Sumardi Sariesendy, Latief Benny S, Kuijpers-Jagtman Anne Marie, Ongkosuwito Edwin M, Bronkhorst Ewald M, Kuijpers Mette A R
Faculty of Dentistry, Department of Orthodontics, Universitas Indonesia, Jakarta, Indonesia.
Faculty of Dentistry, Department of Oral-Maxillofacial Surgery, Universitas Indonesia, Jakarta, Indonesia.
PeerJ. 2021 Dec 16;9:e12643. doi: 10.7717/peerj.12643. eCollection 2021.
Treatment of cleft lip and palate (CLP) requires a comprehensive interdisciplinary approach and long-term follow-up. Only a few studies are available that reported on changes after treatment, which showed that in particular the transverse dimension, in patients with CLP is prone to changes after treatment. However, those studies did not pay attention to concomitant changes in the mandibular arch that occur after treatment.
To evaluate mandibular transverse dental arch dimensions and interarch transverse changes in patients with complete non-syndromic unilateral cleft lip, alveolus, and palate (CUCLAP) up to five years after treatment.
Retrospective longitudinal study in 75 consecutive patients with CUCLAP directly after comprehensive treatment (T0), two (T2), and 5 years after treatment (T5). Great Ormond Street, London and Oslo (GOSLON) scores were available for all patients. Three-dimensional scans of all dental casts were made. Inter premolar and intermolar distances between the mandibular contralateral teeth were measured. The modified Huddart Bodenham (MHB index) was applied to assess the transverse interarch relationship. Paired t-tests and ANOVA were used to analyze transverse and interarch transverse changes. Linear regression analysis was done to define contributing factors.
Paired t-tests showed a significant decrease of the mandibular inter first and second premolar distances ( < 0.05) and an increase of the inter second molar distance, whilst the MHB Index deteriorated at all time points for all segments and for the total arch score ( < 0.05). Linear regression showed no significant contributing factors on the decrease of the transverse distances. However, inter arch transverse relationship was significantly affected by age at the end of treatment, missing maxillary lateral incisor space closure, and the GOSLON Yardstick score at the end of treatment ( < 0.05), especially during the first two years after treatment.
Changes occurred in the mandibular arch expressed as changes in the transverse dimensions and interarch relationship measured by the MHB Index. A younger age at the end of treatment, space closure for a missing maxillary lateral incisor and a higher GOSLON score at the end of treatment negatively influence the interarch transverse deterioration especially in the first two years after treatment. For the transverse dimensional changes in the mandibular arch such influencing factors could not be determined.
唇腭裂（CLP）的治疗需要综合的多学科方法和长期随访。仅有少数研究报告了治疗后的变化，这些研究表明，尤其是CLP患者的横向维度在治疗后容易发生变化。然而，这些研究没有关注治疗后下颌牙弓的伴随变化。
评估完全性非综合征性单侧唇、牙槽突和腭裂（CUCLAP）患者治疗后长达五年的下颌横向牙弓尺寸和牙弓间横向变化。
对75例连续的CUCLAP患者进行回顾性纵向研究，分别在综合治疗刚结束时（T0）、治疗后两年（T2）和治疗后五年（T5）进行。所有患者均有大奥蒙德街儿童医院-伦敦和奥斯陆（GOSLON）评分。对所有石膏模型进行三维扫描。测量下颌对侧牙齿之间的前磨牙间和磨牙间距离。应用改良的哈达特·博登纳姆（MHB指数）评估牙弓间横向关系。采用配对t检验和方差分析来分析横向和牙弓间横向变化。进行线性回归分析以确定影响因素。
配对t检验显示下颌第一和第二前磨牙间距离显著减小（<0.05），第二磨牙间距离增加，而MHB指数在所有时间点的所有节段和全牙弓评分中均恶化（<0.05）。线性回归显示横向距离减小无显著影响因素。然而，牙弓间横向关系在治疗结束时的年龄、上颌侧切牙间隙关闭缺失以及治疗结束时的GOSLON评分有显著影响（<0.05），尤其是在治疗后的头两年。
下颌牙弓发生了变化，表现为MHB指数测量的横向尺寸和牙弓间关系的变化。治疗结束时年龄较小、上颌侧切牙缺失间隙关闭以及治疗结束时较高的GOSLON评分对牙弓间横向恶化有负面影响，尤其是在治疗后的头两年。对于下颌牙弓的横向尺寸变化，无法确定此类影响因素。
