腭裂患者上颌骨发育不良的新治疗方法。牵引面弓结合微型钢板固位。

New treatment modality for maxillary hypoplasia in cleft patients. Protraction facemask with miniplate anchorage.

机构信息

Department of Orthodontics, Seoul National University, Seoul, South Korea.

出版信息

Angle Orthod. 2010 Jul;80(4):783-91. doi: 10.2319/073009-435.1.

Abstract

OBJECTIVE

To present cleft patients treated with protraction facemask and miniplate anchorage (FM/MP) in order to demonstrate the effects of FM/MP on maxillary hypoplasia.

MATERIALS AND METHODS

The cases consisted of cleft palate only (12 year 1 month old girl, treatment duration = 16 months), unilateral cleft lip and alveolus (12 year 1 month old boy, treatment duration = 24 months), and unilateral cleft lip and palate (7 year 2 month old boy, treatment duration = 13 months). Curvilinear type surgical miniplates (Martin, Tuttlinger, Germany) were placed into the zygomatic buttress areas of the maxilla. After 4 weeks, mobility of the miniplates was checked, and the orthopedic force (500 g per side, 30 degrees downward and forward from the occlusal plane) was applied 12 to 14 hours per day.

RESULTS

In all cases, there was significant forward displacement of the point A. Side effects such as labial tipping of the upper incisors, extrusion of the upper molars, clockwise rotations of the mandibular plane, and bite opening, were considered minimal relative to that usually observed with conventional protraction facemask with tooth-borne anchorage.

CONCLUSIONS

FM/MP can be an effective alternative treatment modality for maxillary hypoplasia with minimal unwanted side effects in cleft patients.

摘要

目的

介绍使用牵引面弓和微型板锚固(FM/MP)治疗唇腭裂患者,以展示 FM/MP 对上颌骨发育不全的影响。

材料和方法

该病例包括单纯腭裂(12 岁 1 个月大的女孩,治疗时间=16 个月)、单侧唇裂和牙槽裂(12 岁 1 个月大的男孩,治疗时间=24 个月)和单侧唇腭裂(7 岁 2 个月大的男孩,治疗时间=13 个月)。线性微型板(Martin,Tuttlinger,德国)被放置在上颌骨的颧骨支撑区。4 周后,检查微型板的活动度,并施加 500g 的矫形力(每侧 30 度向下和向前从咬合平面),每天 12 到 14 小时。

结果

所有病例均出现 A 点显著前移位。与传统的牙支抗牵引面弓相比,上切牙唇倾、上颌磨牙外展、下颌平面顺时针旋转、咬合打开等副作用被认为是最小的。

结论

FM/MP 可作为治疗唇腭裂患者上颌骨发育不全的有效替代治疗方法,副作用小。

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