CAJ | 학술논문

背景：部分唇腭裂患者在9-10岁(尖牙牙根发育1/2-2/3)接受植骨后，矫治效果不能保持；且7-10岁患者植骨前后的治疗程序目前尚不统一。锥形束 CT 可在不破坏正常组织结构的前提下精确反映组织的微细结构，并通过相配套的计算机软件获得相关测量数据。目的：利用锥形束CT测量结果，比较不同顺次的正畸联合牙槽嵴裂植骨治疗单侧完全性唇腭裂的疗效。方法：选择2012至2013年就诊于沧州市人民医院的单侧完全性唇腭裂患者60名，分为3组，各20例。A组患者自体髂骨移植修复牙槽嵴裂植骨治疗后佩戴保持器保持3个月行正畸治疗；B组患者正畸治疗后即刻行自体髂骨移植修复牙槽嵴裂植骨治疗并后期佩戴保持器3个月；C组患者正畸治疗后佩戴保持器3个月后行自体髂骨移植修复牙槽嵴裂植骨治疗，植骨治疗完成后保持器保持3个月。结果与结论：锥形束CT结果显示，C组患者蝶鞍点-鼻根点-上齿槽座点角(SNA)、蝶鞍点-鼻根点-下齿槽座点角(SNB)、上齿槽座点-鼻根点-下齿槽座点角(ANB)、上中切牙切缘与鼻根点-上齿槽座点连线的交角(U1/NA)和U1/NA(L1/NB)与A组差异有显著性意义(P <0.01)；B组患者的SNB、L1/NB较A组明显增大(P<0.05)；C组与B组比较，SNB、U1/NA明显减小，SNA、L1/NB明显增大(P <0.05)。提示单侧完全性唇腭裂患者牙槽嵴植骨治疗前、治疗后正畸治疗效果明显优于单纯治疗前或治疗后正畸治疗，并有利于上颌骨矫正后的稳定性。
배경：부분진악렬환자재9-10세(첨아아근발육1/2-2/3)접수식골후，교치효과불능보지；차7-10세환자식골전후적치료정서목전상불통일。추형속 CT 가재불파배정상조직결구적전제하정학반영조직적미세결구，병통과상배투적계산궤연건획득상관측량수거。목적：이용추형속CT측량결과，비교불동순차적정기연합아조척렬식골치료단측완전성진악렬적료효。방법：선택2012지2013년취진우창주시인민의원적단측완전성진악렬환자60명，분위3조，각20례。A조환자자체가골이식수복아조척렬식골치료후패대보지기보지3개월행정기치료；B조환자정기치료후즉각행자체가골이식수복아조척렬식골치료병후기패대보지기3개월；C조환자정기치료후패대보지기3개월후행자체가골이식수복아조척렬식골치료，식골치료완성후보지기보지3개월。결과여결론：추형속CT결과현시，C조환자접안점-비근점-상치조좌점각(SNA)、접안점-비근점-하치조좌점각(SNB)、상치조좌점-비근점-하치조좌점각(ANB)、상중절아절연여비근점-상치조좌점련선적교각(U1/NA)화U1/NA(L1/NB)여A조차이유현저성의의(P <0.01)；B조환자적SNB、L1/NB교A조명현증대(P<0.05)；C조여B조비교，SNB、U1/NA명현감소，SNA、L1/NB명현증대(P <0.05)。제시단측완전성진악렬환자아조척식골치료전、치료후정기치료효과명현우우단순치료전혹치료후정기치료，병유리우상합골교정후적은정성。
BACKGROUND:Some cleft lip and palate patients at 9-10 years of age (the canine root development about 1/2-2/3) cannot achieve a good orthodontic outcome after bone grafting, and moreover, there is no unified therapeutic procedure for patients at 7-10 years of age before and after bone grafting. Cone-beam CT can reflect the fine structure accurately under the premise not to destroy normal tissue structure, and have access to the relevant measurement data by matched computer software. OBJECTIVE:To compare the therapeutic effect of orthodontic surgery combined with alveolar cleft bone grafting at different order for treatment of complete unilateral cleft lip and palate. METHODS: Sixty patients with complete unilateral cleft lip and palate admitted at Cangzhou People’s Hospital from 2012 to 2013 were enroled and divided into three groups with 20 in each group: group A, autologous iliac <br> graft was done folowed by 3 months of wearing orthodontic retainer; Group B, autologous iliac graft was done immediately after orthodontic treatment and then, orthodontic retainer was used for 3 consecutive months; group C, orthodontic retainer was used for 3 consecutive months folowing orthodontic treatment, and then, autologous iliac graft was performed folowed by another 3 consecutive months of wearing orthodontic retainer. RESULTS AND CONCLUSION:There were significant differences between groups A and C in terms of SNA, SNB, ANB, U1-NA and L1-NB (P < 0.01). Group B was significantly higher than the group A in SNB and L1/NB (P < 0.05). Compared with the group B, the SNB and U1/NA were reduced, while the SNA and L1/NB were increased significantly in the group C (P < 0.05). These findings indicate that for complete unilateral cleft lip and palate patients, the orthodontic treatment before and after bone grafting is better than simple pre- or post-grafting orthodontic treatment, which is conductive to the stability of corrected maxila.