Hohoff Ariane, Rabe Heike, Ehmer Ulrike, Harms Erik
Poliklinik für Kieferorthopädie, Universitätsklinikum, Westfälische Wilhelms-Universität, Münster, Germany.
Head Face Med. 2005 Oct 28;1:8. doi: 10.1186/1746-160X-1-8.
The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities.
A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison.
The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature.
Today's knowledge of a newborn's 'normal' palatal morphology is based on non-standardized and limited methodologies for measuring a three-dimensional shape. This shortcoming increases bias and is the reason for contradictory research results, especially if pathologic conditions like syndromes or prematurity are involved. Adequate measurement techniques are needed and the 'normal palatal morphology' should be defined prior to new clinical studies on palatal development.
早产作为“先天性”腭裂风险因素，增加正畸或正颌治疗需求的证据仍不充分。还需要进一步设计完善的临床研究。本综述的目的是对腭部发育研究的方法、混杂因素和结果进行基础分析。本综述的一个重点是对足月儿腭部的研究分析，因为了解“正常”情况是评估异常情况的前提。
采用基于Cochrane检索策略的检索模板，应用于10个医学数据库，以识别现有研究。通过在教科书、百科全书、参考文献列表和书目索引中的手工检索，识别出主要发表于1960年以前的文章。纳入了一个多世纪以来的英文、德文和法文资料。如果给出了关于体重、身长或成熟度的特定信息，则重新计算足月儿的数据。提取的值，特别是来自非英文文献来源的值，未经筛选直接提供以供比较。
检索策略共产生182篇文章，其中155篇文章留作最终分析。上世纪上半叶，足月儿腭部的形态学备受关注。评估腭部形态学主要采用两种方法：视觉描述和测量描述。大多数关于足月儿的研究缺乏可靠性测试。沟系统被认为是婴儿腭部的显著特征。足月儿腭部的形状在视觉和测量上可能有很大差异。性别、种族、分娩方式和鼻畸形被确定为导致腭部形态改变的因素。直到今天，新生儿腭部的解剖特征仍存在命名不统一的情况。
目前关于新生儿“正常”腭部形态的知识基于测量三维形状的非标准化和有限的方法。这一缺陷增加了偏差，是研究结果相互矛盾的原因，特别是在涉及综合征或早产等病理情况时。需要适当的测量技术，并且在新的腭部发育临床研究之前应先定义“正常腭部形态”。
