Isik Aslan Belma, Gülşen Ayşe, Findikçioğlu Kemal, Uzuner Deniz, Üçüncü Neslihan
Department of Orthodontics, Faculty of Dentistry.
Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
J Craniofac Surg. 2018 Mar;29(2):e179-e184. doi: 10.1097/SCS.0000000000004243.
The purpose of this study was to evaluate and compare the efficacy of nasoalveolar molding (NAM) therapy in the improvement of alveolar and palatal cleft deformity on unilateral (UCLP) versus bilateral (BCLP) cleft lip and palate.
A total of 19 UCLP (14 boys and 5 girls) and 8 BCLP (7 boys and 1 girl) infants completed NAM therapy were included in this study. Standardized parameters of cleft width of alveol and palate were measured on photocopies taken from the pre- and post-treatment plaster casts. To assess the intragroup differences, paired-samples test in UCLP and Wilcoxon test in BCLP groups were used. Mann-Whitney U test was used to evaluate the differences between the groups.
Significant decreases in alveolar and palatal cleft gaps were achieved in an average period of 3.3 ± 1.9 and 3.7 ± 1.6 months in UCLP and BCLP patients, respectively. The alveolar cleft decreased 7.85 ± 4.59 mm in UCLP and 4.25 ± 3.13 and 3.81 ± 3.50 mm in right and left alveolar cleft sides in BCLP, respectively. The palatal clefts were decreased 4.63 ± 2.44 mm in medial and 3.72 ± 2.62 mm in posterior parts in UCLP. The decrements in BCLP were 3.00 ± 2.75 mm in medial and 2.88 ± 2.75 mm in posterior palatal cleft distances. No significant differences were determined in the amount of alveolar or palatal cleft closure between UCLP and BCLP groups. The only decrease in arch width was 1.39 mm in medial part of palate in UCLP.
The NAM device provides significant decreases in both alveolar and palatal cleft deformities in UCLP and BCLP infants, as compared with their birth status.
本研究旨在评估和比较鼻牙槽塑形(NAM)疗法对单侧唇腭裂(UCLP)和双侧唇腭裂(BCLP)患儿牙槽突裂和腭裂畸形的改善效果。
本研究纳入了19例完成NAM治疗的UCLP患儿(14例男性,5例女性)和8例完成NAM治疗的BCLP患儿(7例男性,1例女性)。在治疗前和治疗后的石膏模型影印件上测量牙槽突和腭裂宽度的标准化参数。为评估组内差异,UCLP组采用配对样本检验,BCLP组采用Wilcoxon检验。采用Mann-Whitney U检验评估两组之间的差异。
UCLP和BCLP患儿分别在平均3.3±1.9个月和3.7±1.6个月的时间内,牙槽突裂和腭裂间隙显著减小。UCLP患儿的牙槽突裂减小了7.85±4.59mm,BCLP患儿右侧和左侧牙槽突裂分别减小了4.25±3.13mm和3.81±3.50mm。UCLP患儿的腭裂在中部减小了4.63±2.44mm,在后部减小了3.72±2.62mm。BCLP患儿腭裂中部减小了3.00±2.75mm,后部减小了2.88±2.75mm。UCLP组和BCLP组在牙槽突裂或腭裂闭合量上未发现显著差异。UCLP患儿仅腭中部弓宽度减小了1.39mm。
与出生时相比,NAM装置可使UCLP和BCLP患儿的牙槽突裂和腭裂畸形均显著减小。