头颅定位测量对大年龄未手术腭裂患者上颌骨发育的研究分析

目的研究分析大年龄未手术腭裂患者上颌骨发育的情况。方法运用电脑图象测试系统，对３７名未手术的大年龄腭裂患者头颅定位Ｘ片进行测量分析，并与２０名正常成人对照。结果大年龄未手术患者上颌骨前后发育受限，而垂直向发育与正常成人无显著性差异。结论腭裂畸形本身可影响上颌骨的发育     

成人腭裂患者腭盖表面积和倾斜度的比较研究

目的:观察腭裂患者上颌骨是否具有正常的生长发育潜能.方法:应用三维CT扫描成像系统,对比分析正常(牙合)成人、单侧完全性唇腭裂均已手术修补组以及腭裂未手术修补组成人患者的腭盖表面积和倾斜度.结果:腭裂未手术组的腭盖倾斜度显著高于正常对照组,腭盖向颅侧旋转,位置更加垂直;无论腭裂手术修补与否,腭裂患者的腭盖面积均显著小于正常对照组.结论:单侧完全性腭裂患者存在内在性的组织发育不足.     

成年腭裂患者软组织侧貌X线头影测量研究

目的　研究成年时尚未接受手术治疗的腭裂患者软组织侧貌的形态特征。方法　采用X线头影测量方法 ,对 49例成年腭裂患者软组织侧貌进行测量 ,并与正常人进行比较分析。结果　腭裂患者的上、下面高度比例协调 ,接近正常 ,上唇长度、唇间隙减小 ,下唇增长 ,颏唇沟深度无明显变化。结论　未手术成年腭裂患者软组织侧貌的畸形主要表现在面下部 ,即上、下唇长度比例失调。     

Management of the impaired adult cleft patient: the last chance.

OBJECTIVE: Unfortunately, not all patients receive the benefits of a well-trained, experienced, multidisciplinary cleft team, and a significant number of patients reach adulthood with severe neglected cleft related problems. The vast majority of this group have made their way through several surgical procedures, usually performed by different surgeons in different centers, and still carry the original cleft stigmata aggravated by variable degrees of maxillary hypoplasia, fistulae, scarring, muscle pull, soft tissue tension, lost teeth, dental adaptation, and instability of bony fragments. Adult patients who reach this stage with their original deformities have, in most instances, lost their best opportunity to be properly treated. With this assumption in mind, an aggressive surgical plan focused mainly on the deformities that can objectively achieve functional and aesthetical improvement should be individualized for each patient. In this article, experience with 38 consecutive adult patients with cleft managed following a two-stage protocol used at our cleft clinic for the last 4 years is presented. CONCLUSION: An algorithm to help definitively solve these deformities is suggested.     

未手术成人腭裂患者颅面形态的X线头影测量分析

目的:应用X线头影测量方法对未接受手术修复的成年腭裂患者(年龄为16～27岁)颅面形态进行测量分析,探讨腭裂对颌骨发肓的影响。方法:用X线头影测量机获取15例(男7例,女8例)未手术成年腭裂患者的头颅定位侧位片,联合采用Downs和Steiner分析法进行定点测量分析,测量结果均值与广西正常成年人群牙颌资料进行比较,以t检验进行统计学分析。结果:未手术修复成人单纯腭裂患者上牙槽座角SNA,上颌体长度ANS-Ptm(FH),下中切牙-下颌平面角L1-MP的均值与正常颌比较均变小,而Po-NB距与正常组比较则变大,其差异均有统计学意义(P<0.05或0.01)。结论:未手术成年腭裂患者颅面畸形主要表现为上颌骨前后向发育不足,垂直向发育未受影响;前颅底和下颌骨发育正常,而下牙槽突代偿性后缩可导致成年腭裂患者的假性颏前突。     

Maxillary arch width in unoperated adult of the unilateral cleft lip and alveolus patients

Background  

The transversal measurement on the dento-alveolar fragments of the maxilla, in the unoperated adult patients with unilateral cleft lip and alveolus are rare and have not been well documented and archived in the scientific journals. The effect of the congenital malformation is obvious in the Unilateral Cleft Lip and Alveolus (UCLA) patients and is well documented.     

Prosthodontic treatment of the edentulous adult cleft palate patient.

Clefts of the upper lip and plate are relatively common, yet dental treatment of these patients is still very poor and many grow up suffering dental neglect. Dental practitioners should become involved in the treatment team as dental needs are present from birth to death. Adult cleft patients often need tooth replacement with obturation of any residual clefts. They are best treated with tooth-supported removable appliances including partial and complete overdentures, thus preservation of their natural dentition is desirable. Edentulous cleft palate patients present with restorative difficulties due to their compromised maxillary arches as well as the presence of scar tissue in their palates and lips. An outline of these complications and guidelines for their treatment is illustrated in the form of three case reports from members of one family all presenting with varying cleft lip and palate defects. This article highlights the need for dental students to be exposed to dentally compromised patients so that they will feel confident enough to treat them in private practice.     

Pulp test response of the maxillary anterior teeth in cleft palate patients

The relative pulpal responsiveness of the six maxillary incisors to electrical and cold thermal stimuli was tested in patients with complete unilateral and bilateral clefts. The six maxillary anterior teeth were tested at random to electrical stimuli. After a 5-minute interval, the same teeth were tested at random to cold stimuli with an ice pencil. Unilateral and bilateral cleft palate patients had statistically significant higher mean electrical pulp test thresholds for the maxillary anterior teeth than the noncleft palate patients. No statistically significant difference between unilateral and bilateral cleft palate patients was found in electric pulp test responses of the maxillary anterior teeth. No statistically differences in electric pulp test responses and cold test responses of the maxillary anterior teeth in both cleft palate and noncleft palate individuals based on differences in sex were observed. No statistically significant difference in cold test responses were observed between cleft palate and noncleft palate patients. Cleft palate patients who completed orthodontic treatment within 1 year of testing showed elevated mean electrical pulp test thresholds as did noncleft palate patients who received orthodontic treatment within 1 year of testing.     

正畸结合上颌前部牵引成骨矫治严重骨性畸形唇腭裂患者

Objective To treat cleft patient with maxillary deficiency by means of orthodontics and maxillary distraction osteogenesis. Method Maxillary distraction osteogenesis was performed to increase bone mass and orthodontic treatment was carried out after surgery. Results The cleft patient with maxillary deficiency was treated successfully, ANB was increased by 9° and good occlusal relationship was achieved. Conclusions The cleft patient with maxillary deficiency could be treated successfully with maxillary distraction osteogenesis and orthodontics.     

正畸结合上颌前部牵引成骨矫治严重骨性畸形唇腭裂患者

目的 探讨采用正畸结合部分上颌骨牵引成骨的方法,治疗上颌骨严重发育不足的唇腭裂患者.方法 使用正畸结合上颌骨部分牵引成骨的方法,首先进行上颌骨前部牵引成骨,增加上颌骨的骨量,再进行正畸治疗排齐牙齿,最终解决上颌骨发育不足和牙齿拥挤的问题.结果 患者矫治后ANB角增加9°,面型明显改善,(牙合)关系良好.结论 采用正畸结合上颌骨部分牵引成骨这一新技术,矫治上颌骨发育严重不足的唇腭裂患者能够获得良好的治疗效果.

Abstract：

Objective To treat cleft patient with maxillary deficiency by means of orthodontics and maxillary distraction osteogenesis. Method Maxillary distraction osteogenesis was performed to increase bone mass and orthodontic treatment was carried out after surgery. Results The cleft patient with maxillary deficiency was treated successfully, ANB was increased by 9° and good occlusal relationship was achieved. Conclusions The cleft patient with maxillary deficiency could be treated successfully with maxillary distraction osteogenesis and orthodontics.     

A study model analysis of adult unoperated Sri Lankans with unilateral cleft lip and palate

The maxillary arch-form of 41 Sri Lankan adults with unoperated complete unilateral cleft lip and palate (8 female and 33 male) were compared to a control group of 100 normal Sri Lankan adults (45 female and 55 male). The teeth in the cleft group were smaller than their equivalents in the control group, the most marked difference being found in the central and lateral incisors. Arch widths of the cleft groups were reduced, more anteriorly than posteriorly, resulting in more V-shaped arches. No differences were found in the arch length or chord lengths between the groups. Crossbites occurred in 19.5 percent of the cleft group as compared to none of the controls. The overjet was greater in the cleft group than in the controls. A higher percentage of missing teeth was recorded in the cleft group.     

Cephalometric analysis of maxillofacial morphology in unoperated cleft palate patients.

This study was designed to investigate maxillofacial morphology in adolescents and adults with unrepaired cleft palate, with or without cleft lip. Twenty-two Chinese patients with unilateral cleft lip and palate (the UCLP group), and 21 Chinese with cleft palate (the CP group) were cephalometrically evaluated and classified into the five ranges established from the means and standard deviations for matched normal Chinese populations. Many subjects in both UCLP and CP groups showed an intrinsic maxillary retrusion and a steeper mandible. The others had nearly normal maxillofacial morphology. The tendency for maxillary retrusion and a steeper mandible became increasingly remarkable with age. In the long axis of upper incisors in subjects with permanent dentition, there were no UCLP subjects with labial inclination, whereas three CP subjects exhibited labial inclination.     

The Sri Lankan Cleft Lip and Palate Project: the unoperated cleft lip and palate

Since 1984, the Sri Lankan Cleft Lip and Palate Project has developed a large surgical and research program collecting records on over 500 subjects with unrepaired cleft lip and palate. In addition, 410 operations were performed by Project and will be followed by individual reports on facial growth and morphology, speech, surgical and anesthetic aspects, and the otologic significance of cleft palate in this issue and subsequent ones.     

成年女性未手术不全腭裂患者颌面部软组织形态学研究

目的：通过对成年后未接受手术治疗的女性不全腭裂患者颌面部软组织形态的测量、分析,研究此类畸形对颌面部软组织发育的影响。方法：收集具有完整临床资料的湖北籍不全腭裂女性患者10例。采用颌面部软组织X线头影测量方法,对软组织侧貌进行测量,参考湖北地区女性正常牙合成人颅颌面软组织结构参数,以t检验进行统计学分析。结果：不全腭裂患者的上、下面高比例基本协调,上唇长度和厚度的均值比正常值略小,下唇厚度和突度的均值比正常值略大,但均无显著性差异。结论：不全腭裂对颌面部软组织发育的影响比较小。