da Silva Filho O G, de Castro Machado F M, de Andrade A C, de Souza Freitas J A, Bishara S E
Hospital for Research and Rehabilitation of Cleft Lip and Palate, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 1998 Aug;114(2):154-61. doi: 10.1053/od.1998.v114.a86380.
Literature has shown that, even with the conservative nontraumatic surgical techniques, early repairing surgeries induce changes in the upper dental arch morphologic characteristics in patients with cleft lip and palate. The evaluation of unoperated adult cleft patients enables us to exclude the influence of treatment, emphasizing the morphologic characteristics inherent to the presence of the cleft and its functional counterbalances, that is, the morphologic pattern imposed by cleft. In this study, the maxillary dental casts of 31 unoperated adult complete bilateral cleft lip and palate patients (20 men and 11 women) were compared to a noncleft sample matched for gender. Intercanine, inter-first premolar, inter-second premolar and inter-first molar arch widths measurements as well as arch length were measured from xerox copies taken of the models. The findings indicate the presence of premaxillary prognathism and a progressive increase in the constriction of the dental arches. This constriction of the maxillary segments, even in the absence of surgical intervention, is a result of the absence of an intact palate between the two maxillary processes. Although gender significantly influenced the size of the maxillary arches in the noncleft patients, similar differences were not observed in the cleft group. It seems that the presence of the cleft in itself has the greater influence on the morphologic characteristics of the maxillary arch than gender.
文献表明，即使采用保守的非创伤性手术技术，早期修复手术也会导致唇腭裂患者上颌牙弓形态特征发生变化。对未接受手术的成年腭裂患者进行评估，使我们能够排除治疗的影响，突出腭裂存在所固有的形态特征及其功能平衡，即腭裂所施加的形态模式。在本研究中，将31例未接受手术的成年双侧完全性唇腭裂患者（20名男性和11名女性）的上颌石膏模型与性别匹配的非腭裂样本进行比较。从模型的复印件上测量犬齿间、第一前磨牙间、第二前磨牙间和第一磨牙间的牙弓宽度以及牙弓长度。研究结果表明存在前颌前突以及牙弓缩窄的逐渐增加。即使在没有手术干预的情况下，上颌节段的这种缩窄也是两个上颌突之间缺乏完整腭部的结果。虽然性别对非腭裂患者上颌牙弓的大小有显著影响，但在腭裂组中未观察到类似差异。似乎腭裂本身对上颌牙弓形态特征的影响比性别更大。
