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两种不同腭裂整复术式(非松弛切口)治疗的中国单侧完全性腭裂患儿颌骨生长的比较:初步研究。

A comparison of maxillofacial growth in Chinese children with isolated cleft palate treated with two different palatoplasty techniques without relaxing incisions: a preliminary study.

机构信息

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, ChengduSichuan, 610041, China.

Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Ibb, Yemen.

出版信息

BMC Oral Health. 2023 Nov 23;23(1):914. doi: 10.1186/s12903-023-03588-6.

Abstract

OBJECTIVE

To assess the maxillofacial growth of patients with isolated cleft palate following the Sommerlad-Furlow modified technique and compare it with the effect of the Sommerlad technique.

STUDY DESIGN

A Retrospective Cohort Study.

METHODS

A total of 90 participants, 60 patients with non-syndromic isolated soft and hard cleft palate (ISHCP) underwent primary palatoplasty without relaxing incision (30 patients received the Sommerlad-Furlow modified (S-F) technique and 30 received Sommerlad (S) technique). While the other 30 were healthy noncleft participants with skeletal class I pattern (C group). All participants had lateral cephalometric radiographs at least 5 years old age. All the study variables were measured by using stable landmarks, including 11 linear and 9 angular variants.

RESULTS

The means age at collection of cephalograms were 6.03 ± 0.80 (5-7 yrs) in the S group, 5.96 ± 0.76 (5-7 yrs) in the S-F group, and 5.91 ± 0.87 (5-7 yrs) in the C group. Regarding cranial base, the results showed that there were no statistically significant differences between the three groups in S-N and S-N-Ba. The S group had a significantly shortest S-Ba than the S-F & C groups (P = 0.01), but there was no statistically significant difference between S-F and C groups (P = 0.80). Regarding skeletal maxillary growth, the S group had significantly shorter Co-A, S- PM and significantly less SNA angle than the C group (P =  < 0.01). While there was no significant difference between S-F & C groups (P = 0.42). The S group had significantly more MP-SN inclination than the C group (P =  < 0.01). Regarding skeletal mandibular growth, there were no statistically significant differences in all linear and angular mandibular measurements between the three groups, except Co-Gn of the S group had a significantly shorter length than the C group (P = 0.05). Regarding intermaxillary relation, the S-F group had no significant differences in Co-Gn-Co-A and ANB as compared with the C group. The S group had significantly less ANB angle than S-F & C groups (P = 0.01 & P =  < 0.01). In addition, there were no significant differences in all angular occlusal measurements between the three groups.

CONCLUSION

As a preliminary report, Sommerlad-Furlow modified technique showed that maxillary positioning in the face tended to be better, and the intermaxillary relationship was more satisfactory than that in Sommerlad technique when compared them in healthy noncleft participants.

摘要

目的

评估采用 Sommerlad-Furlow 改良技术治疗单纯腭裂患者的颌面生长情况,并与 Sommerlad 技术的效果进行比较。

研究设计

回顾性队列研究。

方法

共有 90 名参与者,60 名非综合征性单纯软腭裂和硬腭裂患者(ISHCP)接受了未行松弛切口的初次腭裂修复术(30 名患者接受了 Sommerlad-Furlow 改良(S-F)技术,30 名患者接受了 Sommerlad 技术(S))。而另 30 名参与者为健康无腭裂的骨骼 I 类患者(C 组)。所有参与者的年龄均至少为 5 岁,均有侧位头颅侧位片。所有研究变量均使用稳定的解剖标志进行测量,包括 11 个线性和 9 个角度变量。

结果

S 组的平均收集头影测量片年龄为 6.03±0.80(5-7 岁),S-F 组为 5.96±0.76(5-7 岁),C 组为 5.91±0.87(5-7 岁)。关于颅底,三组之间 S-N 和 S-N-Ba 无统计学差异。S 组的 S-Ba 明显短于 S-F 和 C 组(P=0.01),但 S-F 和 C 组之间无统计学差异(P=0.80)。关于上颌骨的骨骼生长,S 组的 Co-A、S-PM 和 SNA 角明显小于 C 组(P<0.01)。而 S-F 和 C 组之间无显著差异(P=0.42)。S 组的 MP-SN 倾斜度明显大于 C 组(P<0.01)。关于下颌骨的骨骼生长,三组之间所有下颌骨线性和角度测量均无统计学差异,除了 S 组的 Co-Gn 明显短于 C 组(P=0.05)。关于颌间关系,S-F 组的 Co-Gn-Co-A 和 ANB 与 C 组无显著差异。S 组的 ANB 角明显小于 S-F 和 C 组(P=0.01 和 P=0.01)。此外,三组之间所有角度咬合测量均无显著差异。

结论

作为初步报告,与 Sommerlad 技术相比,Sommerlad-Furlow 改良技术在健康无腭裂的参与者中显示上颌骨定位更倾向于良好,且颌间关系更为满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cae/10668460/06e958cf7348/12903_2023_3588_Fig1_HTML.jpg

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