Vig K W, Turvey T A
Clin Plast Surg. 1985 Oct;12(4):735-48.
The orthodontist's role in the cleft palate team requires close collaboration with the surgeons and other team members. The rationale of timing and sequencing of orthodontic treatment have been discussed in the various time frames, which for convenience have been considered as follows: (1) neonatal or infant maxillary orthopedics; (2) orthodontic considerations in the primary dentition; (3) mixed dentition orthodontics to include presurgical recommendations before an alveolar bone graft and its rationale for use in selected patients; and (4) orthognathic surgery combining an orthodontic and surgical approach to the correction of dental and skeletal components of malocclusion in the permanent dentition. Speech considerations and the communicative skills of the patient with a cleft are important aspects in planning orthognathic surgery for this group of patients. Also, subsequent nose and lip revisions for cosmetic improvement must not be underestimated in the enhancement of the final result following correction of the skeletal and dental discrepancies. Provided the timing and sequencing of appropriate treatment modalities are planned in a closely coordinated, problem-oriented approach by the team members, cleft patients should currently have optimal functional and esthetic results.
正畸医生在腭裂治疗团队中的角色需要与外科医生及其他团队成员密切协作。正畸治疗的时机和顺序原理已在不同时间框架下进行了讨论，为方便起见，可作如下考虑：（1）新生儿或婴儿上颌骨矫形；（2）乳牙列期的正畸考量；（3）混合牙列期正畸，包括牙槽骨植骨术前的手术建议及其在特定患者中的应用原理；（4）正颌外科手术，采用正畸与手术相结合的方法来矫正恒牙列错牙合的牙齿和骨骼组成部分。对于这组患者，语音考量以及腭裂患者的沟通能力是正颌外科手术规划中的重要方面。此外，在矫正骨骼和牙齿差异后的最终效果改善中，后续为改善美观而进行的鼻唇修复绝不可被低估。只要团队成员以密切协作、以问题为导向的方式规划适当治疗方式的时机和顺序，腭裂患者目前应能获得最佳的功能和美观效果。
