyne PJ, Sands NR : Secondary bone grafting of residual alveolar and palatal clefts. J Oral Surg 30 : 87, 1972 
    27. Kortebein MJ, Nelson CL, Sadove AM : Retrospective analysis of 135 secondary alveolar cleft grafts using iliac or calvarial bone. J Oral Maxillofac Surg 49 : 493, 1991 
    28. LaRossa D, Buchman S, Rothkopf DM et al : A comparison of iliac and cranial bone in secondary grafting of alveolar clefts. Plast Reconstr Surg 96 : 789, 1995 
    29. Shaw WC, Semb G : Current approaches to the orthodontic management of cleft lip and palate. J R Soc Med 83 : 30, 1990 
  • 이 논문을 인용한 문헌 (1)

    1. Noh, Lyang-Seok ; Kim, Jong-Bae ; Chin, Byung-Rho ; Kwon, Tae-Geon ; Lee, Sang-Han 2011. "Evaluation of an Alveolar Bone Graft for Cleft Patients" 대한악안면성형재건외과학회지 = The journal of Korean association of maxillogacial plastic and reconstructive surgeons, 33(4): 314~318     

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