Abstract:

Abstract：Objective To evaluate the effects of impacted anterior teeth traction in the patients with complete unilateral cleft lip and palate（UCLP）after bone grafting and to investigate the associated causes of success or failure. Methods Eight patients with UCLP（5 males and 3 females）who had received successful secondary alveolar bone grafting in mixed dentition were included，mean age （10.5 ± 2.6） y（ranging from 9 ~ 14yrs）.The lateral incisor was impacted in 2 patients，and canines were impacted in 6 patients. Orthodontic traction was applied after space openning and closed surgical exposure. Results Six cases were successful treated with an average treatment time of （22.5 ± 4.5）months and traction time（from surgical exposure to gingival eruption）（6.5 ± 3.5） months. The traction teeth were aligned well with adjacent teeth，while the gingival morphology was not so aesthetic compared with that of homonymous normal teeth. Another 2 cases（one lateral incisor，the other canine）failed to erupt by traction. Conclusion The orthodontic traction should be applied on time for those impacted anterior teeth in patients with UCLP after bone grafting. The success of traction is closely related to the timing of bone grafting，the success rate of bone grafting，the eruption angle of impacted canine，the position of impacted canine with adjacent teeth，and the surgical exposure technique.

Key words: complete unilateral cleft lip and palate（UCLP）, alveolar bone grafting, impacted anterior teeth, orthodontic traction

摘要：

目的 观察单侧完全性唇腭裂患者牙槽突裂植骨术后，阻生前牙牵引助萌效果，并分析其成败原因。方法 选取2002—2012年大连大学附属口腔医院 大连市口腔医院诊治的8例二期植骨成功的替牙期单侧完全性唇腭裂伴牙槽突裂患者，其中男5例，女3例，年龄（10.5 ± 2.6）岁。均有尖牙或侧切牙阻萌，其中侧切牙阻萌2例、尖牙阻萌6例。采用直丝弓矫治技术，在牙列排齐整平并开大阻生前牙间隙后与外科配合进行闭合式牵引助萌，同时进行矫治结果分析。结果 6例牵引成功，平均疗程（22.5 ± 4.5）个月，牵引时间（从手术开窗到牙齿破龈）平均（6.5 ± 3.5）个月；牵引到位的牙齿与邻牙邻接关系良好，牙合关系稳定，但与对侧正常萌出前牙相比，牙龈形态略不同。其余2例（1例阻生侧切牙、1例阻生尖牙）牵引失败。结论 对于唇腭裂伴牙槽嵴裂植骨术后出现前牙阻萌患者，应在矫治中及时进行牵引助萌。植骨时间、成功率、阻生尖牙萌出角度及与邻牙关系、助萌手术对阻生牙影响等均直接关系到牵引助萌的成败。

关键词: 单侧完全性唇腭裂, 牙槽突裂植骨, 阻生前牙, 牵引助萌