• 대한두개안면성형외과학회지
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• 제24권6호
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• pp.284-287
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• 2023

The ultimate goal of cleft palate repair is to achieve an intact palate with the separation of the oral and nasal cavities. However, some patients develop an oronasal fistula in the secondary palate after palatoplasty. Postoperatively, a secondary palatal oronasal fistula may develop, leading to functional problems. In this study, we describe a patient with recurrent oronasal fistula and alveolar cleft with multiple failed previous reconstructions at another clinic. The oronasal fistula and alveolar cleft were repaired using a tongue flap and an iliac bone graft, respectively. The patient demonstrated excellent clinical progress with no recurrence of the oronasal fistula at the 1-year follow-up.

• 대한장애인치과학회지
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• 제6권2호
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• pp.105-111
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• 2010

이종골의 치아맹출에 대한 기존 문헌 및 동물실험 연구를 바탕으로, 자가골 및 동종골 이식이 어려운 구순구개열 환자에서 이종골(Bio-$Oss^{(R)}$)을 이식하여 성공적으로 매복된치아의 맹출을 유도하였고, 치근의 형성 및 치아의 골내 이동도 정상적으로 이루어졌다.

• 대한치과의사협회지
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• 제53권7호
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• pp.457-467
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• 2015

Patients with cleft lip and palate require interdisciplinary treatment to achieve successful rehabilitation. However, there are special difficulties in orthodontic treatment of adult cleft lip and palate patients: 1. Lack of Tissue, Bone, and Soft tissue; 2. Heavy Scar Tissue, Vestibule, and Palate; 3. Severe Anteroposterior discrepancy and Impaired Maxilla; 4. Distortion of Alveolar Ridge; 5. Abnormal Eruption Path and Malalignment of Tooth. Solving these problems, orthodontist should have differential diagnosis on extent of cleft site and residual deformities of adult cleft lip and palate patient. The tooth missing area in cleft site was commonly treated with a removable or fixed prosthesis, but this method is not stable to retain maxillary arch shape. To establish the more stable arch shape in cleft lip and palate, endosseous implants in the alveolar clefts with bone graft is helpful for management of adult cleft lip and palate patient.

• 대한치과교정학회지
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• 제28권6호
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• pp.905-914
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• 1998

본 연구의 목적은 1) 편측성 순구개열 신생아 환자에 대한 술전 비치조 정형장치(PNAM) 치료를 소개하고, 2) 이 장치의 치조골 정형 효과를 평가하는 것이다. 서울대학교병원 교정과에 내원하여 PNAM장치를 사용하여 치료받은 4명의 편측성 순구개열 환자(남자 3명, 여자 1명, 평균 초진연령 : 23.2일)을 대상으로 하였으며, 치조골에서 대분절과 소분절 파열부간의 평균거리는 8.27mm였고 치조골 정형치료의 평균 기간은 9.7주였다. 초진시 (Ti)와 성공적인 치조골 정형술이 이루어진 시기(T2)에 이들 환자의 인상을 채득하여 모형을 제작한 후, 사진촬영과 digital caliper를 사용하여 7개의 길이항목과 5개의 각도항목을 계측하였다. SPSS win. ver 7.5 프로그램을 사용하여 통계처리하였고, 평균치의 차이를 비교하기 위하여 paired t-test를 사용하였다. 1. 신생아의 치조골 후방부는 치조골 정형술을 시행하는 동안 안정된 구조물이었다. 2. 치조골 정형술에 의하여 대분절의 전방 성장이 억제되었다. 3. 피조골 정형술에 의한 파열부의 폐쇄는 주로 대분절 전방부의 내측과 후방 굴곡 및 소분절 전체의 외측 굴곡에 의한 것이었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권3호
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• pp.267-272
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• 2009

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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권6호
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• pp.409-416
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• 2020

Objectives: The goal of this retrospective study was to determine the significance and impact of several factors on the alveolar cleft bone grafting procedure. Materials and Methods: The medical records were reviewed. In addition, x-rays were checked. The size of every cleft was measured in this retrospective study. The analyzed factors included sex, age, type of cleft, size of the cleft, and the type of flap used in surgery. The patients were characterized into group A (no complications, Bergland scale 1 or 2), group B (complications or Bergland scale 3), or group C (failure cases). Statistical analysis was performed with a P-value set at 0.05. Results: There were 32 cases in group A, 26 in group B, and 9 in group C. Multinomial logistic regression showed an association between the type of the cleft and the size of the cleft, with the presence of complications, or achieving type 3 on the Bergland scale, with odds ratios of 5.118 and 6.000, respectively. The type of cleft was related to failure with an odds ratio of 4.833. Given a small sample, statistical analysis could not be performed to evaluate the relationship between the size of the cleft and group C. Age, sex, and the type of the flap were not significant factors. Conclusion: The cleft size of more than 10 mm and bilateral clefts were listed regarding their effect on the procedure. Clinicians should not overlook these factors. In addition, patients must be informed of any risks that are present.

• 대한구순구개열학회지
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• 제10권1호
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• pp.39-56
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• 2007

The bilateral cleft lip, a more severe form of clefting than unilateral cleft lip, involves separation of the lip along philtral lines, isolating the central segment (prolabium). Bilateral cleft lip may be either symmetrical or asymmetrical, in which case the cleft lip is split more on one side than on the other. The cleft affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child's ability to eat, speak, hear, and breathe. Although there would seem to be quite a variance in reported figures, ratios of cleft lip with or without cleft palate have gone as high as 1:500 and as low as 1:1000. It is known that less than 10% of cleft lips are bilateral. Although bilateral cleft lip is less common than unilateral cleft lip, the deformity is more severe, and the reconstructive technique is more complex. Surgery is the only treatment necessary for patients with bilateral cleft lip. Accompanying the evolution of surgical repair is the increasingly important role of orthodontic support with early presurgical alveolar and nasal molding. Repositioning the maxillary and alveolar segments into a more anatomic position allows the surgeon to repair the lip and associated nasal deformity under more optimal conditions. The purpose of this article is to review the related anatomy, presurgical management, and surgical management of bilateral cleft lip.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권2호
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• pp.189-191
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• 2001

Objective : The objective of this study was to determine which forms of iliac cancellous bone grafts better restore alveolar clefts. Study design : Forty consecutive patients who required a unilateral alveolar cleft graft were studied. Group I (20 patients) had reconstruction with iliac cancellous particulate bone grafts and group II (20 patients) had reconstruction with iliac cancellous block bone grafts. The two groups were evaluated radiographically and clinically. Results : The group with the block bone grafts showed less postoperative problems and better incorporation of the bone graft than the group with the particulate grafts. Conclusion : Surgical reconstruction of alveolar process defects in patients with alveolar cleft using iliac cancellous block bone is a more reliable method than particulate bone grafts both for closing the oronasal fistula and for building interalveolar septal height.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권2호
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• pp.85-93
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• 2022

Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

• 대한구순구개열학회지
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• 제6권2호
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• pp.107-115
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• 2003

The case unveils an early orthodontic intervention on 3-week old infant innately with bilateral cleft lip and palate. Presurgical Nasoalveolar Molding(PNAM) procedures were carried out for 2 months for the sake to diminish the anticipated strain of postsurgical scar by means of the retraction of protruded premaxilla and the extension of collapsed columella. The gap on the alveolar cleft decreased by 2,5 mm, and the columella manifested 1. 5 mm increase of its length, which yielded the consequent downward and backward movement of premaxilla, and expected to bring down the technical complexity of primary lip surgery. PNAM with sophisticated technical procedures at an optimal timing disclosed the passive molding of the alveolar segments and the formation of nasolabial soft tissue integuments and permitted one-time primary lip surgery.