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采用形态计量评估分析新生儿单侧和双侧唇腭裂在新生儿唇裂整复术后 12 个月内的腭部生长变化。

Palatal growth changes in newborns with unilateral and bilateral cleft lip and palate from birth until 12 months after early neonatal cheiloplasty using morphometric assessment.

机构信息

Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic.

Department of Software and Computer Science Education, Faculty of Mathematics and Physics, Charles University, Malostranské Náměstí 25, 118 00, Prague 1, Czech Republic.

出版信息

Clin Oral Investig. 2021 Jun;25(6):3809-3821. doi: 10.1007/s00784-020-03711-9. Epub 2021 Jan 6.

Abstract

OBJECTIVES

To compare palatal growth changes in infants with complete unilateral (UCLP) or bilateral (BCLP) cleft lip and palate during the first year of life.

MATERIALS AND METHODS

Upper dental arches of 68 neonates with UCLP and BCLP were evaluated using 2D and 3D morphometry based on dental casts obtained in two age categories (T0 before early neonatal cheiloplasty-UCLP 4 ± 3 days, BCLP 6 ± 5 days; T1 before palatoplasty-UCLP 10 ± 2 months, BCLP 12 ± 3 months).

RESULTS

Intensive palatal growth was manifested in both directions of the palate. Palatal growth in the anterior direction was not restricted, despite the intercanine (CC´) and anterior (LL´) widths being significantly narrowed in the BCLP group (CC´ p = 0.019, LL´ p = 0.009). The posterior dental arches were significantly enlarged (UCLP p ≤ 0.001; BCLP p ≤ 0.001). The negative effect of cleft severity on palatal length was not confirmed (p = 0.802). Variability of the palate was immense mainly in BCLP infants (T0); however, it decreased in both cleft types, confirming the formative effect of palatal growth leading to alveolar cleft closure (UCLP p ≤ 0.001; BCLP p = 0.006 on the right, 0.005 on the left).

CONCLUSIONS

Both analyzed cleft groups (UCLP, BCLP) grew favorably during the first year of life, and the palatal growth was not limited in any direction.

CLINICAL RELEVANCE

Geometric morphometry allowed a comprehensive analysis of the palate, which can contribute to the improvement of surgical methods.

摘要

目的

比较完全单侧唇腭裂(UCLP)和双侧唇腭裂(BCLP)婴儿在出生后第一年的腭部生长变化。

材料和方法

使用基于牙模的 2D 和 3D 形态测量法,对 68 例 UCLP 和 BCLP 新生儿的上牙弓进行评估,这些牙模是在两个年龄段获得的(T0:早期新生儿唇裂修复前-UCLP 为出生后 4 ± 3 天,BCLP 为出生后 6 ± 5 天;T1:腭裂修复前-UCLP 为 10 ± 2 个月,BCLP 为 12 ± 3 个月)。

结果

腭部呈现出向两个方向的强烈生长。尽管 BCLP 组的中切牙间距(CC´)和前牙间距(LL´)明显变窄,但腭部的前向生长不受限制(CC´p=0.019,LL´p=0.009)。后牙弓明显增大(UCLP p≤0.001;BCLP p≤0.001)。严重程度对腭部长度的负面影响未得到证实(p=0.802)。腭部的变异在 BCLP 婴儿中非常大(T0);然而,在两种腭裂类型中,这种变异都减少了,这证实了腭部生长对牙槽裂闭合的形成作用(UCLP p≤0.001;BCLP 右侧 p=0.006,左侧 p=0.005)。

结论

在出生后的第一年,这两种分析的腭裂组(UCLP、BCLP)都表现出有利的生长,腭部的生长没有受到任何方向的限制。

临床相关性

几何形态测量法允许对腭部进行全面分析,这有助于改进手术方法。

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