Rong M R
Department of second Orthodontics, Faculty of Dentistry, Tokyo Medical and Dental University.
Kokubyo Gakkai Zasshi. 1994 Dec;61(4):492-511.
This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex.
本研究旨在通过计算机断层扫描（CT）阐明唇腭裂（CLP）患者鼻上颌复合体的三维特征，并研究上颌牙弓扩弓后其变化情况。对11名单侧唇腭裂男孩（UCLP）、6名双侧唇腭裂男孩（BCLP）和4名非腭裂男孩（非腭裂）获取了层厚2mm的连续CT图像。此外，利用UCLP患者牙弓扩弓前后的两组上颌石膏模型以及CT图像，评估牙弓扩弓对鼻上颌复合体的影响。与非腭裂患者相比，UCLP表现出明显的鼻上颌畸形，其特征为上颌窦体积减小。腭裂侧与非腭裂侧鼻腔的体积和形状均存在显著差异。然而，除牙槽弓体积减小外，BCLP的鼻上颌形态与非腭裂患者相似。UCLP和BCLP的比较研究显示鼻上颌形态存在显著差异。牙弓扩弓与鼻上颌各组成部分的变化之间存在一些显著相关性，提示扩弓力对UCLP患者鼻上颌复合体有影响。然而，扩弓力引起的变形因鼻上颌复合体的各组成部分而异。
