Larson M, Hellquist R, Jakobsson O P
Eastman Institutet, Stockholm, Sweden.
Scand J Plast Reconstr Surg Hand Surg. 1998 Jun;32(2):203-12. doi: 10.1080/02844319850158831.
The aim of this study was to evaluate the influence of cleft size and surgical treatment on the development of permanent teeth in patients with isolated cleft palate. The series comprised 109 children with isolated cleft palate, 70 girls and 39 boys, including 14 patients with Robin sequence. The patients were grouped according to the sagittal extent of the palatal cleft, measured on dental casts obtained before the primary palate surgery. Forty-six children were treated by one-stage palatoplasty, and 63 in two stages. The dentition was studied on orthopantomograms taken at 5, 8, 11, and 14 years of age. Congenitally missing permanent teeth (third molars excluded) were found in 33 subjects (30%). Children with large clefts had significantly more missing teeth than children with small clefts. The tooth most usually missing was the mandibular second premolar, followed by the maxillary lateral incisor, and the upper second premolar. The incidence of dental malformation was 23%, mostly mild forms. Ectopic eruption of the upper first permanent molars was seen in 23 (45%) of the subjects with large clefts, and in 18 (31%) of those with small clefts. The surgical method did not significantly affect the direction of the eruption. There is a correlation between cleft size and hypodontia, dental deformity, and ectopic eruption. Children with Robin sequence had almost the same incidence of hypodontia, malformed teeth, and ectopic eruption as children with large clefts. There was no correlation between surgical method and ectopic eruption of the maxillary first permanent molars.
本研究的目的是评估腭裂大小和手术治疗对孤立性腭裂患者恒牙发育的影响。该系列包括109例孤立性腭裂患儿，其中70例女孩，39例男孩，包括14例患有罗宾序列的患者。根据腭裂的矢状范围对患者进行分组，该范围在初次腭裂手术前获取的牙模上测量。46例患儿接受一期腭裂修复术，63例接受两期修复术。在5岁、8岁、11岁和14岁时拍摄曲面断层片对牙列进行研究。在33名受试者（30%）中发现先天性恒牙缺失（不包括第三磨牙）。腭裂大的患儿比腭裂小的患儿缺失牙明显更多。最常缺失的牙齿是下颌第二前磨牙，其次是上颌侧切牙和上颌第二前磨牙。牙齿畸形的发生率为23%，大多为轻度畸形。在腭裂大的受试者中有23例（45%）出现上颌第一恒磨牙异位萌出，在腭裂小的受试者中有18例（31%）出现。手术方法对萌出方向没有显著影响。腭裂大小与牙列缺损、牙齿畸形和异位萌出之间存在相关性。患有罗宾序列的患儿与腭裂大的患儿在牙列缺损、牙齿畸形和异位萌出的发生率几乎相同。手术方法与上颌第一恒磨牙异位萌出之间没有相关性。
