Matsumura Takashi, Kawanabe Hitoshi, Nemoto Naoko, Ogino Saki, Fukui Kazunori, Oyama Akihiko, Okamoto Toru
Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Ohu University, 31-1 Triangular Hall, Tomita-cho, Koriyama 963-8611, Fukushima, Japan.
Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Ohu University, 31-1 Triangular Hall, Tomita-cho, Koriyama 963-8611, Fukushima, Japan.
J Pers Med. 2022 Oct 20;12(10):1741. doi: 10.3390/jpm12101741.
A two-stage surgical procedure involving labioplasty and palatoplasty is a common surgical modality performed in children with cleft lip and palate. Additionally, an alveolar cleft bone graft is performed prior to the eruption of the canine teeth. These three surgeries impose the burden of general anesthesia separately for each procedure, and the formation of scar tissue from the procedure inhibits maxillary growth. We adopted a single-stage surgical procedure to overcome these drawbacks. To date, there have been no reports comparing the treatment outcomes of alveolar morphology and maxillary growth and development in children who underwent single-stage surgery with those who underwent two-stage surgery using plaster casts and cephalograms. Twenty children aged 5-7 years were equally divided into two groups based on whether they had undergone a two- or single-stage procedure. Cephalometric analysis and analysis of dentition models were conducted. The results showed that the single-stage surgery exhibited significant differences in the sella-nasion angle, point A to McNamara line, maxillary length, mandibular body length, and posterior arch width and length compared with the two-stage surgery. Therefore, it was suggested that the single-stage surgery had a favorable effect on maxillary growth compared with the two-stage surgery.
一种包括唇成形术和腭成形术的两阶段手术程序是唇腭裂患儿常见的手术方式。此外，在尖牙萌出之前进行牙槽嵴裂植骨术。这三种手术每次都要分别承担全身麻醉的负担，而且手术形成的瘢痕组织会抑制上颌骨生长。我们采用了单阶段手术程序来克服这些缺点。迄今为止，尚无报告使用石膏模型和头影测量片比较接受单阶段手术的儿童与接受两阶段手术的儿童在牙槽形态以及上颌生长发育方面的治疗结果。根据是否接受两阶段或单阶段手术程序，将20名5至7岁的儿童平均分为两组。进行了头影测量分析和牙列模型分析。结果显示，与两阶段手术相比，单阶段手术在蝶鞍-鼻根点角、A点至麦克纳马拉线、上颌长度、下颌体长以及后牙弓宽度和长度方面存在显著差异。因此，有人提出与两阶段手术相比，单阶段手术对上颌骨生长具有有利影响。
