Kato Junya, Mikoya Tadashi, Ito Yumi, Sato Yoshiaki, Uematsu Setsuko, Kodama Yasumitsu, Susami Takafumi, Yamanishi Tadashi, Takagi Ritsuo
Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan.
Cleft Palate Craniofac J. 2022 Mar;59(3):355-364. doi: 10.1177/10556656211010606. Epub 2021 Apr 29.
To compare dental arch relationship outcomes following 3 different 2-stage palatal repair protocols.
Retrospective, cross sectional.
Three cleft palate centers (A, B, C) in Japan.
Ninety (A: 39, B: 26, C: 25) consecutively treated Japanese patients with complete unilateral cleft lip and palate.
In A, the soft palate and the posterior half of the hard palate were repaired at a mean age of 1 year 7 months. In B, the soft palate and hard palate were closed separately at a mean age of 1 year 6 months and 5 years 8 months, respectively. In C, the soft palate and hard palate were closed at a mean age of 1 year and 1 year 5 months, respectively.
Dental arch relationships were assessed using the 5-Year-Olds' (5-Y) index by 5 raters and the Huddart/Bodenham (HB) index by 2 raters.
Intra- and inter-rater reliabilities showed substantial or almost perfect agreement for the 5-Y and HB ratings. No significant differences in mean values and distributions of 5-Y scores were found among the 3 centers. The mean HB index scores of molars on the minor segment were significantly smaller in C than those in A and B ( < .05).
There were no significant differences in dental arch relationships at 5 years among the times and techniques of hard palate closure. However, further analysis of the possible influence of infant cleft size as a covariable on a larger sample size is needed.
比较3种不同的两阶段腭裂修复方案后的牙弓关系结果。
回顾性横断面研究。
日本的三个腭裂中心(A、B、C)。
90例(A组39例,B组26例,C组25例)连续接受治疗的日本完全性单侧唇腭裂患者。
在A组,软腭和硬腭后半部在平均1岁7个月时修复。在B组,软腭和硬腭分别在平均1岁6个月和5岁8个月时关闭。在C组,软腭和硬腭分别在平均1岁和1岁5个月时关闭。
由5名评估者使用5岁儿童(5-Y)指数和2名评估者使用Huddart/Bodenham(HB)指数评估牙弓关系。
评估者内和评估者间的可靠性显示,5-Y和HB评分具有高度或几乎完美的一致性。3个中心之间在5-Y评分的平均值和分布上未发现显著差异。C组小片段磨牙的平均HB指数得分显著低于A组和B组(P<0.05)。
硬腭关闭的时间和技术在5岁时的牙弓关系上没有显著差异。然而,需要在更大样本量上进一步分析婴儿腭裂大小作为协变量的可能影响。