Bergamo Mariel Tavares Oliveira Prado, Ambrosio Eloá Cristina Passucci, de Carvalho Carrara Cleide Felício, Machado Maria Aparecida Andrade Moreira, Oliveira Thais Marchini
Department of Pediatric Dentistry, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
Department of Pediatric Dentistry, Orthodontics and Public Heath, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
Odontology. 2025 Jul;113(3):1288-1295. doi: 10.1007/s10266-024-01048-3. Epub 2025 Jan 3.
This study aimed to compare the dimensional alterations of the dental arches and the palate symmetry in patients with unilateral complete cleft lip and palate before and after the performance of primary surgeries by different surgical techniques. The sample was divided into Group 1, G1 - cheiloplasty (Millard technique) and single-stage palatoplasty (von Langenbeck technique); Group 2, G2 - cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler and Sommerlad techniques). The digital dental models were evaluated before (Time 1, T1) and after (Time 2, T2) primary surgeries. The straight linear (I-C, I-T, C-T, I-C', I-T', C'-T') and angular measurements (< ICT, < CTT', < IC'T', < C'T'T) were performed. Statistical analysis was applied with α = 5%. In the intragroup analysis, G1 and G2 showed a significant increase in T2 for all linear parameters except I-C' and I-T' and a decrease in all angular parameters except for < IC'T' in G1 and < CTT' in G2. In the intergroup analysis, at T2, there was an increase in C-T and I-T' and a decrease in < ICT for G2. Regarding the asymmetry in T1, for G1 and G2, we observed asymmetry in I-C vs I-C', I-T vs I-T', C-T vs C'-T', and < CTT' vs < C'T'T analyses. At T2, we observed asymmetry in all parameters except for I-T vs I-T' in G1 and for C-T vs C'-T' in G2. It is concluded that in following single-stage palatoplasty, there is symmetry in the total segment length, while two-stage palatoplasty is specifically effective in preserving symmetry in the posterior segment length.
本研究旨在比较采用不同手术技术进行一期手术后，单侧完全性唇腭裂患者牙弓的尺寸变化和腭部对称性。样本分为1组（G1）——唇裂修复术（米勒德技术）和一期腭裂修复术（冯·兰根贝克技术）；2组（G2）——唇裂修复术（米勒德技术）和二期腭裂修复术（汉斯·皮克勒技术和索默拉德技术）。在一期手术前（时间1，T1）和术后（时间2，T2）对数字化牙模进行评估。进行直线测量（I-C、I-T、C-T、I-C'、I-T'、C'-T'）和角度测量（<ICT、<CTT'、<IC'T'、<C'T'T）。采用α = 5%进行统计分析。在组内分析中，G1和G2在T2时，除I-C'和I-T'外的所有线性参数均显著增加，G1中除<IC'T'外、G2中除<CTT'外的所有角度参数均降低。在组间分析中，在T2时，G2的C-T和I-T'增加，<ICT降低。关于T1时的不对称性，对于G1和G2，我们在I-C与I-C'、I-T与I-T'、C-T与C'-T'以及<CTT'与<C'T'T分析中观察到不对称性。在T2时，我们观察到除G1中的I-T与I-T'以及G2中的C-T与C'-T'外，所有参数均存在不对称性。结论是，采用一期腭裂修复术时，总节段长度存在对称性，而二期腭裂修复术在保留后段长度对称性方面特别有效。
