单侧完全性唇腭裂及非唇腭裂上颌后缩的上颌骨特征

Characteristics of maxillary morphology in unilateral cleft lip and palate patients and skeletal class Ⅲ patients compared to normal subjects

目的分析单侧完全性唇腭裂和非唇腭裂上颌后缩的上颌骨形态、位置、特征及上颌骨发育的差异。方法选取单侧完全性唇腭裂手术后成年上颌后缩的唇腭裂组32例，上颌后缩的非唇腭裂组24例，对照组32例。拍摄CT片，用Mimics16．01软件分别测量牙齿标记点到矢状面、冠状面及水平面的距离并进行分析比较。结果唇腭裂组上颌骨骨量VM以及上颌骨总体积Vτ均明显小于对照组（P〈0．05），而上颌窦体积与对照组差异无统计学意义（P〉0．05），其上颌骨牙弓前段、后段以及全段长度在矢状向上投影（A1-P1M⊥CP、P3M-P6M⊥CP和A1-P5M⊥CP）均明显小于对照组（P〈0．05）。唇腭裂组与非唇腭裂组比较，上颌牙弓最突点A1到冠状面的距离差异无统计学意义（P〉0．05），而唇腭裂组P3M点、P6m点到冠状面的距离大于非唇腭裂组（均P〈0．05）；唇腭裂组的上颌骨在牙弓水平的前段及全段长度在矢状向上投影（A1-P3M⊥CP和A1-P6m⊥CP）均明显小于非唇腭裂组（P〈0．05）。结论唇腭裂患者上颌骨矢状向的发育不足和位置后移均会导致上颌突度不足；而非唇腭裂上颌后缩患者上颌骨的位置较唇腭裂上颌后缩患者明显后移。

Objective To investigate features of maxillary morphology in unilateral cleft lip and palate （UCLP） with maxillary retrusion and the dissimilarities of retruded maxilla. Methods Cranio- facial measurements were done in 32 UCLP adult patients with maxillary retrusion （GC）, 24 adult patients in classⅢ （GⅢ）, and 32 healthy adults （GN）. The CT slice data was reconstructed into a 3D video model and measured by Mimics 16.01 . Results The maxillary volume （GM） and the volume composed of maxilla and maxillary sinuses （G7） were significantly smaller （P〈0.05） in GC. The anterior and posterior parts of the maxillary length （A1-P3M ⊥CP and P3M-P6M⊥CP） and overall maxillary length（A1-P6M⊥CP）at the dental level were all significantly reduced （P 〈0.05）. There was no significant difference of the distances of A1⊥CP between the GC and GⅢ groups, while the P3M-CP and P6M-CP in the GⅢ group were significantly shorter （all P〈0.05）. The anterior and overall maxillary length at the dental level （A1-P3M ⊥CP and A1-P6M ⊥CP） in the GC group was significantly smaller than that in the Gill group （all P〈0.05）. Conclusions The decreased prominence of maxillary complex could be caused by the shortened maxillary length in UCLP patients; the posterior position of the maxilla is more obvious than that of GC group in class Ⅲ patients.