Linton J L
Woong Dental Clinic, Seoul, Korea.
Am J Orthod Dentofacial Orthop. 1998 May;113(5):526-37. doi: 10.1016/s0889-5406(98)70264-1.
Patients with complete unilateral cleft lip and palate present difficult growth problems. Their anteroposterior discrepancies in jaw and dentition are frequently so severe that some epidemiologic studies report the necessity of orthognathic surgery in 25% of their sample. The aims of this study were three-fold: (1) to delineate diagnostic measures in borderline surgical cases of unilateral cleft lip and palate, (2) to verify the significance of negative overjet as a measure of anteroposterior discrepancy, and (3) to compare these diagnostic measures with those of borderline surgical cases of noncleft Class III malocclusions. The sample consisted of 29 patients with unilateral cleft lip and palate and 25 noncleft Class III Korean patients (mean age, 18.69 years); all had crossbites of all four incisors. Each of their pretreatment study casts and cephalograms were analyzed. The group with unilateral cleft lip and palate was divided into two subgroups on the basis of the method of their anterior crossbite resolution; 18 subjects were treated with orthodontics alone (Cleft-NS) and 11 subjects with orthognathic surgery (Cleft-Surg). The noncleft Class III group was divided into two subgroups; 6 of the subjects were orthodontically treated (Cl III-NS), and 19 were surgically treated (Cl III-Surg). The group with unilateral cleft lip and palate showed smaller SNA and SNB angles than the noncleft Class III group, but the ANB angles and the amount of anterior crossbites showed no statistical differences. When the Cleft-NS and the Cleft-Surg groups were compared, the ANB angle and the Wits measurements were significantly different. When the Cl III-NS and Cl III-Surg groups were compared, the SNB, ANB, L1GoGn, Wits, and the crossbite showed significant differences. For borderline surgical Class III unilateral cleft lip and palate cases, ANB angle, Wits appraisal, and ABGoGn angle were critical diagnostic parameters. On the other hand, the magnitude of anterior crossbite, the negative overjet, was shown not to be a significant measure of anteroposterior discrepancy.
完全性单侧唇腭裂患者存在棘手的生长问题。他们颌骨和牙列的前后差异常常非常严重，以至于一些流行病学研究报告称，在其样本中有25%的患者需要进行正颌手术。本研究的目的有三个：（1）明确单侧唇腭裂临界手术病例的诊断方法；（2）验证负覆盖作为前后差异测量指标的意义；（3）将这些诊断方法与非腭裂III类错牙合临界手术病例的诊断方法进行比较。样本包括29例单侧唇腭裂患者和25例非腭裂韩国III类患者（平均年龄18.69岁）；所有患者均为四个切牙反牙合。对他们治疗前的研究模型和头影测量片进行了分析。单侧唇腭裂组根据前牙反牙合的解决方法分为两个亚组；18名受试者仅接受正畸治疗（唇腭裂-非手术组），11名受试者接受正颌手术（唇腭裂-手术组）。非腭裂III类组也分为两个亚组；6名受试者接受正畸治疗（III类-非手术组），19名受试者接受手术治疗（III类-手术组）。单侧唇腭裂组的SNA和SNB角比非腭裂III类组小，但ANB角和前牙反牙合的程度无统计学差异。比较唇腭裂-非手术组和唇腭裂-手术组时，ANB角和Wits测量值有显著差异。比较III类-非手术组和III类-手术组时，SNB、ANB、L1GoGn、Wits和反牙合有显著差异。对于临界手术的III类单侧唇腭裂病例，ANB角、Wits评估和ABGoGn角是关键的诊断参数。另一方面，前牙反牙合的程度，即负覆盖，并非前后差异的重要测量指标。
