Mishima K, Sugahara T, Mori Y, Minami K, Sakuda M
Second Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Osaka University, Suita, Japan.
Cleft Palate Craniofac J. 1998 May;35(3):227-32. doi: 10.1597/1545-1569_1998_035_0227_eopoti_2.3.co_2.
To align the protruding premaxilla in infants with bilateral cleft lip and palate (BCLP), an intraoral appliance (i.e., Hotz plate) and an extraoral appliance consisting of a band covering the head and elastics are used as a presurgical orthopedic treatment in our clinic. The aim of this study was to analyze the configuration and position of the premaxilla and the vomer in infants with BCLP and to investigate the factors generating deviation and bending of the vomer and twisting of the premaxilla.
Palatal casts were obtained serially from 10 infants with complete BCLP from 1 to 3 months of age.
These casts were automatically measured using a highly accurate contact-type measuring apparatus. After three-dimensional wire frame models generated from the serial casts were automatically superimposed, the magnitude and direction of the shift were calculated. A discriminant analysis was used for investigation of predictor variables generating the twisting or bending vomer.
The vomer was found to be bent in two infants and the premaxilla was twisted in three infants. In the infants whose vomers were bent, the magnitude of the posterior shift of the premaxilla was greater than that of the inferior shift. A discriminant analysis indicated that at 1 month of age, a greater inclination and a smaller deviation of the vomer and a longer distance between the cleft edges of the lateral segments had a tendency to be associated with bending of the vomer or twisting of the premaxilla.
为了矫正双侧唇腭裂（BCLP）婴儿前颌骨突出的问题，在我们诊所，口内矫治器（即霍茨板）和由覆盖头部的带环及弹力带组成的口外矫治器被用作术前正畸治疗。本研究的目的是分析BCLP婴儿前颌骨和犁骨的形态及位置，并研究导致犁骨偏斜和弯曲以及前颌骨扭转的因素。
连续获取10例1至3个月大的完全性BCLP婴儿的腭模型。
使用高精度接触式测量仪器对这些模型进行自动测量。在对连续模型生成的三维线框模型进行自动叠加后，计算移位的大小和方向。采用判别分析来研究导致犁骨扭转或弯曲的预测变量。
发现2例婴儿的犁骨弯曲，3例婴儿的前颌骨扭转。在犁骨弯曲的婴儿中，前颌骨向后移位的幅度大于向下移位的幅度。判别分析表明，在1个月大时，犁骨的倾斜度较大、偏斜度较小以及外侧段裂隙边缘之间的距离较长，往往与犁骨弯曲或前颌骨扭转有关。
