PDF(Pubmed)
Abstract：
OBJECTIVE: The aim of this study was to evaluate the stress distributions and possible amount of movement in the maxillofacial region resulting from different maxillary advancement protocols in patients with unilateral cleft lip and palate.
METHODS: A unilateral cleft lip and palate model (CLP model) with Goslon score 4 was created for finite element analysis. Three different protocols were compared: Group 1: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over a conventional acrylic plate; Group 2: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over miniplates placed in the infrazygomatic crest region; Group 3: usage of elastic from the menton plate placed in the mandible to the infrazygomatic plates in the maxilla.
RESULTS: Dental effects were greater in the maxillary protraction protocol with a face mask over a conventional acrylic plate (Von Misses Stress Values; Group 1?=?cleft side:0.076, non-cleft side:0.077; Group 2?=?cleft side:0.004, non-cleft side: 0.003; Group 3?=?cleft side:0.0025; non-cleft side:0.0015), whereas skeletal effects were greater in maxillary protraction protocols with face mask using skeletal anchorage (Von Misses Stress Values; Group 1:0.008; Group 2:0.02; Group 3:0.0025). The maximum amount of counterclockwise rotation of the maxilla as a result of protraction was observed in traditional acrylic plate face mask protocol, and the minimum amount was observed by using elastics between infrazygomatic plates and menton plate.
CONCLUSIONS: In individuals with unilateral cleft lip and palate with Goslon score 4, it was observed that the skeletally anchored face mask caused more skeletal impact and displacement than both the traditional acrylic plate face mask model and the pure skeletally supported maxillary protraction model.
CONCLUSIONS: When planning maxillary protraction treatment in patients with cleft lip and palate, it should be considered that more movement in the sagittal plane might be expected on the cleft side than the non-cleft side, and miniplate and screws on the cleft side are exposed to more stress when using infrazygomatic plates as skeletal anchorage.
METHODS: A unilateral cleft lip and palate model (CLP model) with Goslon score 4 was created for finite element analysis. Three different protocols were compared: Group 1: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over a conventional acrylic plate; Group 2: usage of a face mask with elastics placed at a 30? angle to the occlusal plane over miniplates placed in the infrazygomatic crest region; Group 3: usage of elastic from the menton plate placed in the mandible to the infrazygomatic plates in the maxilla.
RESULTS: Dental effects were greater in the maxillary protraction protocol with a face mask over a conventional acrylic plate (Von Misses Stress Values; Group 1?=?cleft side:0.076, non-cleft side:0.077; Group 2?=?cleft side:0.004, non-cleft side: 0.003; Group 3?=?cleft side:0.0025; non-cleft side:0.0015), whereas skeletal effects were greater in maxillary protraction protocols with face mask using skeletal anchorage (Von Misses Stress Values; Group 1:0.008; Group 2:0.02; Group 3:0.0025). The maximum amount of counterclockwise rotation of the maxilla as a result of protraction was observed in traditional acrylic plate face mask protocol, and the minimum amount was observed by using elastics between infrazygomatic plates and menton plate.
CONCLUSIONS: In individuals with unilateral cleft lip and palate with Goslon score 4, it was observed that the skeletally anchored face mask caused more skeletal impact and displacement than both the traditional acrylic plate face mask model and the pure skeletally supported maxillary protraction model.
CONCLUSIONS: When planning maxillary protraction treatment in patients with cleft lip and palate, it should be considered that more movement in the sagittal plane might be expected on the cleft side than the non-cleft side, and miniplate and screws on the cleft side are exposed to more stress when using infrazygomatic plates as skeletal anchorage.
摘要：
目的：本研究的目的是评估单侧唇腭裂患者不同上颌前移方案导致的颌面部区域的应力分布和可能的运动量。
方法：创建了Goslon评分为4的单侧唇腭裂模型（CLP模型）进行有限元分析。比较了三种不同的方案：第1组：在常规丙烯酸板上使用与咬合平面成30°角放置弹性件的面罩；第2组：在放置在下颌骨区域的微型板上使用与咬合平面成30°角放置弹性件的面罩；第3组：使用从下颌骨中放置的menton板到颌骨下颌骨下骨板的弹性。
结果：在使用面罩而不是常规丙烯酸板的上颌前牵引方案中，牙科效果更大（VonMisses应力值；第1组？=？裂侧：0.076，非裂侧：0.077；第2组？=？裂侧：0.004，非裂侧：0.003；第3组？=？裂侧：0.0025；非裂侧：0.0015）而在使用骨骼锚固的面罩的上颌前牵引方案中，骨骼影响更大（VonMisses应激值；第1组：0.008；第2组：0.02；第3组：0.0025）。在传统的丙烯酸板面罩协议中观察到由于前移而导致的上颌骨逆时针旋转的最大值，通过在下颌板和menton板之间使用弹性材料观察到最小量。
结论：在Goslon得分为4的单侧唇腭裂患者中，观察到骨骼锚定面罩比传统的丙烯酸板面罩模型和纯骨骼支持的上颌前牵引模型引起更多的骨骼撞击和位移。
结论：当计划对唇腭裂患者进行上颌前牵引治疗时，应该考虑到，与非裂隙侧相比，裂隙侧可能会有更多的矢状面运动，和微型板和螺钉在裂隙侧暴露于更多的压力时，使用下骨板作为骨骼锚固。
方法：创建了Goslon评分为4的单侧唇腭裂模型（CLP模型）进行有限元分析。比较了三种不同的方案：第1组：在常规丙烯酸板上使用与咬合平面成30°角放置弹性件的面罩；第2组：在放置在下颌骨区域的微型板上使用与咬合平面成30°角放置弹性件的面罩；第3组：使用从下颌骨中放置的menton板到颌骨下颌骨下骨板的弹性。
结果：在使用面罩而不是常规丙烯酸板的上颌前牵引方案中，牙科效果更大（VonMisses应力值；第1组？=？裂侧：0.076，非裂侧：0.077；第2组？=？裂侧：0.004，非裂侧：0.003；第3组？=？裂侧：0.0025；非裂侧：0.0015）而在使用骨骼锚固的面罩的上颌前牵引方案中，骨骼影响更大（VonMisses应激值；第1组：0.008；第2组：0.02；第3组：0.0025）。在传统的丙烯酸板面罩协议中观察到由于前移而导致的上颌骨逆时针旋转的最大值，通过在下颌板和menton板之间使用弹性材料观察到最小量。
结论：在Goslon得分为4的单侧唇腭裂患者中，观察到骨骼锚定面罩比传统的丙烯酸板面罩模型和纯骨骼支持的上颌前牵引模型引起更多的骨骼撞击和位移。
结论：当计划对唇腭裂患者进行上颌前牵引治疗时，应该考虑到，与非裂隙侧相比，裂隙侧可能会有更多的矢状面运动，和微型板和螺钉在裂隙侧暴露于更多的压力时，使用下骨板作为骨骼锚固。
