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1.
Objective:To test the null hypothesis that there is no significant difference in the initial growth pattern among three cleft types before alveolar bone graft (ABG) according to cleft type (unilateral cleft lip and alveolus [UCLA], unilateral cleft lip and palate [UCLP], and cleft palate [CP]).Materials and Methods:Samples consisted of the UCLA group, the UCLP group, and the CP group. Individuals were treated with the identical surgical technique by the same surgeon and had no history of orthodontic/orthopedic treatment. Lateral cephalograms taken 1 month before ABG were analyzed using 29 variables. One-way analysis of variance (ANOVA) testing and bivariate and logistic regression analyses were performed.Results:An increasing tendency for Class III relationships in the order of UCLA, UCLP, and CP was noted (ANB, AB-to-facial plane angle, AB-to-mandibular plane angle; P < .001, respectively). UCLP and CP groups demonstrated more posterior positioning of the maxilla (SNA, A-to-N-perp; P < .001, respectively) and a hyperdivergent pattern (gonial angle, SN-GoMe angle, FMA; P < .001, respectively) compared with the UCLA group. Because no differences in palatal plane angle and SN-to-occlusal plane angle were noted among the three groups, the hyperdivergent pattern in the UCLP and CP groups might be due to an innate growth pattern and eventual adaptation of the mandible to maxillary growth. UCLP and CP groups showed more Class III relationships (ANB: P < .05, P < .001, respectively) and a more hyperdivergent pattern (FMA: P < .05, P < .01, respectively) than the UCLA group.Conclusion:When the degree of cleft involvement increases from the primary palate to the secondary palate, the predominance of the Class III relationship and the hyperdivergent pattern increases also.  相似文献   

2.
The identification of clinical patterns of tooth agenesis in individuals born with craniofacial deformities may be a useful tool for risk determination of these defects. We hypothesize that specific craniofacial deformities are associated with third molar agenesis.ObjectiveThe aim of this study was to identify if third molar agenesis could have a relation with other craniofacial structure alterations, such as cleft lip and palate, skeletal malocclusion, or specific growth patterns in humans.DesignData were obtained from 550 individuals ascertained as part of studies aiming to identify genetic contributions to oral clefts. 831 dental records of patients aged over eight years seeking orthodontic treatment were also included. SN-GoGn angle were used to classify the growth pattern (hypo-divergent, normal and hyper-divergent), and the ANB angle was used to verify the skeletal malocclusion pattern (Class I, II and III). Panoramic radiographs were used to determine third molar agenesis.ResultsA high frequency of third molar agenesis among individuals born with cleft lip with or without cleft palate (55%), as well as among their relatives (93.5%) was found. Third molar agenesis was not associated to skeletal malocclusion or growth pattern.ConclusionIt appears that third molar agenesis is associated with the disturbances that lead to cleft lip and palate.  相似文献   

3.
ObjectivesTo assess the effectiveness of bone-anchored maxillary protraction (BAMP) in patients with unilateral cleft lip and palate (UCLP) and whether it was enhanced when preceded by maxillary expansion.Materials and MethodsThe sample consisted of 28 growing children (9–13 years old) with UCLP and Class III malocclusion. They were divided into two equal groups. In group I, patients were treated with BAMP not preceded by maxillary expansion. In group II, patients were treated with BAMP preceded by maxillary expansion. To assess treatment changes in three dimensions, Cone-beam computed tomography images were taken 1 week after surgical placement of the miniplates (T1) and after 9 months of treatment (T2).ResultsBAMP produced forward movement of the maxilla in both groups (3.17 mm) and (3.37 mm) respectively, without significant differences between the two groups except for clockwise rotation of the palatal plane in group I (1.60).ConclusionsBAMP is an effective treatment modality for correcting midface deficiency in patients with UCLP whether or not maxillary expansion was carried out.  相似文献   

4.
Sixteen individuals with complete unilateral cleft lip and palate (UCLP) were evaluated for determination of several craniofacial dimensional means and growth rates. Each had undergone primary lip and palatal closure and alveolar bone grafting. Serial cephalographs from ages 8 to 18 years, taken every 2 years, were utilized for determination of six cephalometric dimensions: anterior cranial base, upper and lower facial heights, posterior nasomaxillary height, maxillary horizontal length, and mandibular length. These were then compared to published cephalometric standards of a nonclefted group. All dimensions, except mandibular length, were smaller in the UCLP group. The horizontal maxillary length was the most diminished in mean length and growth rate; it appears to be most affected in UCLP. The remaining dimensions and growth rates are affected by UCLP, but to a lesser degree. These findings indicated that individuals with unilateral cleft lip and palate are primarily and adversely affected by clefting (and the surgery as described) in the horizontal maxilla, both in dimension and growth rate.  相似文献   

5.
目的 利用锥形束CT(cone-beam CT,CBCT)研究单侧完全性唇腭裂(unilateral cleft lip and palate,UCLP)患者前牙区牙槽骨开窗、骨开裂的发生率。方法 选取2014年6月—2017年9月就诊于中南大学湘雅二医院的UCLP患者42例(男25例,女17例)。匹配性别和年龄,纳入42例骨性Ⅲ类非唇腭裂患者为对照组。利用CBCT评估UCLP组与对照组前牙区骨开窗和骨开裂的发生率,采用SPSS 22.0软件包对数据进行统计学分析。结果 裂隙侧、非裂隙侧及对照组前牙骨开裂发生率分别为50.88%、42.39%和28.77%。UCLP组裂隙侧上颌前牙同名牙骨开裂的发生率均显著高于对照组(P<0.05),非裂隙侧上颌侧切牙骨开裂的发生率显著高于对照组(P<0.05),裂隙侧上颌中切牙骨开裂发生率显著高于非裂隙侧(P<0.05)。裂隙侧、非裂隙侧与对照组前牙区骨开裂均好发于唇侧。骨开窗的发生率在裂隙侧、非裂隙侧及对照组间无显著差异(P>0.05)。结论 在UCLP患者中,牙槽骨开窗和骨开裂较常见,临床治疗中应引起重视。  相似文献   

6.
目的探讨生长发育高峰前期单侧完全性唇腭裂(UCLP)术后前牙反与非唇腭裂前牙反患者对前方牵引治疗反应的异同,以利于UCLP前牙反的治疗。方法进行前瞻性临床研究设计,UCLP术后前牙反患者18例,年龄(9·6±1·2)岁;非唇腭裂前牙反患者18例,年龄(9·8±1·4)岁,均处于生长发育高峰前期。使用前方牵引进行治疗,治疗前后拍头颅侧位片并测量,进行成组设计和配对设计t检验。结果前方牵引治疗后UCLP组SNA增加1·45°,A-TFH增加2·19mm,非唇腭裂组SNA增加1·42°,A-TFH增加2·12mm,两组差异无统计学意义(P>0·05)。UCLP组SNB减小2·18°,ANB增加3·64°,MP/SN增加2·78°,LL-EP增加0·88mm;非唇腭裂组SNB减小1·32°,ANB增加2·68°,MP/SN增加1·47°,LL-EP减小1·37mm,两组差异有统计学意义(P<0·05)。结论通过前方牵引治疗,生长发育高峰前期UCLP术后轻中度骨性前牙反患者与非唇腭裂前牙反患者的上下颌骨关系、软组织面型得到改善。两组上颌骨对治疗的反应相似。UCLP组较非唇腭裂组颌间关系改变大,下颌向后向下旋转多;UCLP组患者治疗后下唇变化不如非唇腭裂组明显。  相似文献   

7.
ObjectivesTo examine the relationship between mandibular volume and craniofacial morphology in patients with cleft lip and palate using cone beam computed tomography (CBCT) and to compare these findings with control (noncleft) patients undergoing CBCT for other purposes during the deciduous dentition period.Materials and MethodsEighty-four patients were categorized into the unilateral cleft lip and alveolus (UCLA) group (n = 25; mean age, 4.60 ± 0.40 years), unilateral cleft lip and palate (UCLP) group (n = 23; mean age, 4.52 ± 0.39 years), bilateral cleft lip and palate (BCLP) group (n = 22; mean age, 4.54 ± 0.37 years), and control group without cleft (n = 14; mean age, 5.19 ± 0.52 years). Mandibular volume and craniofacial cephalometric measurements were obtained using CBCT. All measurements were assessed by analysis of covariance (ANCOVA) using Bonferroni post hoc pairwise comparison tests.ResultsANCOVA revealed no statistically significant differences in mandibular volume among the groups. SNA° and ANB° were significantly larger in the UCLA and BCLP groups than in the control group. SN-MP° was smallest in the UCLA group. Co-A in the UCLP group was shorter than in the UCLA and BCLP groups. Go-Gn was shortest in the UCLP and BCLP groups compared with the control group.ConclusionsThree-dimensional evaluation of craniofacial morphology using CBCT can provide valuable information on malocclusion and other dentoskeletal problems among patients with CLP.  相似文献   

8.
目的探讨前方牵引治疗单侧完全性唇腭裂(UCLP)患者术后前牙反[牙合]畸形的效果。方法进行前瞻性临床研究设计,UCLP术后骨性前牙反[牙合]患者治疗组18例,年龄9.63±1.24岁,观察对照组14例,平均8.71±1.92岁,均处于生长发育高峰前期。使用前方牵引进行治疗,治疗或观察前后拍摄头颅侧位片并测量,进行成组设计和配对设计t检验。结果UCLP治疗组前方牵引后,上颌骨前移;下颌后移合并后下旋转;上下颌间关系和面型改善明显,上颌与下颌改变的比值为1:1.7。对照组上下颌不调、前牙反覆盖、凹面型加重。结论UCLP术后轻中度骨性前牙反[牙合]畸形,前方牵引能够促进上颌骨向前,改善上下颌骨关系和软组织面型,应该早期矫形治疗。  相似文献   

9.
目的:通过与同龄非唇腭裂正常 儿童比较,研究替牙期骨性Ⅲ类单侧完全性唇腭裂(unilateral cleft lip and palate,UCLP)患者上下颌不同位点口周力的特征。 方法:选取替牙期6~12岁UCLP患者20例(男14例,女6例)为UCLP组;同龄正常 儿童21例(男14例,女7例)为对照组。采用口周肌压力采集系统测量每个研究对象息止 位时双侧上下颌中切牙、尖牙或乳尖牙、第一前磨牙或乳磨牙、第一恒磨牙的唇颊、舌腭侧龈缘的口周力。使用SPSS 25.0统计软件对数据进行统计分析。 结果:1.UCLP组上颌口周力裂侧大于非裂侧( P<0.05),下颌口周力两侧无差异( P>0.05)。2. UCLP组上颌口周力大于对照组( P<0.05),两组上颌唇颊侧的口周力均在第一前磨牙/乳磨牙区最大,在中切牙区最小。3. UCLP组下颌唇颊侧口周力小于对照组( P<0.01),下颌中切牙舌侧区UCLP组大于对照组( P<0.05)。4. UCLP组上颌牙弓内外口周力差值大于对照组( P<0.05),下颌差值小于对照组( P<0.01)。 结论:替牙期骨性Ⅲ类UCLP患者口周力较同龄非唇腭裂正常 儿童存在异常。  相似文献   

10.
目的:探讨唇腭裂患者与安氏I类错牙合患者上颌骨发育的差异。方法:选取单侧完全性唇腭裂(complete unilateral cleft lip and palate,UCLP)50例、单侧完全性唇裂(complete unilateral cleft lip,UCL)28例,按不同颈椎骨龄分期分为3组,将其与相同发育期的安氏I类患者头影测量数据进行比较。结果:在所有发育期,UCLP的SNA(°)ANB (°)U1-U6(mm)均较安氏I类错牙合者小。CS1-6期结果显示:UCLP的SNA(°)ANB(°)U1-U6均值分别较安氏I类错牙合者小7.07°、4.05°、5.56 mm,SN-PP(°)均值较安氏I类错牙合者大3.98°。UCLP患者ANS-PNS(mm)、U1-PP(mm)等随发育较安氏I类错牙合者逐渐减小的趋势;结论:UCLP患者较安氏I类错牙合上颌位置靠后,上颌矢状向长度不足,腭平面顺时针旋转,上前牙舌倾。UCL患者上颌骨大小及位置与安氏I类错牙合相似。  相似文献   

11.
目的 比较替牙期单侧完全性唇腭裂(unilateral complete cleft lip and palate,UCLP)患者裂隙侧与非裂隙侧下颌骨体积的差异,并将两者分别与非唇腭裂(non cleft lip and palate,NCLP)儿童单侧下颌骨体积比较,以研究唇腭裂对下颌骨生长发育的影响。方法 选取2012—2016年于青岛大学附属医院口腔正畸科就诊的替牙期UCLP患者25例作为UCLP组,另选同期就诊的替牙期NCLP儿童25名作为NCLP组。对所有研究对象的头颅部进行锥形束CT(cone-beam CT,CBCT)扫描,获取影像数据,利用Mimics 17.0软件对下颌骨进行三维重建。比较两组双侧的下颌升支、体部及半侧下颌骨体积,并将UCLP组裂隙侧和非裂隙侧的上述测量指标分别与NCLP组进行比较。结果 (1)UCLP组裂隙侧下颌升支体积大于非裂隙侧,差异有统计学意义(t = 2.192,P < 0.05);而下颌体部及半侧下颌骨的体积比较,差异无统计学意义(均P > 0.05);NCLP组两侧的下颌升支、体部及半侧下颌骨体积差异均无统计学意义(均P > 0.05)。(2)UCLP组裂隙侧与非裂隙侧的下颌升支体积均小于NCLP组,UCLP组非裂隙侧半侧下颌骨体积小于NCLP组,差异均有统计学意义(t值分别为-2.938、-3.325、-2.023,P < 0.05)。结论 替牙期UCLP患者两侧下颌骨体积存在差异,裂隙侧下颌升支体积大于非裂隙侧,且替牙期UCLP患者下颌骨的生长发育较NCLP儿童差。  相似文献   

12.
13.
Objective:To compare the effect of secondary alveolar bone graft (SABG) on the tooth development stage of the maxillary central incisor (MXCI) and maxillary canine (MXC) in terms of the severity of unilateral cleft.Materials and Methods:The subjects consisted of 50 boys with unilateral cleft lip and alveolus (UCLA) or unilateral cleft lip, alveolus, and palate (UCLP). The age- and sex-matched subjects were divided into group 1 (UCLA, n = 25; 9.3 ± 0.8 years old) and group 2 (UCLP, n = 25; 9.4 ± 0.6 years old). In panoramic radiographs taken 1 month before (T0) and 1 year after SABG (T1), tooth development stage was evaluated according to the Nolla developmental (ND) stage. A panoramic radiograph taken 3 years after SABG was used as a reference for the final root length of individual tooth.Results:In groups 1 and 2, the ND stage of the MXCI did not exhibit differences between the cleft and non-cleft sides at T0 and T1, respectively. However, although the ND stage of the MXC of group 2 was delayed on the cleft side compared with the non-cleft side at T0 (P < .05), the MXC on the cleft side developed faster than that on the non-cleft side after SABG (P < .01). In terms of tooth development speed, group 2 showed a higher rate of faster developed MXCs on the cleft side compared with the non-cleft side after SABG than group 1 (36.0% vs 8.0%, P < .05).Conclusion:SABG performed at approximately 9 years of age might increase tooth development speed of MXC in patients with UCLP compared with patients with UCLA.  相似文献   

14.
OBJECTIVE: To evaluate dental arch relationships and dimensions, relative to an age matched noncleft sample, in Caucasian 3-year-old children with repaired unilateral cleft lip (UCL) or unilateral cleft lip and palate (UCLP). DESIGN: Prospective, cross-sectional, case-control study performed in Scotland, U.K. PARTICIPANTS: Eleven children with repaired unilateral cleft lip, 16 children with repaired unilateral cleft lip and palate, and 78 children as controls. MAIN OUTCOME MEASURES: Dental arch relationships and linear arch dimensions. RESULTS: Prevalence of Class III incisor relationship was 31.3% in children with unilateral cleft lip and palate compared with 9.1% in children with unilateral cleft lip. A buccal crossbite was present in 36% of children with unilateral cleft lip, compared with 75.6% of children with unilateral cleft lip and palate.Mean linear maxillary arch dimensions did not differ significantly between children with unilateral cleft lip and the controls. Except for second intermolar width, statistically significant differences existed in mean linear maxillary arch dimensions between the unilateral cleft lip and the unilateral cleft lip and palate groups; the mean linear maxillary arch dimensions were significantly greater in the control group than in the unilateral cleft lip and palate group. The mean cleft-affected anterior quadrant length appeared to be the arch dimension with the greatest power of discrimination among the three groups. There were no significant differences in mean linear mandibular arch dimensions among the three groups. CONCLUSIONS: Anterior crossbite was almost three times more common in the unilateral cleft lip and palate group than in the unilateral cleft lip group. Mean linear maxillary arch dimensions differed significantly between the unilateral cleft lip and palate group and the control group. There were no significant differences in mean linear maxillary arch dimensions between unilateral cleft lip and controls or between mean linear mandibular arch dimensions for unilateral cleft lip, unilateral cleft lip and palate, and controls.  相似文献   

15.

Objective

The aim of this study was to evaluate and compare the craniofacial cephalometric morphologies among different cleft types in a Spanish population.

Methods

A retrospective cross-sectional study was carried out on 212 patients. The patients were subdivided into four groups according to their cleft types: unilateral cleft lip and palate; bilateral cleft lip and palate; cleft lip; and cleft palate. Angular and linear cephalometric measurements were taken on lateral radiographs.

Results

Unilateral cleft lip and palate was associated with a dolichofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Bilateral cleft lip and palate was associated with a mesofacial growth pattern, skeletal Class I with protruded maxillary position, and lingual incisor inclination. Cleft palate was associated with a mesofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Cleft lip was associated with a brachyfacial growth pattern, skeletal Class I with protruded maxillary position, lingual upper incisor inclination, and corrects lower incisor inclination. Significant correlations were observed between cleft types and their craniofacial cephalometric measurements.

Conclusions

The present information can be used for the determination of orthodontic treatment and even future orthognathic surgery planning, a requirement in most cleft patients.
  相似文献   

16.
目的:评估青少年单侧不完全性唇腭裂患者术后上颌骨及上气道的三维形态结构特征,并探索二者之间的相关性。方法:选取8~12岁青少年单侧不完全性唇腭裂术后患者30例及与年龄、性别相匹配的非唇腭裂骨性Ⅰ类错 畸形患者30例,拍摄CBCT影像并对其上颌骨及上气道进行三维结构参数的测量分析,分析唇腭裂组上颌骨及上气道三维结构参数的相关性。 结果:唇腭裂组在上颌长度、上颌高度、上颌体积及硬腭长度分别为(44.60±3.01) mm、(48.33±4.32) mm、(36.75±6.87)×10 3 mm 3、(40.46±4.90) mm上与对照组分别为(49.04±3.23) mm、(51.86±2.98) mm、(42.24±6.71)×10 3 mm 3、(47.09±2.76) mm相比明显减小;其腭咽气道容积及上气道总容积分别为(5.34±2.15)×10 3 mm 3、(14.59±6.72)×10 3 mm 3与对照组相比分别为(8.82±3.46)×10 3 mm 3、(19.46±6.33)×10 3 mm 3也明显减小,差异具有统计学意义( P<0.05)。唇腭裂组鼻咽气道容积与上颌高度呈显著的正相关性,而与硬腭高度呈显著的负相关性;腭咽气道容积与硬腭高度呈显著的正相关性;舌咽气道容积及上气道总容积与上颌体积呈显著的正相关性。 结论:青少年单侧不完全性唇腭裂患者术后上颌骨主要在矢状向和垂直向上发育受限;腭咽气道容积及上气道总容积明显减小。上气道容积与上颌骨垂直向和体积等相关三维结构参数呈显著的相关性。  相似文献   

17.
目的研究替牙期唇腭裂术后患儿上气道结构特征。方法以52例替牙期男性单侧完全性唇腭裂(unilateral cleft lip and palate,UCLP)术后前牙反殆患者作为研究对象,52例年龄分布与之相近的替牙期非裂反胎患者作为对照,分别对这些患者的上气道结构进行头影测量分析。结果UCLP组患者舌根后气道间隙及会厌谷后气道间隙大小分别为10.44mm±3.23mm及13.82mm±2.82mm,非裂对照组舌根后气道间隙及会厌谷后气道间隙大小分别为13.78rnm±3.47Inrn及15.63mm±2.79rain,两组差异具有统计学意义(P=0.00);UCLP组及非裂对照组下颌平面角大小分别为39.78°±5.22°及33.41°±4.35。,差异具有统计学意义(P=0.00);而UCLP组患者软腭长、腭咽气道深度及腭咽闭合需值与对照组相比皆无统计学差异。结论较非裂反骀患者而言,UCLP患者更符合阻塞性睡眠呼吸暂停综合征患者气道及颅面的某些特征;腭裂术后腭咽闭合不全发生的原因不仅仅与软腭长及腭咽气道深度有关。  相似文献   

18.
目的比较不完全性腭裂患者修复术后与健康儿童替牙期颅面形态的差别,进一步了解不完全性腭裂患者的颅面特征。方法选择20例不完全性腭裂修复术后,处于替牙期的患者作为腭裂组,年龄7~11岁;选择年龄、性别匹配的非腭裂健康儿童35名作为对照组。对两组研究对象的头颅侧位X线片进行X线头影测量对比分析。结果腭裂组全颅底长、上颌长、下颌有效长度分别为86.48mm、44.79mm、65.45mm,对照组分别为91.27mm、48.84mm、70.49mm,差异均有统计学意义(P〈0.001)。结论不完全性腭裂患者颅面部发育不足,呈Ⅲ类骨面型。  相似文献   

19.
目的:研究唇腭裂修复术对下颌骨形态和位置的影响。方法:选取21例非唇腭裂患者(非裂患者)作为A组(男10例,女11例,平均年龄13.10岁),19例单侧唇腭裂伴牙槽突裂患者作为B组(男11例,女8例,平均年龄11.57岁),17例双侧唇腭裂伴牙槽突裂患者作为C组(男10例,女7例,平均年龄12.50岁)。在正畸治疗前进行头影测量,分析下颌骨的形态和位置,使用SPSS17.0软件包对3组患者的测量数据进行独立样本t检验。结果:单侧唇腭裂患者与非裂患者在ANSMe、SNB、BaNPog和CoGo-MP存在显著差异(P〈0.05),在CoGo、GoGn、CoGn、SGo和NMe也存在显著差异(P〈0.01)。双侧唇腭裂患者与非裂患者在GoGn和SN-MP存在显著差异(P〈0.05),在SNB和CoGo-MP也存在显著差异(P〈0.01)。结论:唇腭裂修复术对下颌骨生长发育的影响主要表现在下颌骨矢状向位置偏后,下颌体长度减小,下颌支高度降低以及下颌骨向后、向下旋转。  相似文献   

20.
Objectives: Clefts of the lip and/or palate (CL/P) are the most common congenital disorders of the head and neck. In Norway, the incidence is 1.9/1000 live births. The aim of this study was to investigate the frequency and distribution of various types of clefts and dental anomalies in patients treated by the cleft lip and palate (CLP) team in Bergen, Norway.

Material and methods: The material comprised the records of patients 6 years of age, examined by the CLP team in Bergen from spring 1993 to autumn 2012, incomplete records were excluded. The records of 989 patients were analysed, using frequencies and Chi-square test to compare differences in percentages between groups.

Results: The gender distribution was 58.8% male and 41.2% female. Isolated cleft palate (CP) was the most common condition (39.5%). Clefts of the lip, jaw and palate (CLP) constituted (30%) of cases and (30.5%) had isolated cleft lip (CL). The frequencies of agenesis, supernumerary and peg-shaped teeth were (36.5%), (17.8%) and (7.5%), respectively. Over 50% of the study population were diagnosed with one or more malocclusion. Of the CLP patients, 61.4% had Angle Class III occlusion. Statistical analysis disclosed a positive association of agenesis with Class III occlusion (OR =1.8, p≤?0.001).

Conclusions: The findings supported the hypothesis that the distribution of dental anomalies and occlusal disorders varied among patients with CL, CP and CLP. In patients with cleft, there is a twofold chance to get Class III malocclusion in the presence of agenesis.  相似文献   

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