背景:小儿耳鼻喉科医师已经发现,上唇系带可能是喂养困难和上颌中线纵隔(MMD)发展的罪魁祸首。这种增加可能是由于父母在互联网上接触有关母乳喂养和孩子潜在的长期美学问题的医疗建议而鼓励的。随后,儿科耳鼻喉科医师进行唇上切除的压力越来越大。据报道,自2000年以来,连续手术增加了10倍。然而,关于上阴唇切除术在预防中线舒张方面的益处,文献中没有达成共识。
目的:通过系统回顾现有的关于阴唇上指带与中线舒张的相关文献,为医生和家长提供最新的信息。
方法:在MEDLINE(PubMed)进行了文献检索,EMBASE,WebofScience,Cochrane图书馆和牙科和口腔科学源(DOSS)。使用Covidence平台,进行了系统审查。最初确定的314篇文章进行了系统审查,最终审查中包括了11项研究。
结论:可用数据,主要来自牙科文献,显示frenum的两种亚型:乳头状和乳头状穿透性frenum,与上颌中线舒张有关。上唇缘切除术应推迟到永久侧切牙萌出为止,因为这可以自发地关闭生理MMD。目前的文献建议在用正畸治疗扩张之前不要进行全系切除术,这有助于防止舒张复发。还必须排除其他牙源性和口腔原因的舒张,比如拇指吸吮,牙齿发育不全,和其他原因。在线信息可能并不总是完全具有代表性,在转诊进行手术干预之前,应在患者病史的完整背景下进行解释。
BACKGROUND: Pediatric otolaryngologists have seen an increased focus on upper lip
frenum as a possible culprit for feeding difficulties and the development of maxillary midline diastema (MMD). This increase may be encouraged by parents\' exposure to medical advice over the internet about breastfeeding and potential long-term aesthetic concerns for their children. Subsequently, there has been increased pressure on pediatric otolaryngologists to perform superior labial frenectomies. There has been a reported 10-fold increase in frenectomies since the year 2000. However, there is no consensus within the literature regarding the benefit of superior labial frenectomy in preventing midline diastema.
OBJECTIVE: To provide physicians and parents with the most updated information by systematically reviewing the available literature for the association between superior labial
frenum and midline diastema.
METHODS: A literature search was performed in MEDLINE (PubMed), EMBASE, Web of Science, the Cochrane Library and Dental and Oral Sciences Source (DOSS). Using the Covidence platform, a systematic review was conducted. The initial 314 articles identified underwent systematic review and 11 studies were included in the final review.
CONCLUSIONS: Available data, primarily from the dental literature, showed that two subtypes of
frenum: papillary and papillary penetrating
frenum, are associated with maxillary midline diastema. Superior labial frenectomy should be delayed until permanent lateral incisors have erupted, as this can spontaneously close the physiological MMD. Current literature recommends against frenectomy before addressing the diastema with orthodontics, which helps to prevent diastema relapse. It is also imperative to rule out other odontogenic and oral cavity causes of diastema, such as thumb sucking, dental agenesis, and other causes. Online information may not always be fully representative and should be interpreted in the full context of the patient\'s medical history before referral for surgical intervention.