Tahmasbi Soodeh, Jamilian Abdolreza, Showkatbakhsh Rahman, Pourdanesh Fereydoun, Behnaz Mohammad
Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Orthodontics, School of Dentistry, Islamic Azad University, Tehran, Iran.
Eur J Dent. 2018 Jul-Sep;12(3):393-397. doi: 10.4103/ejd.ejd_374_17.
The present study was designed to compare the effects of two surgical methods, anterior maxillary segmental distraction (AMSD) versus conventional Le Fort I osteotomy, on cephalometric changes of velopharyngeal area of patients with cleft lip and palate.
This study was conducted on 20 CLP in two groups. The first group had classic Le Fort I maxillary advancement and the second group had AMSD with a modified hyrax as an intraoral tooth-borne distractor. In the second group, 1 week after the surgery, activation of hyrax screw was started with the rate of 2 times a day for about 10 days. Initial and final lateral cephalograms were traced and analyzed by OrthoSurgerX software.
The changes in variables evaluating velopharyngeal status showed a significant difference between the two groups. In Group A (conventional), the mean of nasopharyngeal area and Nasopharynx floor length showed a significant increase ( < 0.05) after the surgery, while in Group B (DO), the trend of changes was vice-versa. The changes in SNA, overjet, and soft-tissue convexity were similar in both groups.
AMSD can improve facial profile, almost similar to the conventional Le Fort I advancement, while there is a significant decrease in nasopharyngeal; hereby there is no increase in the velopharyngeal sphincter.
本研究旨在比较两种手术方法，即上颌前部节段性牵张成骨术（AMSD）与传统的Le Fort I截骨术，对唇腭裂患者腭咽区域头影测量变化的影响。
本研究对20例唇腭裂患者进行分组研究。第一组采用经典的Le Fort I上颌前徙术，第二组采用AMSD并使用改良的Hyrax作为口腔内牙支持式牵张器。在第二组中，术后1周开始每天2次激活Hyrax螺钉，持续约10天。通过OrthoSurgerX软件对初始和最终的侧位头影测量片进行描记和分析。
评估腭咽状态的变量变化在两组之间存在显著差异。在A组（传统组）中，术后鼻咽部面积和鼻咽底部长度的平均值显著增加（<0.05），而在B组（牵张成骨组）中，变化趋势则相反。两组的SNA、覆盖和软组织凸度变化相似。
AMSD可以改善面部轮廓，几乎与传统的Le Fort I前徙术相似，同时鼻咽部显著减小；因此腭咽括约肌没有增加。
