Quirynen M, Dewinter G, Avontroodt P, Heidbüchel K, Verdonck A, Carels C
Department of Periodontology, Research group for Microbial Adhesion, Catholic University of Leuven, Belgium.
J Clin Periodontol. 2003 Jan;30(1):49-56. doi: 10.1034/j.1600-051x.2003.300108.x.
Complete unilateral cleft lip and palate (UCLP) is a hereditary or multifactorial malformation that can be corrected successfully with a combined orthodontic, surgical and restorative treatment. Such multidisciplinary treatment takes many years and demands a lot of attention to both patients' teeth and periodontium.
This split-mouth study aimed to compare the periodontal health as well as the microbial parameters between cleft and non-cleft region.
75 patients (52 males, 23 females) between 8 and 20 years with a complete unilateral cleft lip and palate (before (n = 30), during (n = 34) and after (n = 11) the active orthodontic treatment) volunteered for this study. Four regions were defined for the split-mouth comparison: teeth neighbouring cleft (site 1), tooth in cleft (site 2), and the corresponding contra-lateral teeth, respectively, in the unaffected quadrants (sites 3 and 4). At all sites the following periodontal parameters were recorded: plaque and gingivitis indices, pocket depth, attachment loss, bleeding on probing, tooth mobility (visual and Periotest), radiographic bone loss and gingival width. In addition, three pooled subgingival plaque samples were taken (around tooth in cleft, teeth facing the cleft, and contra-lateral teeth of the latter).
The differences between the teeth neighbouring the cleft and the corresponding contra-lateral opponents were of borderline significance (P <or= 0.05) for the plaque index, the approximal probing depths and the attachment loss (teeth facing the cleft always had slightly higher parameters). When the tooth in the cleft was compared to the contra-lateral tooth, differences were only found for both the approximal probing depths, attachment loss and bone loss, which were significantly higher for the tooth in the cleft. The microbial analysis did not reveal differences between the different sites, neither in the proportion of aerobic and anaerobic bacteria (differences < 0.5 log), nor in the detection frequency of periopathogens.
These data indicate that the periodontium in UCLP patients can cope well with a long-term orthodontic treatment, even in unfavourable conditions (like absence of attached gingiva and poor oral hygiene).
完全性单侧唇腭裂（UCLP）是一种遗传性或多因素导致的畸形，可通过正畸、外科和修复联合治疗成功矫正。这种多学科治疗需要数年时间，并且需要对患者的牙齿和牙周组织给予大量关注。
本双侧对照研究旨在比较腭裂侧与非腭裂侧的牙周健康状况以及微生物参数。
75例年龄在8至20岁之间的完全性单侧唇腭裂患者（52例男性，23例女性，其中包括正畸治疗前30例、正畸治疗期间34例和正畸治疗后11例）自愿参与本研究。为双侧对照比较定义了四个区域：邻近腭裂的牙齿（部位1）、腭裂处的牙齿（部位2）以及未受影响象限中相应的对侧牙齿（部位3和4）。在所有部位记录以下牙周参数：菌斑指数、牙龈炎指数、牙周袋深度、附着丧失、探诊出血、牙齿松动度（视觉检查和Periotest）、影像学骨丧失和牙龈宽度。此外，采集了三个龈下菌斑混合样本（腭裂处牙齿周围、面对腭裂的牙齿周围以及后者的对侧牙齿周围）。
邻近腭裂的牙齿与相应对侧对照牙之间，菌斑指数、邻面探诊深度和附着丧失的差异具有临界显著性（P≤0.05）（面对腭裂的牙齿各项参数总是略高）。当将腭裂处的牙齿与对侧牙齿进行比较时，仅在邻面探诊深度、附着丧失和骨丧失方面发现差异，腭裂处的牙齿这些指标显著更高。微生物分析未显示不同部位之间在需氧菌和厌氧菌比例（差异<0.5 log）以及牙周病原菌检测频率方面存在差异。
这些数据表明，UCLP患者的牙周组织即使在不利条件下（如无附着龈和口腔卫生不良）也能很好地耐受长期正畸治疗。
