双侧唇腭裂婴幼儿正畸与外科治疗新技术——术前鼻-牙槽骨塑形和早期同期唇-鼻-牙槽整复术

目的：探索双侧唇腭裂婴幼儿术前鼻-牙槽骨塑形及同期唇-鼻-牙槽整复术的时机、方法、特点，并进行其疗效的初步观察。方法：对21例双侧唇腭裂婴幼儿进行了术前鼻-牙槽骨塑形和同期唇-鼻-牙槽整复术。术前鼻-牙槽骨塑形主要包括前颌后退、牙槽骨间隙的关闭、唇的牵张及鼻的矫形；同期唇-鼻-牙槽整复术包括牙龈-牙周膜-牙槽骨整形术及改良长庚式双侧唇裂唇鼻同期整复术。结果：21例行术前鼻-牙槽骨塑形的患者前唇后退充分；唇裂隙宽度变窄，裂隙两侧唇组织适度牵张；鼻小柱延长及鼻塌陷畸形明显改善；牙槽裂隙变窄为1～2mm。19例术后患者经1～5年随访，结果表明：唇鼻形态良好；前庭沟连续；口-鼻腔瘘封闭；16例上牙槽连续、稳定，但部分病例牙槽高度、宽度稍嫌不足，其中13例患者在原牙槽裂隙处长出乳齿。结论：双侧唇裂患者为了获得理想的唇鼻形态及完整稳定的牙槽骨，术前进行正畸鼻-牙槽突塑形和早期同期唇-鼻-牙槽整复术是一种实用、无创、安全、可行、经济、值得借鉴的序列治疗方法。

An innovative orthodontic and surgical technique for bilateral complete cleft lip-presurgical noso-alveolar molding and early simultaneous lip-nose-alveolar repairs

Objective Presurgical nose-alveolar molding for infants with cleft lip and palate has been one of new methods and techniques of the cleft lip and palate team approach.The purpose of this paper was to study the effects of presurgical nasoalveolar molding in bilateral complete cleft lip/palate and early simultaneous lip-nose-alveolar repairs and to discuss the optimum time,methods,skills,characteristics of using the technique.Methods 21 cases with bilateral complete cleft lip/palate were underwent presurgical...