Objective:This study aimed to explore the effects of different types of palatal lateral excisions on the growth and development of the maxilla and dental arch, and to investigate the underlying mechanisms. Methods: A ...Objective:This study aimed to explore the effects of different types of palatal lateral excisions on the growth and development of the maxilla and dental arch, and to investigate the underlying mechanisms. Methods: A total of 112 3-week-old Sprague-Dawley (SD) male rats were randomly divided into a control and 3 experimental groups: the mucoperiosteal denudation group, the mucosal flap excision group, and the periosteum excision group. In the experimental groups, bilateral mucoperiosteal, mucosal flap and periosteum were excised respectively in the lateral one half of the palate. Four rats in each group were randomly chosen for sacrifice every two weeks. The maxilla was dissected following the excision. The widths of the maxilla and dental arch were measured and the histological phenomena were investigated at different phases. At the same time, 12 animals in each group were sequentially injected with calcein every two weeks. Three animals in each group, whose fluorescent labeling was used, were sacrificed for investigating bone formation at Week 8 following injection. Results: (1) Each experimental group presented the constriction of the maxilla and dental arch. The upper first molars in the experimental groups inclined medially. The mucoperio-steal denudation group showed the largest degree of effect followed by the periosteum excision group. The indices of the mucosal flap excision group, which retained the structures of the periosteum layer, had the most approximate values to the control group; (2) Different histological changes among the experimental groups were detected. The fibers penetrated into the palatal bone as Sharpey's fibers in the mucoperiosteal denudation group. The pattern of bone deposition was the bundle type. Sharpey's fibers were not found in the mucosal flap and periosteum excision groups and the depositions of palatal bone were the lamellar type as those in the control group; (3) The rates of bone deposition in the experimental groups decreased compared with the control group. The rates in different phases were the most approximate values to those of the control group in the mucosal flap excision group, which has the same structure of periosteum as the control group. Conclusion: There were different effects on the growth and development of the maxilla and dental arch in different types of palatal lateral excisions. Periosteum is important for bone for-mation and deposition pattern. The prevention of Sharpey's fibers forming and attaching to the palatine can effectively avert the following malformation.展开更多
Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mi...Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects： early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau＇s pushback palatoplasty and Langenbeck＇s palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Stilt, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.展开更多
目的评价安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式对上气道位置形态的影响。方法选取2015年2月至2016年3月就诊于乌鲁木齐市口腔医院正畸科的安氏Ⅱ类均角错畸形汉族男性患者40例,按照78.5°≤SNA角≤86.8°为上颌正...目的评价安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式对上气道位置形态的影响。方法选取2015年2月至2016年3月就诊于乌鲁木齐市口腔医院正畸科的安氏Ⅱ类均角错畸形汉族男性患者40例,按照78.5°≤SNA角≤86.8°为上颌正常、76.2°≤SNB角≤84.0°为下颌正常标准,将患者分为上下颌正常组(A组)12例、上颌正常下颌后缩组(B组)10例、上颌前突下颌正常组(C组)9例、双颌后缩组(D组)9例。分析患者术前颅面部锥体束计算机断层扫描(CBCT)片。结果上下颌不同生长型组ANB角、FMA角、下颌骨总长、下颌骨体长、ad1-PNS、ad2-PNS、ANS-PNS to PPW、AAO-PNS、P-PP、PH-PPH、ANS-PNS to P角、P-SN及M-SN等差异均有统计学意义(均P<0.05);并且各组间比较结果均有不同程度的差异性,且差异性具有统计学意义。结论安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式间口咽部及软腭部形态存在着显著差异,根据生长模式的不同运用合适的矫治器可以在一定程度上改善呼吸。展开更多
文摘Objective:This study aimed to explore the effects of different types of palatal lateral excisions on the growth and development of the maxilla and dental arch, and to investigate the underlying mechanisms. Methods: A total of 112 3-week-old Sprague-Dawley (SD) male rats were randomly divided into a control and 3 experimental groups: the mucoperiosteal denudation group, the mucosal flap excision group, and the periosteum excision group. In the experimental groups, bilateral mucoperiosteal, mucosal flap and periosteum were excised respectively in the lateral one half of the palate. Four rats in each group were randomly chosen for sacrifice every two weeks. The maxilla was dissected following the excision. The widths of the maxilla and dental arch were measured and the histological phenomena were investigated at different phases. At the same time, 12 animals in each group were sequentially injected with calcein every two weeks. Three animals in each group, whose fluorescent labeling was used, were sacrificed for investigating bone formation at Week 8 following injection. Results: (1) Each experimental group presented the constriction of the maxilla and dental arch. The upper first molars in the experimental groups inclined medially. The mucoperio-steal denudation group showed the largest degree of effect followed by the periosteum excision group. The indices of the mucosal flap excision group, which retained the structures of the periosteum layer, had the most approximate values to the control group; (2) Different histological changes among the experimental groups were detected. The fibers penetrated into the palatal bone as Sharpey's fibers in the mucoperiosteal denudation group. The pattern of bone deposition was the bundle type. Sharpey's fibers were not found in the mucosal flap and periosteum excision groups and the depositions of palatal bone were the lamellar type as those in the control group; (3) The rates of bone deposition in the experimental groups decreased compared with the control group. The rates in different phases were the most approximate values to those of the control group in the mucosal flap excision group, which has the same structure of periosteum as the control group. Conclusion: There were different effects on the growth and development of the maxilla and dental arch in different types of palatal lateral excisions. Periosteum is important for bone for-mation and deposition pattern. The prevention of Sharpey's fibers forming and attaching to the palatine can effectively avert the following malformation.
文摘Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects： early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau＇s pushback palatoplasty and Langenbeck＇s palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Stilt, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.
文摘目的评价安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式对上气道位置形态的影响。方法选取2015年2月至2016年3月就诊于乌鲁木齐市口腔医院正畸科的安氏Ⅱ类均角错畸形汉族男性患者40例,按照78.5°≤SNA角≤86.8°为上颌正常、76.2°≤SNB角≤84.0°为下颌正常标准,将患者分为上下颌正常组(A组)12例、上颌正常下颌后缩组(B组)10例、上颌前突下颌正常组(C组)9例、双颌后缩组(D组)9例。分析患者术前颅面部锥体束计算机断层扫描(CBCT)片。结果上下颌不同生长型组ANB角、FMA角、下颌骨总长、下颌骨体长、ad1-PNS、ad2-PNS、ANS-PNS to PPW、AAO-PNS、P-PP、PH-PPH、ANS-PNS to P角、P-SN及M-SN等差异均有统计学意义(均P<0.05);并且各组间比较结果均有不同程度的差异性,且差异性具有统计学意义。结论安氏Ⅱ类错畸形患者上下颌骨矢状向不同生长模式间口咽部及软腭部形态存在着显著差异,根据生长模式的不同运用合适的矫治器可以在一定程度上改善呼吸。
