三维头颅模型研究腭裂腭板植骨对上颌骨发育的影响

目的 探讨腭裂腭板植骨对上颌骨发育的影响.方法 于1997年1月至1999年12月在浙江大学医学院附属第二医院口腔外科就诊的腭板骨缺损先天性Ⅱ度腭裂患者40例,随机分为对照组和植骨组,植骨组腭板骨缺损利用羟基磷灰石骨水泥复合人工骨修复,所有患者年满16周岁时复诊,颌骨CT扫描三维表面重建快速成型制作三维头颅模型,在头颅模型上直观定点、测量,与牙颌模型测量相结合,分析腭板植骨对上颌骨发育的影响.结果 三维头颅模型与牙颌模型测量结果比较差异无统计学意义;三维头颅模型测量显示:植骨组与对照组在上颌骨长度发育上、高度发育上差异均无统计学意义;植骨组与对照组在上颌骨后部宽度发育上差异均有统计学意义(67.6 mm±4.3 mm比61.3 mm±4.1 mm、63.5 mm±3.9 mm比57.3 mill±3.1 mm、26.2 mm±1.8 mm比26.4mm±1.9 mm,均P<0.05),植骨组上颌骨后部宽度明显大于对照组.结论 三维头颅模型上定点测量评价上颌骨生长发育直观、准确,是一种较好的研究方法.腭板植骨对上颌骨后部宽度的发育存在明显的促进作用,腭裂序列治疗应考虑对腭板进行植骨修复.

Abstract：

Objective To observe the effect of artificial bone implantation of hard cleft palate on the development of maxilla.Methods From January 1997 to December 1999,40 patients with hard cleft palate were randomly divided into two groups:control group and implantation group(n=20 each).The patients in the implantation group received an implantation of compound artiffcial bone of HA-Bone cement.All pailents had a follow-up since 16 years old.A tllree dimensional model was established with computed tomography and rapid prototype technique to analyze the maxilla in three dimension.At the same time,a dentognathic model was employed.Results There were no differences in the results between the three dimensional and dentognathic models.No difference was found in the development of maxilla in length and height between the control and implantation groups.There were marked differences in the development of maxilla in width between two groups(67.6 mm±4.3 mm vs 61.3 1131/1±4.1 mm.63.5 mln±3.9 mm vs 57.3 mm±3.1 mm,26.2 mm±1.8 mm vs 26.4 mm±1.9 mm,all P<0.05).The width of maxilla in the implantation group was markedly wider than that in the control group.Conclusions The application of three dimensional model for evaluating the development of maxilla is both straightforward and accurate.Bone implantation of hard cleft palate is an obvious boost to the development of maxilla in width.It should be included into a comprehensive orthodontic treatment for patients with hard cleft palate.

Application of three dimensional model in evaluating the effect of artificial bone implantation of hard cleft palate on the development of maxilla

Objective To observe the effect of artificial bone implantation of hard cleft palate on the development of maxilla.Methods From January 1997 to December 1999,40 patients with hard cleft palate were randomly divided into two groups:control group and implantation group(n=20 each).The patients in the implantation group received an implantation of compound artiffcial bone of HA-Bone cement.All pailents had a follow-up since 16 years old.A tllree dimensional model was established with computed tomography and rapid prototype technique to analyze the maxilla in three dimension.At the same time,a dentognathic model was employed.Results There were no differences in the results between the three dimensional and dentognathic models.No difference was found in the development of maxilla in length and height between the control and implantation groups.There were marked differences in the development of maxilla in width between two groups(67.6 mm±4.3 mm vs 61.3 1131/1±4.1 mm.63.5 mln±3.9 mm vs 57.3 mm±3.1 mm,26.2 mm±1.8 mm vs 26.4 mm±1.9 mm,all P<0.05).The width of maxilla in the implantation group was markedly wider than that in the control group.Conclusions The application of three dimensional model for evaluating the development of maxilla is both straightforward and accurate.Bone implantation of hard cleft palate is an obvious boost to the development of maxilla in width.It should be included into a comprehensive orthodontic treatment for patients with hard cleft palate.