Abstract:
The secondary alveolar bone grafting procedure is typically recommended during the late mixed dentition phase, prior to the eruption of the permanent canine, in patients with cleft lip and palate. The anatomical and functional adaptations observed in the grafted area allow spontaneous migration and eruption of the adjacent maxillary canine. An alveolar bone graft can be performed using autogenous bone or recombinant human bone morphogenetic protein-2 (rhBMP-2). Employing rhBMP-2 in a collagen membrane eliminates the need for a donor site, thus reducing surgical morbidity. This paper aims to present a case involving complete orthodontic rehabilitation with a three-year follow-up of a male patient with a unilateral complete cleft lip and palate, posterior and anterior crossbite, where grafting was performed with rhBMP-2 at a single centre. Orthodontic intervention began at 8 years of age with rapid maxillary expansion, followed by facemask therapy. The alveolar bone grafting procedure was performed using rhBMP-2 in a collagen membrane, according to the surgical protocol developed by the Oslo team. Comprehensive orthodontic treatment started 15 months post bone grafting, during which the maxillary permanent lateral incisor distal to the alveolar cleft was successfully moved mesially into the grafted region. This intervention resulted in adequate occlusal and periodontal outcomes. The alveolar graft with rhBMP-2 produced adequate and stable alveolar bone formation, facilitating tooth eruption, orthodontic movement, and stability at the cleft site.
摘要:
通常建议在混合牙列后期进行二次牙槽骨移植手术,在永久性犬科动物爆发之前,唇腭裂患者。在移植区域观察到的解剖和功能适应允许相邻上颌犬齿的自发迁移和喷发。可以使用自体骨或重组人骨形态发生蛋白-2(rhBMP-2)进行牙槽骨移植。在胶原膜中使用rhBMP-2消除了对供体部位的需要,从而降低手术发病率。本文旨在介绍一例涉及完全正畸康复的病例,对一名单侧完全性唇腭裂的男性患者进行为期三年的随访,后咬合和前咬合,在单个中心用rhBMP-2进行移植。正畸干预始于8岁,上颌骨快速扩张,其次是面罩疗法。使用胶原膜中的rhBMP-2进行牙槽骨移植程序,根据奥斯陆团队开发的手术方案。植骨后15个月开始综合正畸治疗,在此期间,牙槽裂远端的上颌永久侧切牙被成功地向近中移动到移植区。这种干预导致足够的咬合和牙周结果。带rhBMP-2的牙槽移植物产生足够和稳定的牙槽骨形成,促进牙齿萌出,正畸移动,和裂隙部位的稳定性。