Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants
| Autor: | Marko Vuletić, Predrag Knežević, Dražen Jokić, Jerko Rebić, Domagoj Žabarović, Darko Macan |
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| Rok vydání: | 2016 |
| Předmět: |
stomatognathic diseases
Cleft Lip Cleft Palate Alveolar Bone Grafting Bone Morphogenetic Proteins Dental implants Dental prosthesis Orthodontic Space Closure Review Article rascjep usne rascjep nepca alveolarna kost usađivanje nadomjestka koštani morfogenetski proteini zubni implantati zubne proteze ortodontsko zatvaranje prostora |
| Zdroj: | Acta stomatologica Croatica : International journal of oral sciences and dental medicine Volume 48 Issue 4 |
| ISSN: | 0001-7019 1846-0410 |
| Popis: | Rascjep usne i nepca najčešći je prirođeni deformitet kraniofacijalne strukture. Orofacijalni rascjep znatno utječe na kvalitetu života – na estetiku, funkciju te na dentalni razvoj i rast lica, a ima i psihološki učinak. Glavni razlog za njegov nastanak jest nekompletno spajanje facijalnih nastavaka od četvrtog do desetog tjedna gestacije. Zatvara se alveolarnim koštanim presatkom kirurškim postupkom nazvanim osteoplastika, a zlatnim standardom smatra se autogena kost s kriste ilijake. Presađivanje može biti podijeljeno u dvije faze: primarnu i sekundarnu. Defekt alveolarnog grebena obično se rekonstruira između sedme i jedanaeste godine i često je povezan s razvojem korijena maksilarnog očnjaka. Nakon uspješnog zahvata defekt rascjepa je zatvoren, ali nedostaje zub. Zatvaranje toga prostora ortodontskom terapijom uspješno je u 50 do 75 posto slučajeva. Ako to nije moguće, zub koji nedostaje može se nadomjestiti na tri načina: protetskim mostom, transplantacijom zuba i dentalnim implantatom. Dentalnom je implantatu zadatak držati protetski nadomjestak, prevenirati atrofiju kosti i zadržavati augmentacijski materijal u području rascjepa. Unatoč tomu što je autologna kost s kriste ilijake zlatni standard, nije idealni izbor za rekonstrukciju alveolarnog defekta. Kao alternativni koštani materijal može se upotrijebiti morfogenetski protein (BMP). U ovom članku želi se objasniti morfologija rascjepa, povijesna saznanja, kirurške tehnike i mogućnosti implantoprotetske rehabilitacije. Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75 % success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation. |
| Databáze: | OpenAIRE |
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