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唇腭裂患者正畸治疗远期复发的预测因素。一项临床随访研究。

Predictors for long-term relapse of orthodontic treatment in patients with cleft lip and palate. A clinical follow-up study.

机构信息

Department of Orthodontics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 32, 50937, Cologne, Germany.

出版信息

Clin Oral Investig. 2024 Apr 3;28(4):239. doi: 10.1007/s00784-024-05632-3.

Abstract

OBJECTIVES

To identify predictors for long-term relapse of orthodontic therapy in patients with cleft lip and palate (CLP).

MATERIALS AND METHODS

Patients with uni- and bilateral non-syndromal CLP were followed up at least two years after completion of their orthodontic therapy. Plaster casts of the start of treatment (T1), after completion of treatment (T2), and at follow-up (T3) were measured using the modified Huddart Bodenham Index. Characteristics of multidisciplinary therapy were taken from the patient files. Potentially influencing factors of relapse were investigated using logistic regression analyses and Spearman correlations.

RESULTS

In total 58.07% of the included 31 patients showed a stable treatment outcome at follow-up after an average of 6.9 years. Even if relapse occurred, 61.54% of these patients still showed improvement regarding their occlusion compared to baseline. Predictors for the occurrence of relapse were the severity of dysgnathia at baseline (p = 0.039) and the extent of therapeutic change (p = 0.041). The extent of therapeutic change was additionally a predictor for the extent of post-therapeutic relapse (ρ = 0.425; p = 0.019).

CONCLUSIONS

Patients with CLP benefit from their orthodontic therapy in the long term despite an increased tendency to relapse.

CLINICAL RELEVANCE

Results of this long-term study could be used to adapt the treatment concept for patients with CLP and reinforce the significance of a patient-centered orthodontic treatment concept for affected patients.

摘要

目的

确定唇腭裂(CLP)患者正畸治疗长期复发的预测因素。

材料与方法

对至少在正畸治疗完成后两年接受随访的单侧和双侧非综合征性 CLP 患者进行研究。使用改良的 Huddart Bodenham 指数对治疗开始时(T1)、治疗完成时(T2)和随访时(T3)的石膏模型进行测量。从患者档案中获取多学科治疗的特征。使用逻辑回归分析和 Spearman 相关分析调查复发的潜在影响因素。

结果

在 31 名纳入患者中,有 58.07%的患者在平均 6.9 年的随访中表现出稳定的治疗效果。即使发生复发,其中 61.54%的患者在咬合方面仍较基线有所改善。复发的预测因素为基线时的错畸形严重程度(p=0.039)和治疗变化程度(p=0.041)。治疗变化程度也是治疗后复发程度的预测因素(ρ=0.425;p=0.019)。

结论

尽管存在较高的复发倾向,但 CLP 患者仍能从长期的正畸治疗中获益。

临床相关性

这项长期研究的结果可用于调整 CLP 患者的治疗方案,并加强对受影响患者以患者为中心的正畸治疗理念的重要性。

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