摘要
目的:探讨腭成形术在手术年龄的选择上对上颌骨正常发育的影响。方法:选择郑州大学口腔医学院正畸科门诊1993-01/2004-01腭裂患者30例为腭成形术组,5岁前行腭成形术,现年龄15～21岁。选择郑州大学口腔医学院正畸科2000年普查人群中40例正常牙合样本为正常对照组,年龄15～21岁。2组对象均拍摄标准X射线头颅正侧位片,所有X射线片由第一作者扫描入计算机,同时标志点定点,然后由计算机进行测量。X射线头颅侧位片采用Wylie,Steiner,Ricketts三种经典头影测量分析方法。测量指标为前颅底平面-上齿槽座点角,前颅底平面-下齿槽座点角,上齿槽座点-鼻根点-下齿槽座点角,颌突角,面角,翼上颌裂点-上第一恒磨牙,下颌长度,上颌长度,蝶鞍中心-翼上颌裂点,上颌长度/下颌长度。定量分析腭成形术对患者上颌骨发育的影响。结果:按意向处理分析,30例腭裂患者及40例正常牙合样本的各项指标均进入结果分析。①两组上颌相对颅底的位置关系:腭成形术组前颅底平面-上齿槽座点角、上颌长度、蝶鞍中心-翼上颌裂点、翼上颌裂点-上第一恒磨牙测量值均小于正常对照组[腭成形术组:(76.0±3.45)°,(42.87±2.51),(11.05±1.89),(10.28±1.72)mm;正常对照组:(82.04±3.22)°,(47.96±2.96),(16.90±2.80),(15.24±0.76)mm,P<0.01]。②两组上、下颌骨相对关系:腭成形术组前颅底平面-下齿槽座点角、上齿槽座点-鼻根点-下齿槽座点角、颌突角、下颌长度、上颌长度/下颌长度、面角测量值均小于正常对照组[腭成形术组:(79.6±2.40)°,(-1.62±1.07)°,(-4.12±1.89)°,(107.40±6.50)mm,(0.49±0.02),(86.78±4.02)°;正常对照组:(77.6±2.90)°,(3.79±1.87)°,(6.18±3.12)°,(102.80±4.80)mm,(0.69±0.06),(84.30±3.31)°,P<0.01]。结论:5岁前行腭成形术,成年后头颅侧位片测量结果显示上颌骨长度变小,上颌骨前缘位置后移,显示上颌发育不足,提示可能是由于瘢痕的牵拉使上颌发育受限。
AIM： To study the effects of palate surgery on maxilla growth and development in different ages. METHODS： Totally 30 patients with cleft palate as palatoplasty group were selected from Department of Dysmorphosis, Stomatological Medical College of Zhengzhou University from January 1993 to January 2004. The operation was completed on those patients before 5 years old and the current age of the patients were from 15 to 21. The lateral cephalograms of patients in the two groups were measured after X-ray film which was scanned into computer, meanwhile the landmarks were identified. Three classical measurements （Wylie, Steiner, Ricketts） were used in this study. The criteria were composed： SNA, SNB, ANB, NA-PA, NP-FH, Ptm-U6, Co-Po, ANS-Ptm, S-Ptm, ANS-Ptm/Co-Po. RESULTS： According to intention, 30 patients with cleft palate and 40 normal bite samples entered the final analysis.①The length from upper jaw to the base of skull of the two groups： The value of SNA, ANS-Ptm, S- Ptm, Ptm-U6 in palatoplasty group were smaller than those in the normal control group [palatoplasty group： （76.0±3.45）°, （42.87±2.51）, （11.05±1.89）, （10.28±1.72） mm; normal control group： （82.04±3.22）, （47.96±2.96）, （16.90±2.80）, （15.24±0.76） mm, P 〈 0.01]. ②Correlation between upper and lower jaw bone in the two groups： The data of SNB, ANB, NA-PA, Co-Po, ANS-Ptm/Co-Po, NP-FH were （79.6±2.40）°, （-1.62±1.07）°, （-4.12±1.89）°, （107.40±6.50） mm, （0.49±0.02）, （86.78±4.02）° in palatoplasty group, which were smaller than those in the normal control group （77.6±2.90）°, （3.79±1.87）°, （6.18±3.12）°, （102.80±4.80） mm, （0.69±0.06）, （84.30±3.31）°, P 〈 0.01]. CONCLUSION： The data of lateral cephalogram of adult reveal that the length of upper jaw decreases and the position of anterior border of upper jaw moves back. The present study suggests that repair of cleft palate before five years old may severely affect the growth and development of maxilia negatively.
出处
《中国临床康复》
CAS
CSCD
北大核心
2005年第30期136-137,共2页
Chinese Journal of Clinical Rehabilitation
