上颌扩弓前牵引治疗青少年唇腭裂继发上颌发育不足的近远期疗效研究  

Short-and Long-term Cephalometric Analysis of Maxillary Hypoplasia Secondary to Cleft Lip and Palate in Adolescents Treated with Upper Arch Expansion and Protraction

作　　者：宋少华[1] 蒋丽花 陈翌 莫水学[1] SONG Shaohua;JIANG Lihua;CHEN Yi;MO Shuixue(Department of Orthodontics,Stomatology Hospital Affiliated to Guangxi Medical University,Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction,Guangxi Clinical Research Center for Craniofacial Deformity,Nanning 530021,Guangxi,China)

机构地区：[1]广西医科大学附属口腔医院正畸科、广西口腔颌面修复与重建研究重点实验室、广西颅颌面畸形临床医学研究中心,广西南宁530021

出　　处：《中国美容医学》2024年第2期102-106,共5页Chinese Journal of Aesthetic Medicine

基　　金：广西卫计委科研课题(编号:桂Z20180125);广西卫生适宜技术开发与推广应用项目基金(编号:S2021087)。

摘　　要：目的:回顾分析上颌扩弓及面框前牵引治疗青少年唇腭裂整复术后继发上颌骨发育不足的近、远期头颅侧位片的变化,了解该治疗的稳定性。方法:收集资料完整行上颌扩弓前牵引治疗并远期观察的唇腭裂患者23例,对治疗前(T0)、治疗后即刻(T1)及远期(T2)的头颅定位侧位片进行头影测量分析比较。结果:治疗后T1期发现∠SNA平均增大1.21°,∠SNB减小1.94°,∠ANB增大3.15°,上颌骨位置及大小均变大。下颌平面角增大,下颌骨升支增大,上下颌前后牙槽高度均变大。上前牙唇倾度改善,软组织表现为上唇突度增加。经远期观察(T2)发现上颌骨相关指标稳定,下颌骨体部在牵引结束后开始明显增大,而升支和下颌前后牙槽高度则表现为T0到T2持续增大。下颌平面角减小,但较T0期仍大。∠ANB虽减小但比T0期仍增大2.05°,上唇软组织突度减小。结论:上颌扩弓前牵引可以通过促进上颌发育和下颌后下旋来改善唇腭裂患者的骨性Ⅲ类关系,长期观察上颌前牵引效果稳定,但下颌骨继续生长和前上旋导致效果有所反弹。Objective To retrospectively analyze the short and long-term lateral cephalometric changes of maxillary hypoplasia secondary to CLP repair by upper arch expansion and protraction.And to understand the stability of the treatment.Methods 23 patients with maxillary hypoplasia after CLP surgery were enrolled in this study.Cephalometric analysis was performed on the lateral radiographs before treatment(T0),immediately after treatment(T1)and during long follow-up(T2).Results At the end of protraction(T1),the∠SNA increased by 1.21°,the∠SNB decreased by 1.94°,and the∠ANB increased by 3.15°.The position and size of maxilla became larger.The mandibular plane Angle increased,and the ramus of the mandible became larger.The anterior and posterior alveolar height of the upper and lower jaws became larger.The∠U1-SN were improved,and the soft tissue shows increased protrusion of the upper lip.It was found that the maxillary and the related indicators were stable at T2,while the mandibular body showed significant increase after T1,while the ramus and mandibular anterior and posterior alveolar height showed continuous increase from T0 to T2.The mandibular plane Angle decreased,but it was still larger than T0 stage.The∠ANB still have a significant increase 2.05°compared with T0 stage despite the decrease.The UL-EP decreases.Conclusion Skeletal ClassⅢmalocclusion relationship of cleft lip and palate can be improved by promoting maxillary development and mandibular clockwise rotation.Long-term observation shows that the maxillary protraction effect is stable,but the mandible continues to grow and reverse rotation leads to the relapse to some extent.

关 键 词：唇腭裂 前牵引 头影测量 稳定性 上颌发育不足 近期疗效 远期疗效 

分 类 号：R782.2[医药卫生—口腔医学]