การประเมินปริมาณกระดูกภายหลังการปลูกถ่ายกระดูกทุติยภูมิใน ผู้ป่วยปากแหว่งเพดานโหว่ / นรินทร์ เจนยุทธนา = Evaluation of bone availability after secondary bone grafting in cleft lip and palate patients / Narin jenyuthana
The objectives of this study were to evaluate the quantity of bone after grafting in cleft patients and to investigate factors influencing success of the secondary bone grafting. The sample comprised 100 cleft patients (56 men, 44 women) of Craniofacial Anomaly Clinic at Dental hospital Chulalongkorn University with a mean age of 14.45±5.62 years (8.7-32.5 years). There were 62 unilateral cleft lip and palate, 21 bilateral cleft lip and palate, and 11 unilateral alveolar cleft patients. Occlusal topographic radiographs taken 3-6 months and at least 1 year after bone grafting were used to evaluate the result of bone grafting. The amount of bone was classified into 4 levels: level 1 (≥ 75 %), level 2 (≥ 50 %), level 3 (≥ 25 %), level 4 (< 25 %). The alterations of bone level between short- and long-term follow-up were analyzed by Wilcoxon Matched-Pairs Signed-Ranks test The associations between factors influencing bone grafting and the availability of bone after grafting were analyzed by Chi-square test, at 95% confidence interval. The results showed that in 127 cleft sites, in the short-term follow-up the success rate was 94.5% among them, 76.4 % was level 1, 18.1 % was level 2, and the remaining 5.5 % was level 3 which was unacceptable. The long-term results showed that the success rate was 92.9 % among them, 74.8 % was level 1, 18.1% was level 2, and the remaining 7.1 % was level 3. There is no significant difference between the short- and long-term outcomes. Patient’s age, the stage of canine eruption, and orthodontic tooth movement had significant relation with the success of bone grafting. The results supported the previous studies that the appropriate timing for bone grafting is before the eruption of the canine adjacent to the cleft side.
