Mello Bianca Zeponi Fernandes, Ambrosio Eloá Cristina Passucci, Jorge Paula Karine, de Menezes Márcio, Carrara Cleide Felício Carvalho, Soares Simone, Valarelli Fabrício Pinelli, Moreira Machado Maria Aparecida Andrade, Oliveira Thais Marchini
Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru.
Department of Dentistry, School of Health Science, State University of Amazonas, Manaus.
J Craniofac Surg. 2019 Nov-Dec;30(8):2456-2458. doi: 10.1097/SCS.0000000000005775.
This study aimed to evaluate longitudinally the alteration of the dental arch dimensions of children with different oral cleft types, before and after the primary surgeries. Three-dimensional images of the maxillary dental casts of children with unilateral complete cleft lip (G1), unilateral complete cleft lip and palate (G2), and cleft palate (G3). The children were evaluated at pre-cheiloplasty (T1), pre-palatoplasty (T2), and 1 year after palatoplasty (T3). The measurements obtained: intercanine (C-C') and intertuberosity (T-T') distances, anterior (I-CC') and total (I-TT') arch lengths. To analyze the intraexaminer error, paired t-test was applied and Dahlbergh formula. The intragroups comparisons were applied: paired t-test, ANOVA followed by Tukey, Wilcoxon test, and Kruskal-Wallis test followed by Dunn test. The intergroup comparisons were performed by independent t-test and Mann-Whitney test. In G1, the C-C', T-T', and the I-TT' distances revealed a significant increase of the maxilla. In G2, the C-C' distance statistically decreased from T1 to T3, T-T' distance showed statistical increase from T1 to T3. The I-TT' length increased with statistically significant differences between T1 and T3, T2 and T3. In G3, the C-C', T-T', and I-TT' distance increased was statistically significant. The longitudinal evaluation of the changes occurred in the dental arches with different oral cleft types showed that cheiloplasty and palatoplasty caused the most alterations in the development of the maxillary dimensions of children with complete cleft lip and palate.
本研究旨在纵向评估不同类型口腔裂隙患儿在初次手术前后牙弓尺寸的变化。获取了单侧完全性唇裂患儿(G1组)、单侧完全性唇腭裂患儿(G2组)和腭裂患儿(G3组)上颌牙模的三维图像。在唇裂修复术前(T1)、腭裂修复术前(T2)以及腭裂修复术后1年(T3)对患儿进行评估。测量指标包括:尖牙间(C-C')和结节间(T-T')距离、前部(I-CC')和总牙弓长度(I-TT')。为分析检查者内误差,应用配对t检验和达尔伯格公式。组内比较采用:配对t检验、方差分析后进行Tukey检验、Wilcoxon检验,以及Kruskal-Wallis检验后进行Dunn检验。组间比较通过独立t检验和Mann-Whitney检验进行。在G1组中,C-C'、T-T'和I-TT'距离显示上颌骨显著增大。在G2组中,C-C'距离从T1到T3有统计学意义的减小,T-T'距离从T1到T3有统计学意义的增大。I-TT'长度在T1和T3、T2和T3之间有统计学意义的增加。在G3组中,C-C'、T-T'和I-TT'距离增加有统计学意义。对不同类型口腔裂隙患儿牙弓变化的纵向评估表明,唇裂修复术和腭裂修复术对完全性唇腭裂患儿上颌骨尺寸发育的影响最大。