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日本单侧唇腭裂患者正畸治疗计划与戈斯隆量表评估的关系:一期腭裂修复术与二期腭裂修复术的比较

Relationship between Orthodontic Treatment Plan and Goslon Yardstick Assessment in Japanese Patients with Unilateral Cleft Lip and Palate: One-stage vs. Two-stage Palatoplasty.

作者信息

Ishii Takenobu, Sakamoto Teruo, Ishikawa Munetada, Yasumura Toshihiko, Miyazaki Haruyo, Sueishi Kenji

出版信息

Bull Tokyo Dent Coll. 2016;57(3):159-68. doi: 10.2209/tdcpublication.2016-0700.

DOI:10.2209/tdcpublication.2016-0700
PMID:27665693
Abstract

The present study targeted patients with unilateral cleft lip and palate (UCLP) undergoing either one - (Wardill technique) or two-stage palatoplasty (Perko technique). Correlations between Goslon Yardstick scores and orthodontic appliances used and whether an osteotomy was performed were investigated. No differences were observed between the two types of palatoplasty in terms of Goslon Yardstick scores. A palatal expander and protraction facemask were used in Phase I of orthodontic treatment. The palatal expander was selected for most patients with UCLP in Phase I, regardless of the surgical technique used. A protraction facemask was used in patients undergoing the Wardill procedure who had a Goslon Yardstick score placing them in Group 3 or 4. In contrast, a protraction facemask was used in patients undergoing the Perko procedure who had a Goslon Yardstick score placing them in Group 4. No significant differences were observed in the Goslon Yardstick scores yielded by either type of procedure. The Goslon Yardstick score in relation to whether an osteotomy was performed in Phase II as part of orthodontic treatment was determined, focusing on the relationship between that score and the palatoplasty method used. A protraction facemask was used in patients undergoing the Perko procedure, which eliminated the need for an osteotomy at a future date. However, a protraction facemask was also used in patients undergoing the Wardill option, and those patients were likely to require an osteotomy. In other words, the results suggest that the type of palatoplasty selected will determine the effectiveness of any orthodontic appliances used.

摘要

本研究针对接受一期腭裂修复术(Wardill 技术)或二期腭裂修复术(Perko 技术)的单侧唇腭裂(UCLP)患者。研究了 Goslon 评分与所使用的正畸矫治器以及是否进行截骨术之间的相关性。在 Goslon 评分方面,两种腭裂修复术类型之间未观察到差异。在正畸治疗的第一阶段使用了腭扩展器和前牵引面罩。在第一阶段,大多数单侧唇腭裂患者无论采用何种手术技术均选用腭扩展器。对于接受 Wardill 手术且 Goslon 评分处于 3 组或 4 组的患者使用前牵引面罩。相比之下,对于接受 Perko 手术且 Goslon 评分处于 4 组的患者使用前牵引面罩。两种手术方式所产生的 Goslon 评分均未观察到显著差异。确定了作为正畸治疗第二阶段一部分是否进行截骨术时的 Goslon 评分,重点关注该评分与所采用的腭裂修复术方法之间的关系。对于接受 Perko 手术的患者使用前牵引面罩,这消除了日后进行截骨术的必要性。然而,对于接受 Wardill 手术的患者也使用前牵引面罩,而这些患者可能需要进行截骨术。换句话说,结果表明所选择的腭裂修复术类型将决定所使用的任何正畸矫治器的效果。

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