单侧完全性唇腭裂术后患者牙弓间宽度不调的矫治

Orthodontic treatment of dental arch transverse disharmony in complete unilateral cleft lip and palate patients

目的 通过对单侧完全性唇腭裂术后患者上下颌间牙弓宽度不调的研究及对患者正畸治疗的临床观察 ,总结该类患者正畸治疗的特点。方法 对 4 8例单侧完全性唇腭裂术后患者进行临床检查 ,记录其上下牙弓间的宽度关系 ;根据患者错情况制定不同的治疗方案进行临床治疗。结果 (1)单侧完全性唇腭裂术后患者中出现上下颌牙弓宽度不调的比率为 6 0 .4 % ,双侧后牙反为 33.3% ,单侧后牙反为 16 .7%。男女之间差异无显著性。 (2 )宽度不调以双尖牙区为重 ,上尖牙区是扩弓治疗的重点。 (3)磨牙区牙弓宽度的不协调常较轻微 ,一些患者甚至上颌最后磨牙区略宽 ,对 5例患者 (占 10 4 % )进行了上颌磨牙的腭向移动。结论 单侧完全性唇腭裂患者正畸治疗中上颌多需扩弓 ,且扩弓潜力较大。对于严重拥挤的患者 ,拔牙决定应在扩弓后作出。扩弓治疗应在牙槽突植骨前进行 。

Objective To investigate the dental arch discrepancy in UCLP patients and the characteristics of orthodontic treatment of this kind of patients. Methods 48 Unilateral cleft lip and palate patients were examined clinically and dental arch transverse discrepancy were recorded. Treatment plan was made according to the maloccusion of each patient. Results (1)Dental arch transverse discrepancy was seen in 60.4% , bilateral posterior crossbite in 33.3% ,and unilateral posterior crossbite in 16.7% of patients with UCLP,respectively . (2) Serious crossbite was often seen in bicuspid region, so expansion in this area is the main task of orthodontic treatment. (3)Dental arch transverse discrepancy was usually mild in molar region. The upper molars were moved palatally in 10.4% of patients with UCLP. Conclusions Upper arch expansion is often needed in patients with UCLP , and the potential of dental arch expansion was large. The decision of upper tooth extraction in patients with moderate crowding should be made after dental arch expansion. Dental arch expansion should be done before alveolar bone grafting . Prolonged usage of the retainer is often needed.