Department of Orthodontics and Pediatrics, Faculty of Dentistry, University of Sao Paulo, Sao Paulo, Brazil.
Plastic Surgery Sector, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil.
Cleft Palate Craniofac J. 2021 Oct;58(10):1265-1273. doi: 10.1177/1055665620984352. Epub 2021 Jan 25.
To compare occlusal relationship in patients undergoing neonate versus conventional lip surgery (LS) with and without infant orthopedics (IO) by assessment of dental arch relationship in individuals with complete unilateral cleft lip and palate.
Three groups treated by different protocols; Group I: neonate LS (1-15 days) + IO and palatoplasty (13-31 months); Group II: LS (3-12 months) + IO and palatoplasty (15-35 months); and Group III: LS (3-6 months) without IO and palatoplasty (12-18 months). The 112 intraoral photographs of individuals of all groups, obtained between 6 and 12 years of age, were assessed by the occlusal index for intraoral photograph rating. The groups were compared by the χ test. The correlation between surgical timing and the scores was tested by the Spearman test ( < .05).
Group I presented the highest percentage of score 5, group II exhibited highest percentage of score 1, and group III presented the lowest percentage of score 5 according to the χ test ( = .029). The Spearman correlation test revealed statistically significant difference between timing of LS and the occlusal index. The earlier the surgical timing, the higher the occlusal index ( = .019).
Infant orthopedics has demonstrated the possibility of postponing primary plastic surgeries. Patients submitted to late lip and palate repair had the best prognosis, while patients undergoing lip repair from 1 to 15 days of life, even operating the palate later, had the worst prognosis. Neonate LS negatively influenced the occlusal relationships.
通过评估单侧完全唇腭裂患者的牙弓关系,比较新生儿唇裂手术(LS)与传统 LS 联合(或不联合)婴儿矫形术(IO)的患者的咬合关系。
三组患者采用不同的治疗方案:I 组:新生儿 LS(1-15 天)+IO 和腭裂修复术(13-31 个月);II 组:LS(3-12 个月)+IO 和腭裂修复术(15-35 个月);III 组:LS(3-6 个月)+不进行 IO 和腭裂修复术(12-18 个月)。所有组别的患者在 6-12 岁时拍摄的 112 张口腔内照片,通过口腔内照片咬合指数评价进行评估。通过卡方检验比较各组之间的差异。采用 Spearman 检验( <.05)检测手术时机与评分之间的相关性。
根据卡方检验,I 组的评分 5 比例最高,II 组的评分 1 比例最高,III 组的评分 5 比例最低( =.029)。Spearman 相关性检验显示 LS 手术时机与咬合指数之间存在统计学差异。手术时机越早,咬合指数越高( =.019)。
婴儿矫形术可以推迟初次整形手术的时间。晚期唇腭裂修复的患者预后最佳,而在 1-15 天接受唇裂修复术的患者,即使随后行腭裂修复术,预后最差。新生儿 LS 对咬合关系有负面影响。