Lee Catherine T H, Grayson Barry H, Cutting Court B, Brecht Lawrence E, Lin Wen Yuan
Craniofacial Unit, KK Women's & Children's Hospital, Singapore.
Cleft Palate Craniofac J. 2004 Jul;41(4):375-80. doi: 10.1597/03-037.1.
To examine the long-term effect of nasoalveolar molding and gingivoperiosteoplasty (modified Millard type) on midface growth at prepuberty.
In this retrospective study, 20 consecutive patients with a history of complete unilateral cleft lip and palate were evaluated. Ten patients had nasoalveolar molding and gingivoperiosteoplasty performed at lip closure; 10 control patients had nasoalveolar molding but no gingivoperiosteoplasty because of late start in treatment or poor compliance. A single surgeon (C.B.C.) performed all surgical procedures. Standardized lateral cephalometric radiographs were evaluated at two time periods: T1 at pre-bone-grafting age and T2 at prepuberty age. Superimposition and cephalometric analysis were undertaken to investigate the two groups. Two cephalometric reference planes, sella-nasion and basion-nasion, were used to assess the vertical and sagittal relations of the midface (ANS-PNS). The reference landmarks were procrustes fitted. The mean location and variance of ANS and PNS landmarks were computed. All results were analyzed by permutation test.
No significant difference in mean location or variance of ANS-PNS in both vertical and sagittal planes at both T1 and T2 periods were found between the two groups (p > .05).
The results suggested that midface growth in sagittal or vertical planes (up to the age of 9 to 13 years) were not affected by presurgical alveolar molding and gingivoperiosteoplasty (Millard type).
研究鼻牙槽塑形术和牙龈骨膜成形术(改良Millard术式)对青春期前患儿面中部生长发育的长期影响。
本研究为回顾性研究,对20例单侧完全性唇腭裂患者进行评估。10例患者在唇裂修复时接受鼻牙槽塑形术和牙龈骨膜成形术;10例对照患者因治疗开始较晚或依从性差,仅接受鼻牙槽塑形术,未行牙龈骨膜成形术。所有手术均由同一位外科医生(C.B.C.)完成。在两个时间点进行标准化头颅侧位X线片评估:T1为植骨术前,T2为青春期前。对两组患者进行重叠分析和头影测量分析。使用两个头影测量参考平面,即蝶鞍-鼻根平面和颅底-鼻根平面,评估面中部(前鼻棘-后鼻棘)的垂直和矢状关系。对参考标志点进行普洛透斯拟合。计算前鼻棘和后鼻棘标志点的平均位置和方差。所有结果采用置换检验进行分析。
两组患者在T1和T2期的前鼻棘-后鼻棘在垂直和矢状平面的平均位置或方差均无显著差异(p>.05)。
结果表明,术前牙槽塑形术和牙龈骨膜成形术(Millard术式)不影响面中部在矢状或垂直平面的生长发育(至9至13岁)。