Department of Plastic Surgery, Kobe Children's Hospital, 1-1-1 Takakuradai Suma-Ku, Kobe, Japan.
Department of Plastic Surgery, Kobe Children's Hospital, 1-1-1 Takakuradai Suma-Ku, Kobe, Japan.
J Plast Reconstr Aesthet Surg. 2014 Feb;67(2):167-72. doi: 10.1016/j.bjps.2013.10.017. Epub 2013 Oct 26.
For patients with a wide, complete, unilateral cleft lip and palate, pre-surgical maxillary orthodontic treatments have been used to reduce the alveolar gap before cheiloplasty. However, most of these treatments are complicated and laborious for patients and for medical professionals. Thus, we developed an original pre-surgical orthodontic device made with two separate acrylic resin plates connected with a spring-shaped β-titanium wire (β-TW). When the device was applied on the palate, each segment of the maxilla was automatically aligned for our target formation with the elastic force of β-titanium alloy. This study aimed to evaluate the efficacy of the new device and the size of the maxilla in comparison with the conventional Hotz procedures.
A total of 47 patients with a wide unilateral cleft lip and palate were retrospectively evaluated; 33 patients were treated with our new device (β-TW plate group) and 14 were treated with a Hotz plate (HP group). We evaluated the alveolar gap reduction and the size of the maxilla between the two groups, obtaining intraoral maxillary impressions at birth, at 3 months and 1 year.
The width of the alveolar gap in the β-TW plate group was significantly reduced compared with that in the HP group 1 month after the treatment (p < 0.001). The alveolar gap reduction continued until the age of 1 year (p = 0.02). By contrast, no significant difference in the maxillary size was observed between the two groups at any examination period.
Our treatment protocol using the β-TW plate was not only easy and simple to apply but it was also cost-effective, with highly predictable outcomes. Moreover, it provided the ideal alveolar cleft reduction without detrimental collapse of the alveolar segments. Therefore, we consider our β-TW plate device to be useful for application in pre-surgical orthodontic treatments.
对于单侧完全性宽裂隙唇腭裂患者，术前上颌骨矫形治疗已被用于唇裂整复前缩小牙槽裂隙。然而，这些治疗方法大多对患者和医疗专业人员来说既复杂又费力。因此，我们开发了一种由两个独立的丙烯酸树脂板通过β钛合金弹簧形丝（β-TW）连接而成的原始术前正畸装置。当该装置应用于腭部时，上颌骨的每一段都在β钛合金弹性力的作用下自动对准我们的目标形态。本研究旨在评估新型装置与传统 Hotz 手术相比对上颌骨大小的疗效。
共回顾性评估了 47 例单侧宽裂隙唇腭裂患者；33 例患者接受我们的新型装置（β-TW 板组）治疗，14 例患者接受 Hotz 板（HP 组）治疗。我们比较了两组患者牙槽裂隙缩小和上颌骨大小，在出生时、3 个月和 1 岁时获得口腔上颌内托印模。
β-TW 板组治疗 1 个月后牙槽裂隙宽度明显小于 HP 组（p<0.001）。牙槽裂隙缩小一直持续到 1 岁（p=0.02）。相比之下，两组在任何检查期内上颌骨大小均无显著差异。
我们使用β-TW 板的治疗方案不仅易于操作，而且经济实惠，具有高度可预测的效果。此外，它提供了理想的牙槽裂隙缩小，而不会导致牙槽段的不利塌陷。因此，我们认为我们的β-TW 板装置在术前正畸治疗中具有应用价值。
