Aksu Muge, Saglam-Aydinatay Banu, Akcan Cenk Ahmet, El Hakan, Taner Tulin, Kocadereli Ilken, Tuncbilek Gokhan, Mavili Mehmet Emin
Faculty of Dentistry, Department of Orthodontics, Hacettepe University, Ankara, Turkey.
J Oral Maxillofac Surg. 2010 Feb;68(2):254-9. doi: 10.1016/j.joms.2009.03.030. Epub 2010 Jan 15.
To evaluate skeletal and dental stability in adult cleft lip and palate patients treated with a rigid external distraction system at the end of distraction and during the postdistraction period.
Lateral cephalograms of 7 patients were obtained before distraction, at the end of distraction, and during the postdistraction period. The mean age before distraction was 21.56 +/- 4.73 years. The mean follow-up was 37.3 +/- 12.4 months.
The assessment of findings showed that skeletal maxillary sagittal movement was achieved in a superoanterior direction. The maxillary depth angle and effective maxillary length increased significantly (2 degrees and 9 mm, respectively) after distraction, whereas the palatal plane angle increased by 8 degrees , resulting in an anterior movement of the maxilla with a counterclockwise rotation. The lower facial height showed no significant changes after distraction. The sagittal movement of the upper incisors and the angulation of the upper first molars increased significantly (4.5 mm and 5.5 degrees , respectively). During the postdistraction period, the maxilla showed a slight relapse (22%). The effective maxillary length decreased by 2 mm. The palatal plane angle almost returned to its original position, showing 7 degrees of clockwise rotation. The lower facial height remained stable. The upper incisors moved anteriorly and the upper first molars showed a significant mesioangular change during follow-up.
After distraction, significant maxillary advancement was achieved with a counterclockwise rotation. The upper incisors moved labially, and the upper first molars angulated mesially. After 3 years, a 22% relapse rate was seen in the maxilla. The counterclockwise rotation of the maxilla was returned to its original position. The upper incisors moved more anteriorly.
评估采用坚固外牵张系统治疗的成年唇腭裂患者在牵张结束时及牵张后期的骨骼和牙齿稳定性。
获取7例患者在牵张前、牵张结束时及牵张后期的头颅侧位片。牵张前的平均年龄为21.56±4.73岁。平均随访时间为37.3±12.4个月。
结果评估显示，上颌骨在矢状面上向前上方移动。牵张后，上颌深度角和有效上颌长度显著增加（分别增加2°和9mm），而腭平面角增加了8°，导致上颌骨向前移动并逆时针旋转。牵张后下颌面部高度无显著变化。上颌切牙的矢状移动和上颌第一磨牙的倾斜度显著增加（分别为4.5mm和5.5°）。在牵张后期，上颌骨出现轻微复发（22%）。有效上颌长度减少2mm。腭平面角几乎恢复到原来位置，显示顺时针旋转7°。下颌面部高度保持稳定。随访期间，上颌切牙向前移动，上颌第一磨牙出现显著的近中倾斜变化。
牵张后，上颌骨显著前移并逆时针旋转。上颌切牙唇向移动，上颌第一磨牙近中倾斜。3年后，上颌骨出现22%的复发率。上颌骨的逆时针旋转恢复到原来位置。上颌切牙向前移动更多。
