From the Department of Oral and Maxillofacial Surgery, Saint-Nazaire Hospital; Nantes Dental School; Department of Oral and Maxillofacial Surgery, Nantes University Hospital; and Cleft Lip and Palate Center, Clinique Jules Verne.
Plast Reconstr Surg. 2022 Sep 1;150(3):613e-624e. doi: 10.1097/PRS.0000000000009477. Epub 2022 Jul 1.
Maxillary lateral incisors are frequently missing in patients with cleft lip and/or palate. The aim of this study was to assess how orthodontic gap closure or prosthetic rehabilitation of the missing maxillary lateral incisor affected dental arch relationships and symmetry at the end of treatment. The authors also aimed to determine the effect of the level of oral hygiene on the decision made to manage the missing maxillary lateral incisor gap.
A descriptive, retrospective cohort study including all patients with cleft lip and/or palate born between 1980 and 1999 and treated at Nantes Cleft Center was performed. Patients presenting unilateral or bilateral missing maxillary lateral incisors were reviewed. Data on management of the missing incisor gap, dental arch relationships, symmetry, and level of oral hygiene were collected.
A total of 486 patients with cleft lip and/or palate were reviewed, including 212 patients with unilateral or bilateral missing maxillary lateral incisors. When compared with orthodontic gap closure, prosthetic replacement of the gap was associated with better final dental arch relationships (59.8 percent versus 10.3 percent; p < 0.01) and better dental arch symmetry (88.1 percent versus 44.0 percent; p < 0.01) for patients with unilateral missing incisors but not for patients with bilateral missing incisors. A higher level of oral hygiene was associated with more cases of prosthetic replacement for patients with unilateral missing incisors ( p = 0.03) but had no effect for patients with bilateral missing incisors.
Prosthetic replacement of the missing maxillary lateral incisor gap provided better functional and aesthetic results for patients with cleft lip and/or palate presenting with unilateral missing maxillary lateral incisor.
唇腭裂患者常缺失上颌侧切牙。本研究旨在评估缺失的上颌侧切牙的正畸间隙关闭或修复治疗对治疗结束时牙弓关系和对称性的影响。作者还旨在确定口腔卫生水平对决定如何处理缺失的上颌侧切牙间隙的影响。
进行了一项描述性、回顾性队列研究，纳入了所有 1980 年至 1999 年间出生并在南特腭裂中心接受治疗的唇腭裂患者。回顾了单侧或双侧缺失上颌侧切牙的患者。收集了缺失侧切牙间隙的处理、牙弓关系、对称性和口腔卫生水平的数据。
共回顾了 486 例唇腭裂患者，其中 212 例单侧或双侧缺失上颌侧切牙。与正畸间隙关闭相比，间隙的修复治疗与更好的最终牙弓关系（59.8%对 10.3%；p<0.01）和更好的牙弓对称性（88.1%对 44.0%；p<0.01）相关，单侧缺失切牙的患者，但对于双侧缺失切牙的患者则不然。更高的口腔卫生水平与单侧缺失切牙患者更多的修复治疗病例相关（p=0.03），但对于双侧缺失切牙患者则没有影响。
对于单侧缺失上颌侧切牙的唇腭裂患者，缺失上颌侧切牙间隙的修复治疗提供了更好的功能和美学效果。
