单侧完全性唇腭裂患者牙弓宽度正畸扩弓治疗后的稳定性研究

Stability of dental arch width in the patients with complete Unilateral Cleft Lip and Palate after the treatment of orthodontic expansion

目的探讨单侧完全性唇腭裂后牙反患者正畸扩弓矫治后牙弓宽度的稳定性。方法已经完成保持的经过四角舌弓及固定矫治器正畸治疗的手术后单侧完全性唇腭裂患者20名(男性14名,女性6名),三维测量仪对治疗前、治疗后及保持后的研究模型进行尖牙间、第一、二双尖牙、第一磨牙间宽度以及基骨和牙槽弓宽度的测量。统计方法为配对资料的方差分析,两两比较用 Fisher LSD 法。结果经过四角舌弓及固定矫治器治疗后单侧完全性唇腭裂患者上颌各段宽度均增加,差异有统计学意义;下颌除第一双尖牙外各段宽度变化不具统计学意义。正畸治疗后上颌牙弓宽度的增加在尖牙和双尖牙区大于磨牙区。保持结束后牙弓各段宽度较治疗后均有减小,其中上颌尖牙间宽度减小1.34±0.82 mm(P<0.05)、第一双尖牙间宽度减小1.52±0.78 mm(P<0.05)达到显著水平。但是保持结束后上颌各段的牙弓宽度仍大于治疗前,差异有统计学意义。结论经过四角舌弓及固定矫治器系统治疗后,单侧完全性唇腭裂患者上颌牙弓各段的宽度均显著增加;保持结束后上颌牙弓各段宽度虽有复发,但是大部分矫治结果能够保持。

Objective To evaluate the transverse stability of the dental arch in unilateral cleft lip and palate （UCLP） patients after orthodontic treatment of upper arch expansion. Methods Twenty repaired complete UCLP patients with posterior crossbite were chosen as the study subjects. All had ceased retention. Measurements were carried out directly on the pretreatment, posttreatment and postretention study models using a three-dimensional dental cast analyzer. The interdental widths were measured for the canines, first premolars, second premolars, first molars, basal bone and the alveolar arch. Two-way analysis of variance and Fisher＇s LSD was performed in comparing the difference between intervals. Results Lower inter-first-premolar width and upper arch widths of each region increased significantly （P〈 0.05） after orthodontic treatment. The expansion was greater in the anterior than the posterior region in the upper arch; the greatest increase was in the upper first premolar region. Upper arch width decreased after retention, the decrease of the arch width in the upper canine 1.34±0. 82 mm and first premolar 1.52±0. 75 mm regions were statistically significant. The increased upper arch width in each region and the lower interfirst-premolar width maintained significant expansion after retention. Conclusions The widths of the dental arch increased significantly after expansion with a Quad-helix followed by preadjusted edgewise treatment. Relapse occurred, especially in the upper canine and first premolar region, but most of the treatment effect on the upper arch remained after retention.