Zemann Wolfgang, Mossböck Rudolf, Kärcher Hans, Kozelj Vesna
Department of Oral and Maxillofacial Surgery, University Hospital Graz, Austria.
J Craniomaxillofac Surg. 2007 Dec;35(8):343-9. doi: 10.1016/j.jcms.2007.05.005. Epub 2007 Oct 22.
The purpose of the study was to compare sagittal growth of the facial skeleton of 6-year-old children treated in two cleft centres with different surgical protocols.
Each group consisted of 20 consecutive non-syndromic children with complete unilateral cleft lip, alveolus and palate. They all had presurgical orthopaedics with a passive plate and external strapping until lip repair. Centre 1 had lip repair at the age of 3 months and one stage palatal closure at the age of 1 year. Closure of the alveolar cleft was planned at 9 years with bone grafting. In centre 2 lip repair was performed at the age of 6 months, soft palate repair at 12 months and hard palate repair together with mucoperiosteal closure of the alveolar cleft at the age of 30 months. At the time of investigation, the children from both centres had not received any postoperative orthodontic treatment. Sagittal growth was evaluated on lateral cephalograms using the angles SNA, SNB, ANB and SNPg. For control, Droschl standards were used. The Mann-Whitney U test was used for statistical analysis.
There was no statistically significant difference in SNA, SNB, ANB and SNPg between the centres at the age of 6 years. There were no children with a class III jaw relationship. The sagittal dimensions were close to the values of non-cleft control persons (Droschl standards).
There was considerable similar sagittal growth of the facial skeleton in both centres which has not been affected by the different surgical protocols so far. A final evaluation should be delayed until the growth of the facial skeleton is complete.
本研究旨在比较在两个采用不同手术方案的腭裂治疗中心接受治疗的6岁儿童面部骨骼的矢状面生长情况。
每组由20名连续的非综合征性单侧完全性唇腭裂儿童组成。他们在唇修复前均接受了被动矫治器和外部包扎的术前正畸治疗。中心1在3个月大时进行唇修复,1岁时进行一期腭裂关闭。牙槽突裂计划在9岁时进行植骨修复。在中心2,唇修复在6个月大时进行,软腭修复在12个月大时进行,硬腭修复及牙槽突裂的黏骨膜关闭在30个月大时进行。在调查时,两个中心的儿童均未接受任何术后正畸治疗。使用SNA、SNB、ANB和SNPg角在头颅侧位片上评估矢状面生长情况。作为对照,采用Droschl标准。采用曼-惠特尼U检验进行统计分析。
6岁时,两个中心在SNA、SNB、ANB和SNPg方面无统计学显著差异。没有Ⅲ类颌关系的儿童。矢状面尺寸接近非腭裂对照人群的值(Droschl标准)。
两个中心面部骨骼的矢状面生长情况相当相似,目前尚未受到不同手术方案的影响。最终评估应推迟到面部骨骼生长完成后。