上颌骨前牵引器与正畸联合治疗单侧唇腭裂的评价

目的:对单侧完全性唇腭裂伴上颌骨发育不足的患者,进行面罩式上颌骨前牵引加正畸治疗,探讨其对颌骨发育的影响。方法:14例患者在治疗前、上颌前牵引后及正畸治疗后分别摄X线头颅侧位定位片,通过9个测量指标数据进行治疗前后的比较分析。数据资料用SPSS10.0软件作统计学处理,治疗前后比较用t检验,以确定上颌前牵引及正畸联合治疗对上下颌骨的影响。结果:本组患者经上颌骨前牵引器牵引加后期正畸治疗,获得满意的效果。切牙覆盖达2mm,咬合关系较稳定;侧面呈直面型。SNA角增加,有高度显著性差异,P<0.001。SNB及下颌平面角SN-MP无变化,P>0.05;颌凸角的差值有显著改变(P<0.001)。结论:单侧完全性唇腭裂伴上颌骨发育不足的患者进行整形加正畸治疗,能促进上颌骨的发育,下颌骨未见显著的变化;通过上颌前牙轴倾度增大,下颌前牙轴倾度变小以及舌代偿,上颌前牙前移,覆牙合覆盖改善。这些改变反应在侧貌上,表现为上颌突度增加,上唇变丰满,凹面形变直面形,上下颌协调。

The study of maxillary protraction face mask combined with orthodontics for complete unilateral cleft lip and palate patients

PURPOSE:The purpose of this study was to evaluate the influence of maxillary protraction face mask combined with orthodontics on complete unilateral cleft lip and palate patients' jaws. METHODS: 14 patients with complete unilateral cleft of lip and palate were included. Lateral cephalometric films were taken before orthodontic treatment ,before protracting and after orthodontic treatment. The statistical data were compared and analysed by SPSS10.0. Student's t test was used to determine the effect of maxillary protraction face mask combined with orthodontic treatment on jaw growth before and after treatment. RESULTS: The treatment resulted in good outcomes: incisor's overjet of 2mm, stable occlusion and straight profile. The SNA angle had a significant increase (P<0.001). The SNB angle and mandibular plane angle (SN-MP) have no change (P>0.05). The convexity of angle had significant change (P<0.001). CONCLUSION: Orthopedic force combined orthodontic treatment on patients with UCLP can promote the development of maxilla, without significant effect on the mandible. The overjet and overbite were improved by increasing the clination of upper anterior teeth, compensating lingually on lower anterior teeth and moving the upper anterior forward. The profile was improved from concave to straight, maxillary protrusion was increased, upper lip was plumpand, and the relationship between upper and lower jaws was more compatible.