婴儿期单侧完全性唇腭裂术前正畸治疗的临床研究

目的探讨上颌-鼻软骨整形矫治器在婴儿期单侧完全性唇腭裂术前正畸中的应用与疗效。方法2003年1月~2004年3月,对100例出生后10 d~3个月内单侧完全性唇腭裂婴儿进行上颌-鼻软骨整形矫治器矫治。其中男60例,女40例,健康状况良好。根据矫治起始时间的不同分为观察组(10 d~1个月内)及对照组(1~3个月)各50例,对比两组婴儿正畸治疗前后上唇裂隙、上前牙槽突裂隙关闭程度及唇腭裂联合整复术后3个月鼻翼外观满意度,评价疗效。结果婴儿正畸前后上唇裂隙、上前牙槽突裂隙宽度观察组为5.0±1.6 mm、4.1±2.7 mm,6.9±2.6 mm、6.4±2.9 mm;与对照组7.5±3.1 mm、8.3±3.0 mm,12.5±4.0 mm、10.8±2.6 mm比较,差异均有统计学意义(P<0.05)。两组婴儿正畸前后上唇裂隙、上前牙槽突裂隙宽度自身比较,差异无统计学意义。两组患儿术后鼻翼外观满意度观察组86.3%与对照组62.4%比较,差异有统计学意义(P<0.05)。结论尽早对单侧完全性唇腭裂患儿实施上颌-鼻软骨整形矫治器矫治,可明显改善上颌形态及鼻畸形程度,减小牙槽突裂隙,并有效减小上唇张力,为婴儿期唇腭裂联合手术创造有利条件。

PRESURGICAL ORTHODONTIC TREATMENT OF COMPLETE UNILATERAL CLEFT LIP AND PALATE IN 100 INFANTS

OBJECTIVE: To investigate the application and curative effect of nasoalveolar molding plate in the presurgical orthodontic treatment of complete unilateral cleft lip and palate in infants. METHODS: From January 2003 to March 2004, 100 infants with complete unilateral cleft lip and palate received presurgical orthopedics by using nasoalveolar molding plate. According to the age, 100 infants (aging 10 days to 3 months, including 60 males and 40 females) were divided into the test group (10 days to 1 month) and the control group (1-3 months). The widths of lip cleft and dentoalveolar cleft and the rate of satisfaction for nose wing were compared between 2 groups before treatment and after the treatment. RESULTS: The widths of cleft lip and dentoalveolar cleft before orthodontic (5.0 +/- 1.6 mm, 6.9 +/- 2.6 mm) and after orthodontics (4.1 +/- 2.7 mm, 6.4 +/- 2.9 mm)in the test group were less than those in the control group (7.5 3.1 mm, 12.5 +/- 4.0 mm and 8.3 +/- 3.0 mm, 10.8 +/- 2.6 mm), being statistically different (P < 0.05). The satisfactory rate of nose wing in the test group (86.3%) was significantly higher than that in the control group (62.4%, P < 0.05). CONCLUSION: The advantages of presurgical orthodontic treatment of complete unilateral cleft lip and palate in infants are as follows: repositioning the premaxillary segment, reducing the width of palate cleft, correcting the nasal deformities and facilitating surgical repair of cleft lip and palate.