骨性上颌前牵引在单侧唇腭裂中的应用：头影测量评估。
Bone-anchored maxillary protraction in unilateral cleft lip and palate: a cephalometric appraisal.
机构信息
Department of Maxillofacial Surgery, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.
Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
出版信息
Eur J Orthod. 2019 Sep 21;41(5):537-543. doi: 10.1093/ejo/cjz005.
OBJECTIVES
The aim of this study was to evaluate the cephalometric outcome of bone-anchored maxillary protraction (BAMP) in individuals with unilateral complete cleft lip and palate (UCLP).
MATERIAL AND METHODS
The experimental group (EG) comprised 23 individuals (17 males and 6 females) with UCLP and a mean age of 11.7 years. At least 6 months after secondary alveolar bone grafting, Bollard miniplates were installed in the posterior region of the maxilla and in the anterior region of the mandible. Class III elastics were recommended to be worn for 24 hours/day for a mean time of 18 months. Cone beam computed tomography (CBCT) was obtained before (T1) and after treatment (T2). The control group (CG) consisted of 23 individuals with UCLP matched by initial age and gender with the EG and without any orthopaedic or surgical intervention performed between T1 and T2. The interval between T1 and T2 observations was 18 months for both groups. Twenty-one cephalometric variables were analysed. Intra- and intergroup comparisons were performed using paired and independent t-tests, respectively (P < 0.05).
RESULTS
BAMP caused a greater maxillary protrusion (SNA) and a greater decrease of Class III maxillomandibular discrepancy (ANB and Wits appraisal) compared with the CG. BAMP also caused a counterclockwise rotation of the occlusal plane (Occ Plane to FH) and an improvement in the molar relationship compared with controls.
CONCLUSIONS
BAMP therapy demonstrated a significant orthopaedic maxillary protraction and an improvement in the Class III skeletal pattern in UCLP.
目的
本研究旨在评估骨锚定上颌前牵引（BAMP）在单侧完全性唇腭裂（UCLP）患者中的头影测量结果。
材料和方法
实验组（EG）包括 23 名（17 名男性和 6 名女性）UCLP 患者，平均年龄为 11.7 岁。在二次牙槽骨移植后至少 6 个月，在上颌后区和下颌前区安装 Bollard 迷你板。建议全天佩戴 III 类弹性体，平均时间为 18 个月。在治疗前（T1）和治疗后（T2）获得锥形束 CT（CBCT）。对照组（CG）由 23 名 UCLP 患者组成，与 EG 按初始年龄和性别匹配，且在 T1 和 T2 之间未进行任何正畸或手术干预。两组 T1 和 T2 观察之间的间隔为 18 个月。分析了 21 个头影测量变量。使用配对和独立 t 检验分别进行组内和组间比较（P < 0.05）。
结果
与 CG 相比，BAMP 导致上颌更大的突出（SNA）和 III 类上颌下颌差异（ANB 和 Wits 评估）更大的减小。BAMP 还导致牙合平面（Occ Plane to FH）逆时针旋转，并改善了与对照组相比的磨牙关系。
结论
BAMP 治疗在 UCLP 中表现出显著的矫形上颌前牵引和 III 类骨骼模式的改善。
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