First Clinical Application of New Bone Substitute Material to the Alveolar Cleft

K. Matsui, Tetsu Takahashi, T. Kawai, S. Kamakura
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Abstract

Secondary bone grafting of alveolar cleft using autologous particulate cancellous bone from the ilium is an essential treatment for cleft lip/palate patients. However, secondary surgical invasion represents a disadvantage. To avoid this disadvantage, octacalcium phosphate collagen composites (OCP/Col) were developed as a new bone substitute material. Through preclinical studies and clinical application for cyst holes and extraction sockets, OCP/Col demonstrated satisfactory bone repair. In this case report, OCP/Col alone was implanted into a 13-year-old patient with incomplete unilateral cleft lip and alveolus. Postoperative changes of the OCP/Col treated site were evaluated by computed tomography for two years after operation. It was revealed that sufficient bone bridge was formed in the treated alveolar cleft after implantation of OCP/Col without autologous bone grafting. At the bottom of the nasal cavity, preoperative asymmetry was improved. In addition, usual orthodontic treatment was completed 1 year and 10 months postoperatively, and good occlusion was achieved. These results suggest that OCP/Col is clinically applicable as bone regenerative material, representing an alternative to autologous bone grafting.
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新型骨替代材料在牙槽裂修复中的首次临床应用
自体髂骨颗粒松质骨二次植骨是唇腭裂患者的重要治疗方法。然而,继发性手术侵犯是一个缺点。为了避免这一缺点,八磷酸钙胶原复合材料(OCP/Col)作为一种新的骨替代材料被开发出来。通过临床前研究和临床应用,OCP/Col对囊肿孔和拔牙槽的修复效果良好。在这个病例报告中,OCP/Col被单独植入一个13岁的不完全性单侧唇裂和肺泡患者。术后两年通过计算机断层扫描评估OCP/Col治疗部位的术后变化。结果表明,OCP/Col植入治疗后的牙槽裂无需自体骨移植即可形成足够的骨桥。在鼻腔底部,术前不对称得到改善。术后1年10个月完成常规正畸治疗,牙合良好。这些结果表明OCP/Col作为骨再生材料在临床上是可行的,是自体骨移植的替代材料。
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