前方牵引治疗唇腭裂术后与非唇腭裂前牙反疗效的比较  

Effect of maxillary protraction in patients with unilateral cleft lip and palate and anterior crossbite

作　　者：贾海潮[1] 李巍然[1] 林久祥[1] 

机构地区：[1]北京大学口腔医学院.口腔医院正畸科

出　　处：《中华口腔医学杂志》2006年第12期723-727,共5页Chinese Journal of Stomatology

基　　金："十五"国家科技攻关计划基金资助项目(2004BA720A25)

摘　　要：目的探讨生长发育高峰前期单侧完全性唇腭裂(UCLP)术后前牙反与非唇腭裂前牙反患者对前方牵引治疗反应的异同,以利于UCLP前牙反的治疗。方法进行前瞻性临床研究设计,UCLP术后前牙反患者18例,年龄(9·6±1·2)岁;非唇腭裂前牙反患者18例,年龄(9·8±1·4)岁,均处于生长发育高峰前期。使用前方牵引进行治疗,治疗前后拍头颅侧位片并测量,进行成组设计和配对设计t检验。结果前方牵引治疗后UCLP组SNA增加1·45°,A-TFH增加2·19mm,非唇腭裂组SNA增加1·42°,A-TFH增加2·12mm,两组差异无统计学意义(P>0·05)。UCLP组SNB减小2·18°,ANB增加3·64°,MP/SN增加2·78°,LL-EP增加0·88mm;非唇腭裂组SNB减小1·32°,ANB增加2·68°,MP/SN增加1·47°,LL-EP减小1·37mm,两组差异有统计学意义(P<0·05)。结论通过前方牵引治疗,生长发育高峰前期UCLP术后轻中度骨性前牙反患者与非唇腭裂前牙反患者的上下颌骨关系、软组织面型得到改善。两组上颌骨对治疗的反应相似。UCLP组较非唇腭裂组颌间关系改变大,下颌向后向下旋转多;UCLP组患者治疗后下唇变化不如非唇腭裂组明显。Objective To investigate the different changes after maxillary protraction between the cleft and non-cleft patients with anterior crossbite . Methods Prospective controlled clinical trial was carried ouL Eighteen patients （ aged 9. 6 ＋ 1.2 years） with unilateral cleft lip and palate （UCLP） were chosen as the experimental group. Eighteen non-cleft patients （aged 9. 8± 1.4 years） with similar malocclusions were selected as control group. All the patients were before puberty according to the evaluation of the hand wrist radiograms. Hyrax appliance and reverse headgear were used in both experimental and control groups. Lateral cephalometric radiographs were taken before and after treatment. Computerized cephalometric analysis was carried out. Paired t tests or t test were performed using software package SAS8.1. Results After treatment, the main changes in experimental group were： SNA ＋ 1.45°, A-TFH ＋2. 19 mm, SNB-2. 18°, ANB ＋3.64°,MP/SN ＋2.78°,LL-EP ＋0.88 rmn in UCLP group. And in control group were：SNA ＋ 1.42°, A-TFH ＋2. 12 mm, SNB - 1.32°, ANB ＋2.68°,MP/SN ＋l.47°,LL-EP -1.37 mm. Conclusions Before puberty, maxillary protraction could accelerate maxillary forward growth in UCLP patients and the changes were similar to non-cleft patients. The occlusal relationship and soft tissue profile were improved significantly in both patients with or without cleft. The amount of mandibular posterior rotation in patients with UCLP was larger than in those with no cleft.

关 键 词：口外牵引器 错[牙合] 唇裂 腭裂 

分 类 号：R782.2[医药卫生—口腔医学]