Graf tulang sekunder untuk rekahan alveolar dalam kalangan kanak‐kanak rekahan bibir atau rekahan bibir dan lelangit.
Abstract
Background
Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy.
Objectives
To compare the effectiveness and safety of different secondary bone grafting methods.
Search methods
The final electronic and handsearches were carried out on 11 February 2011, and included the Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Chinese Biomedical Literature Database and WHO International Clinical Trials Registry Platform. All the Chinese professional journals in the oral and dental field were handsearched and conference proceedings consulted. There was no language or time restriction.
Selection criteria
Only randomized clinical trials were selected. Patients with the diagnosis of cleft lip and alveolar process only, unilateral cleft lip and palate and bilateral cleft lip and palate involving the alveolar process and greater than 5 years of age were included.
Data collection and analysis
Two review authors extracted data and assessed the quality of included studies independently. Disagreement between the two review authors was resolved by discussion in the review team. The first authors of the included studies were contacted for additional information, if necessary.
Main results
Two of 582 potential studies met the inclusion criteria and were included. One trial compared alveolar bone grafting using artificial materials (InFuse bone graft substitute impregnated with BMP‐2) with a traditional iliac graft. The other trial investigated the application of fibrin glue to the bone graft. Both trials were small with 21 and 27 patients and were assessed as being at high risk of bias. Any apparent differences between the interventions for outcomes in either study must therefore be treated with great caution and are not highlighted here.
Authors' conclusions
Due to the high level of risk of bias in the two included trials there is insufficient evidence to conclude that one intervention is superior to another.
PICOs
Ringkasan bahasa mudah
Graf tulang sekunder untuk rekahan alveolar dalam kalangan kanak‐kanak rekahan bibir atau rekahan bibir dan lelangit.
Rekahan alveolar adalah kecacatan tulang pada gusi di dalam mulut yang melibatkan hampir 75% pesakit rekahan bibir dan lelangit. Kegagalan untuk memperbaiki kecacatan ini akan mendatangkan banyak masalah. Walaupun graf tulang alveolar telah diterima pakai dengan meluas oleh profesional dalam penjagaan rekahan, masih terdapat kontroversi tentang teknik, masa, bahagian tubuh di mana tulang diambil dan sama ada penggantian tulang tiruan memberi manfaat. Satu persoalan ialah sama ada jenis bahan graf iaitu penggunaan bahan tulang tiruan sahaja mungkin mempunyai kejayaan yang sama berbanding tulang yang diambil secara tradisional dari pinggul apabila dinilai secara klinikal, dengan imej radiograf dan dalam aspek mengurangkan masalah di kawasan pembedahan.
Ulasan ini mendapati terdapat dua kajian, satu kajian membandingkan antara graf menggunakan bahan baharu dengan graf tradisional, satu lagi kajian melihat manfaat mengaplikasi sejenis gam khas kepada graf. . Kedua‐dua kajian ini dianggap berkualiti rendah, oleh itu tiada rumusan yang boleh dicapai sama ada kedua‐dua teknik baharu ini lebih baik daripada graf tradisional.
