Holst Alexandra I, Holst Stefan, Nkenke Emeka, Fenner Matthias, Hirschfelder Ursula
University Clinic Erlangen, Dental Clinic, Department of Orthodontics, Germany.
Cleft Palate Craniofac J. 2009 Sep;46(5):512-20. doi: 10.1597/08-041.1. Epub 2009 Feb 5.
To investigate whether the craniofacial vertical and sagittal jaw relationship in patients with cleft lip and palate (CLP) differed from that of age-matched noncleft controls, before and after the pubertal growth spurt.
Retrospective observational study.
The study group comprised 126 patients with CLP, subdivided according to gender and cleft type, and the control group comprised 53 age-matched skeletal class I patients.
Angular and linear measurements were taken from prepubertal and postpubertal lateral cephalograms of all patients.
In patients with cleft lip and palate, the maxillary retrognathism became more remarkable with increasing age; whereas, the retrognathic position of the mandible became less pronounced as compared with controls. Reduced posterior midfacial height, a common prepubertal finding in patients with cleft lip and palate, was significant in postpubertal girls and young women with unilateral cleft lip and palate (p = .002). The total anterior facial height in male patients with bilateral cleft lip and palate was larger than in control patients (p = .002) after the pubertal growth spurt due to an increased anterior midfacial height. In male patients with unilateral cleft lip and palate, this finding was due to an increased anterior lower facial height (p < .001).
Patients with cleft lip and palate treated according to a standardized treatment concept had adequate craniofacial jaw relationships after puberty. Despite a measured skeletal class I in both male and female patients with cleft lip and palate regardless of cleft type, there was a slight tendency toward a skeletal class III. Findings were similar for all groups of cleft lip and palate patients irrespective of the type of orthodontic treatment performed.
研究唇腭裂(CLP)患者在青春期生长突增前后,其颅面垂直和矢状颌关系是否与年龄匹配的非腭裂对照组不同。
回顾性观察研究。
研究组包括126例唇腭裂患者,根据性别和腭裂类型进行细分,对照组包括53例年龄匹配的骨骼I类患者。
对所有患者青春期前和青春期后的侧位头影测量片进行角度和线性测量。
在唇腭裂患者中,上颌后缩随着年龄增长变得更加明显;而与对照组相比,下颌后缩位置不那么明显。面中部后份高度降低是唇腭裂患者青春期前常见的表现,在青春期后的单侧唇腭裂女孩和年轻女性中显著(p = 0.002)。由于面中部前份高度增加,双侧唇腭裂男性患者在青春期生长突增后,其全面前份高度大于对照组患者(p = 0.002)。在单侧唇腭裂男性患者中,这一发现是由于面下部前份高度增加(p < 0.001)。
按照标准化治疗理念治疗的唇腭裂患者在青春期后有足够的颅面颌关系。尽管无论腭裂类型如何,唇腭裂男性和女性患者测量结果均为骨骼I类,但仍有轻微的骨骼III类倾向。无论进行何种正畸治疗,所有唇腭裂患者组的结果相似。