Sasaki Akiko, Takeshita Satoshi, Publico Andre S, Moss Melvin L, Tanaka Eiji, Ishino Yoshihiro, Watanabe Mineo, Tanne Kazuo
Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-Ku, Hiroshima City 734-8553, Japan.
Med Eng Phys. 2004 Mar;26(2):109-18. doi: 10.1016/j.medengphy.2003.10.005.
The purpose of this study was to clarify the differences in the nature of craniofacial growth between subjects with normal occlusion and patients with unilateral cleft lip and palate (CLP) in terms of the size, shape and principal growth direction of craniofacial skeleton using finite element method (FEM). Lateral cephalograms were taken of 40 subjects as normal group and 178 patients as CLP group. These subjects were divided into seven developmental ages of 4-, 6-, 8-, 10-, 12-, 14- and 18-year-old. For the finite element analysis, the craniofacial complex was discretized into seven structures or elements with three nodal points in each after tracing each lateral cephalogram on acetate paper. For each stage, the growth parameters in CLP group were compared to those in normal group. The growth of upper facial skeleton and maxillary complex was more remarkably inhibited in CLP than in normal group. Especially, the growth inhibition of posterior maxillary complex in a vertical direction was remarkable in CLP group at any ages. Difference in the size and shape of entire mandibular skeleton between CLP and normal groups was not apparent. It is suggested that grow timing and peak velocity, an essential and key determinant to the success in orthodontic treatment, have been clarified in this study more clearly than in previous studies. It is hopefully anticipated to explore some key determinants to predict individual growth of the craniofacial skeleton near future.
本研究的目的是使用有限元法（FEM），从颅面骨骼的大小、形状和主要生长方向方面，阐明正常咬合受试者与单侧唇腭裂（CLP）患者在颅面生长性质上的差异。对40名受试者作为正常组和178名患者作为CLP组拍摄了头颅侧位片。这些受试者被分为4岁、6岁、8岁、10岁、12岁、14岁和18岁这七个发育年龄组。对于有限元分析，在醋酸纸上描绘每张头颅侧位片后，将颅面复合体离散为七个结构或单元，每个结构或单元有三个节点。对于每个阶段，将CLP组的生长参数与正常组的进行比较。CLP组中上颌面部骨骼和上颌复合体的生长比正常组更明显地受到抑制。特别是，CLP组在任何年龄时上颌复合体后部在垂直方向上的生长抑制都很显著。CLP组和正常组之间整个下颌骨骼的大小和形状差异不明显。本研究表明，正畸治疗成功的一个基本且关键的决定因素——生长时机和峰值速度，比以往研究更清晰地得到了阐明。有望在不久的将来探索一些关键决定因素来预测颅面骨骼的个体生长。
