单侧完全性唇腭裂术后牙弓问横向关系的不调及正畸矫治后变化的探讨

目的 探讨单侧完全性唇腭裂术后患者上下颌牙弓间横向关系以及正畸治疗对上颌牙弓的影响。方法 对84名单侧完全性唇腭裂术后患者的错(牙合)畸形和上下颌颌间关系进行研究;并对36名唇腭裂术后患者进行正畸治疗前后的牙(牙合)模型进行测量分析上颌牙弓宽度的变化。结果 (1)单侧完全性唇腭裂术后60.7％的患者出现牙弓间横向关系的不协调,双尖牙区较易受累。(2)在出现牙弓间横向关系不调的患者中,双侧后牙反(牙合)者为60％。(3)正畸治疗后上颌牙弓的尖牙、第一、第二双尖牙间各自的宽度均有显著增加,第一磨牙间宽度变化不显著。上颌第一、第二双尖牙间各自宽度较尖牙间、第一磨牙间宽度增加显著。结论 单侧完全性唇腭裂术后患者上颌宽度的发育受到明显的限制,牙弓间横向关系不协调的比率较高,以双尖牙区为主;正畸矫治扩弓的重点应在双尖牙区。

The investigation of dental arch transverse disharmony and changes after orthodontic treatment in patients with unilateral cleft lip and palate

Objective To investigate the dental arch transverse disharmony and affection of orthodontic treatment in unilateral cleft lip and palate patients. Methods Eighty-four unilateral cleft lip and palate(UCLP) patients in the late mixed or permanent dentition were examined clinically. Malocclusion and transverse dental arch relationship were recorded. Thirty-six UCLP patients with malocclusion were treated and dental model measurements before and after treatment were done. Results (1) Transverse dental arch disharmony were seen in 60. 7% of the patients after surgery in this study, The premolar area was often affected. (2) 60. 7% of the patients who has transverse dental arch disharmony were bilateral posterior crossbite (3) The inter-cuspid, first premolar and second premolar arch width in the upper arch were increased significantly after treatment, whereas the inter-molar width was changed insignificantly. (4) After treatment the changes of dental arch width in first and second premolar region were larger than that of cuspid and first molar regions. Conclusion Transverse dental arch disharmony were often seen in UCLP patients after surgery and premolar regions were very often affected. Dental arch expansion in premolar area is important in orthodontic treatment, and the increase of arch width in premolar area was greater than that of other area.