Bühling Sarah, Selge Helena Mariella, Eslami Sara, Seifert Lukas Benedikt, Sayahpour Babak, Plein Nicolas, Sader Robert, Kopp Stefan
Department of Orthodontics, Johann-Wolfgang Goethe University, Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
Dental Practice, Frankfurter Street 3, 64293 Darmstadt, Germany.
Children (Basel). 2025 May 30;12(6):714. doi: 10.3390/children12060714.
This study investigated the effects of preoperative maxillary plates on cleft width reduction in infants with unilateral cleft lip and palate and their control group. The study also aimed to compare the digital and manual methods in measurement of changes in maxillary segment positioning in sagittal and transverse dimensions using digital 3D models and conventional plaster casts. Twenty infants with unilateral cleft lip and palate and their control group of eleven infants with isolated cleft palate were enrolled in a prospective interventional study (2020 to 2024). Participants were treated with either active or passive maxillary plates. Sagittal, transversal and angular measurements were taken both manually as well as digitally at three time points: 24-48 h postnatal (T0), approximately at six months old (T1, immediately before surgery), and one year postoperatively (T2). Significant reductions in cleft width were observed across all patients over the treatment period, regardless of the type of plate used ( < 0.001). The mean cleft width reduction was 5.050 mm. Infants treated with active plates had a larger reduction in cleft width than those with passive plates ( = 0.024), averaging 5.846 mm compared to 3.571 mm. Neither the side of the cleft nor the patient's gender influenced the degree of cleft reduction ( = 0.884 and = 0.245, respectively). The study found significant modifications in the maxilla's transverse, sagittal, and angular dimensions ( < 0.001). When comparing sagittal growth, the study group differed from the control group ( = 0.004), with isolated cleft palate patients showing more substantial sagittal expansion. Additionally, the overall change in the ITT' distance differed significantly between the study and control groups over time ( < 0.001). Cleft size at baseline did not affect the extent of changes within the cleft area. No significant discrepancies were found between digital and manual measurement methods, confirming the reliability of both. Active plates demonstrated greater efficacy in cleft reduction for wider and more divergent clefts, while passive plates were suitable for smaller clefts.
本研究调查了术前上颌板对单侧唇腭裂婴儿裂隙宽度减小的影响及其对照组情况。该研究还旨在使用数字3D模型和传统石膏模型，比较在矢状面和横断面上测量上颌骨段位置变化的数字测量方法和手工测量方法。20名单侧唇腭裂婴儿及其11名孤立性腭裂婴儿的对照组被纳入一项前瞻性干预研究（2020年至2024年）。参与者接受了主动或被动上颌板治疗。在三个时间点进行矢状面、横断面和角度测量，测量方法包括手工测量和数字测量：出生后24 - 48小时（T0）、大约六个月大时（T1，手术前即刻）和术后一年（T2）。在整个治疗期间，所有患者的裂隙宽度均显著减小，无论使用何种类型的上颌板（P < 0.001）。平均裂隙宽度减小了5.050毫米。接受主动上颌板治疗的婴儿裂隙宽度减小幅度大于接受被动上颌板治疗的婴儿（P = 0.024），平均减小5.846毫米，而后者为3.571毫米。裂隙侧别和患者性别均未影响裂隙减小程度（分别为P = 0.884和P = 0.245）。该研究发现上颌骨在横断、矢状和角度尺寸上有显著改变（P < 0.001）。比较矢状生长时，研究组与对照组不同（P = 0.004），孤立性腭裂患者矢状扩展更明显。此外，研究组和对照组之间ITT距离的总体变化随时间有显著差异（P < 0.001）。基线时的裂隙大小不影响裂隙区域内的变化程度。数字测量方法和手工测量方法之间未发现显著差异，证实了两者的可靠性。主动上颌板对更宽、更分散的裂隙在减小裂隙方面显示出更大疗效，而被动上颌板适用于较小的裂隙。
