Wyrębek Beata, Cudziło Dorota, Plakwicz Paweł
Department of Periodontology, Medical University of Warsaw, Poland.
Head of Department of Maxillofacial Orthopaedics and Orthodontics, Institute of Mother and Child in Warsaw, Poland.
Dev Period Med. 2017;21(2):154-161. doi: 10.34763/devperiodmed.20172102.154161.
To evaluate the periodontal status, mucogingival parameters and oral hygiene in growing patients with bilateral cleft lip and palate.
Assessment was performed in 15 patients aged 6 to 18 years with a bilateral cleft. Records included probing pocket depth, clinical attachment level, keratinized gingiva, recession, vestibule depth, biotype, type of fraena, dental plaque and bleeding.
The mean scores of pocket depth were: 1.9 mm for central incisors, 1.6 mm for lateral incisors, 1.7 mm for canines, 2.0 mm for first premolars. There were only a few teeth with minimal attachment loss (1 mm). Gingival recessions were not recorded. High scores were recorded for the hygiene indicator, especially on the buccal, mesial and distal surfaces. Due to soft and hard tissue malformations, it was difficult to precisely assess the biotype and keratinized gingiva. However, keratinized gingiva was narrower near the teeth adjacent to the cleft. Similarly, the vestibule was shallower in this area. In 12 out of 15 children it was impossible to define the type of labial fraenum.
Evaluation of the periodontal status is important for successful comprehensive rehabilitation in cleft patients. Specific features of hard (alveolar process) and soft tissue (scars, unusual fraena) malformations caused by the cleft and previous surgical procedures have functional and morphological implications. Narrower gingiva and a shallower vestibule in the presence of dental plaque and bleeding are unfavourable conditions to maintain a healthy periodontium. It is essential to include periodontal assessment and preventive treatment to a comprehensive approach as early as possible.
评估双侧唇腭裂生长发育期患者的牙周状况、黏膜牙龈参数及口腔卫生情况。
对15例6至18岁的双侧唇腭裂患者进行评估。记录内容包括探诊深度、临床附着水平、角化龈、牙龈退缩、前庭深度、生物学宽度、系带类型、牙菌斑及出血情况。
各牙位的平均探诊深度为：中切牙1.9mm，侧切牙1.6mm，尖牙1.7mm，第一前磨牙2.0mm。仅有少数牙齿有轻微附着丧失（1mm）。未记录到牙龈退缩情况。卫生指标得分较高，尤其是在颊侧、近中面和远中面。由于软硬组织畸形，难以精确评估生物学宽度和角化龈情况。然而腭裂附近牙齿处的角化龈较窄。同样，该区域的前庭较浅。15名儿童中有12名无法确定唇系带类型。
评估牙周状况对唇腭裂患者成功进行综合康复治疗很重要。腭裂及既往手术造成的硬组织（牙槽突）和软组织（瘢痕、异常系带）畸形的特殊特征具有功能和形态学上的影响。在存在牙菌斑和出血的情况下，较窄的牙龈和较浅的前庭不利于维持健康的牙周组织。尽早将牙周评估和预防性治疗纳入综合治疗方案至关重要。
