目的:这项研究的目的是评估新生儿早期唇形成形术(ENC)1年后完全性双侧唇腭裂(cBCLP)和双侧唇腭裂伴组织桥(BCLP+B)的新生儿的腭生长情况。
方法:该方法基于cBCLP或BCLPB新生儿牙齿模型的经典和形态分析。这些分析包括度量分析,相干点漂移-密集对应分析,超投影方法,和多元统计。在两个年龄类别中观察到牙模,相互比较。在ENC之前(T0,5±5天)从每位患者获得第一个模型,在pal成形术之前(T1,12±6个月)从第二个患者获得。
结果:评估了26例cBCLP和BCLPB新生儿的52个牙科模型。结果显示,在12个月的时间里,由于前部生长和缝合的形成作用,两种裂隙类型的肺泡裂隙均变窄。这通过右侧尺寸的减小(T09.93±2.80mm,T16.64±2.43mm;p≤0.003)和左(T010.71±4.13mm,T16.69±4.29mm;p≤0.003)cBCLP患者的肺泡裂隙。牙槽裂隙宽度的类似减少发生在左侧(T011.69±4.75mm,T14.34±2.97mm;p≤0.001)BCLP+B患者,而在右边,由一个组合的组织桥连接,肺泡裂隙无明显狭窄(T01.61±1.34mm,T11.04±0.70mm;p=0.120)。ENC没有限制后腭生长,意味着结节间宽度在cBCLP中延伸(T032.80±3.15毫米,T135.86±2.80mm;p≤0.001)和BCLPB新生儿(T034.01±2.15mm,T136.21±2.14mm;p≤0.004)。观察组的宽度和长度测量值显示出与无裂隙或LOP患者相同的生长趋势。新生儿cBCLP的腭部变异性更大,但在监测期间减少了,与BCLPB相似。the骨生长最明显的区域主要位于上颌前和上颌段的前端和部分后端。
结论:早期新生儿唇缘整修术在任何方向上对腭生长均无负面影响。在生命的第一年,腭的长度或宽度没有减少,牙槽弓也没有变窄。证实了手术唇在腭前部的形成作用。这个,结合有利的增长,导致肺泡裂隙的闭合。
OBJECTIVE: The aim of this study was to assess palatal growth in newborns with complete bilateral cleft lip and palate (cBCLP) and bilateral cleft lip and palate with tissue bridges (BCLP + B) 1 year after early neonatal cheiloplasty (ENC).
METHODS: The methodology was based on classic and morphometric analysis of dental models of newborns with cBCLP or BCLP + B. These analyses included metric analysis, coherent point drift-dense correspondence analysis, superprojection methods, and multivariate statistics. Dental casts were observed in two age categories, which were compared with each other. The first cast was obtained from each patient before ENC (T0, 5 ± 5 days) and the second one prior to palatoplasty (T1, 12 ± 6 months).
RESULTS: Fifty-two dental models obtained from 26 newborns with cBCLP and BCLP + B were evaluated. The results showed that over the 12-month period, alveolar clefts were narrowed in both cleft types due to anterior growth combined with the formative effect of suturing. This was confirmed by decreases in the dimensions of the right (T0 9.93 ± 2.80 mm, T1 6.64 ± 2.43 mm; p ≤ 0.003) and left (T0 10.71 ± 4.13 mm, T1 6.69 ± 4.29 mm; p ≤ 0.003) alveolar clefts in cBCLP patients. Similar reductions in alveolar cleft widths occurred on the left side (T0 11.69 ± 4.75 mm, T1 4.34 ± 2.97 mm; p ≤ 0.001) of BCLP + B patients, while on the right side, which was connected by a combined tissue bridge, there was non-significant narrowing of the alveolar cleft (T0 1.61 ± 1.34 mm, T1 1.04 ± 0.70 mm; p = 0.120). The ENC did not restrict posterior palatal growth, meaning that intertuberosity width was extended in cBCLP (T0 32.80 ± 3.15 mm, T1 35.86 ± 2.80 mm; p ≤ 0.001) and in BCLP + B neonates (T0 34.01 ± 2.15 mm, T1 36.21 ± 2.14 mm; p ≤ 0.004). Width and length measurements in the observed groups showed growth tendencies equivalent to those in noncleft or LOP patients. Palatal variability was greater in neonatal cBCLP, but was reduced during the monitored period, approximating that for BCLP + B. Regions with the most notable palatal growth were located primarily at the premaxilla and at the anterior and partially posterior ends of the maxillary segments.
CONCLUSIONS: Early neonatal cheiloplasty had no negative effect on palatal growth in any direction. There was no reduction in the length or width of the palate during the first year of life, nor was there narrowing of the dentoalveolar arch. The formative effect of the operated lip on the anterior part of the palate was confirmed. This, in combination with the favorable growth, lead to closure of the alveolar cleft.