Yatabe Marília, Garib Daniela Gamba, Faco Renato André de Souza, de Clerck Hugo, Janson Guilherme, Nguyen Tung, Cevidanes Lucia Helena Soares, Ruellas Antonio Carlos
Hospital for Rehabilitation of Craniofacial Anomalies, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Hospital for Rehabilitation of Craniofacial Anomalies, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil; Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 2017 Sep;152(3):327-335. doi: 10.1016/j.ajodo.2016.12.024.
INTRODUCTION: The aim of this study was to 3-dimensionally assess the treatment outcomes of bone-anchored maxillary protraction (BAMP) in patients with unilateral cleft lip and palate. METHODS: The cleft group comprised 24 patients with unilateral cleft lip and palate and Class III malocclusion with mean initial and final ages of 11.8 and 13.2 years, respectively. The noncleft group comprised 24 noncleft patients with Class III malocclusion with mean initial and final ages of 11.9 and 12.9 years, respectively. Cone-beam computed tomography examinations were performed before and after BAMP therapy in both groups and superimposed at the cranial base. Three-dimensional displacements of maxillary landmarks were quantified and visualized with color-coded maps and semitransparent superimpositions. The t test corrected for multiple testing (Holm-Bonferroni method), and the paired t test was used for statistical comparison between groups and sides, respectively (P <0.05). RESULTS: BAMP produced anterior (1.66 mm) and inferior (1.21 mm) maxillary displacements in the cleft group with no significant differences compared with the noncleft group. The maxillary first molars of the cleft group showed significantly greater medial displacement than did those in the noncleft group. The zygoma showed significantly greater lateral displacement at the cleft side compared with the noncleft side. CONCLUSIONS: BAMP caused similar amounts of maxillary protraction in patients with and without unilateral cleft lip and palatem with discrete differences between the cleft side and the noncleft side.
引言:本研究旨在三维评估骨锚式上颌前牵引(BAMP)治疗单侧唇腭裂患者的效果。 方法:腭裂组包括24例单侧唇腭裂且伴有III类错牙合畸形的患者,平均初始年龄和最终年龄分别为11.8岁和13.2岁。非腭裂组包括24例III类错牙合畸形的非腭裂患者,平均初始年龄和最终年龄分别为11.9岁和12.9岁。两组患者在BAMP治疗前后均进行锥形束计算机断层扫描检查,并在颅底进行叠加。用上色地图和半透明叠加图对颌骨标志点的三维位移进行量化和可视化。采用校正多重检验的t检验(holm - bonferroni法),配对t检验分别用于组间和两侧之间的统计学比较(P<0.05)。 结果:腭裂组BAMP治疗后上颌产生了向前(1.66mm)和向下(1.21mm)的位移,与非腭裂组相比无显著差异。腭裂组上颌第一磨牙的向内侧位移明显大于非腭裂组。与非腭裂侧相比,腭裂侧颧骨的向外侧位移明显更大。 结论:BAMP在有或无单侧唇腭裂的患者中引起了相似程度的上颌前牵引,腭裂侧和非腭裂侧存在明显差异。
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