本文選題：唇腭裂 + 上頜發(fā)育不足��； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的：唇腭裂是口腔頜面部最常見的先天發(fā)育畸形,常伴有上頜發(fā)育不足。為改變患者面型,對乳牙列和混合牙列尚處于生長發(fā)育快速期的患者可采用正畸前方牽引促進面中部的生長發(fā)育,對已處于生長發(fā)育穩(wěn)定期的患者采用正頜手術(shù)來矯正患者牙頜面畸形。無論何種方式前移上頜骨,由于軟腭附麗隨上頜骨前移而前移,造成咽腔深度增大,可能會導(dǎo)致腭咽部結(jié)構(gòu)的變化,繼發(fā)腭咽閉合功能不全或加重已有的腭咽閉合不全。臨床上應(yīng)用上頜前移矯治唇腭裂患者上頜發(fā)育不足能改變患者面型及恢復(fù)咬合功能已成為常規(guī)治療方法,而上頜前移對患者腭咽部結(jié)構(gòu)的影響尚待探討。本研究試探討兩種方法前移上頜骨前后腭咽部結(jié)構(gòu)的變化,為唇腭裂患者的序列治療提供了理論依據(jù)。 方法：本研究就20例上頜發(fā)育不足患者其中10例行上頜骨LeFort Ⅰ型截骨術(shù)(正頜組),唇腭裂5例,非唇腭裂5例；10例行正畸前方牽引矯治(牽引組),唇腭裂5例,非唇腭裂5例。每位患者治療前,治療后一月分別拍攝頭顱定位側(cè)位片,并進行投影測量分析對腭咽部組織的形態(tài)進行評價。 結(jié)果：兩組患者上頜分別平均前移5.28±2.32m.4.39±2.15mm。正頜組X線投影測量結(jié)果顯示：術(shù)后咽腔深度明顯增大(p0.05),同時軟腭長度及軟硬腭夾角較術(shù)前明顯增大(p0.05),軟腭厚度減小。牽引組X線投影測量結(jié)果顯示：軟腭厚度小于術(shù)前(p0.05),唇腭裂骨性咽腔深度明顯增大(p0.05),腭咽間隙無明顯變化,軟硬腭夾角、軟腭長輕度增加(p0.05)。 結(jié)論：上頜前移造成患者咽腔深度顯著增加,對腭咽閉合功能可能有不利影響；但術(shù)后腭咽部軟組織發(fā)生適應(yīng)性變化,這種代償性改變會在一定程度上減輕腭咽閉合不全。前方牽引可在青少年早期矯治上頜發(fā)育不足,X線頭顱定位側(cè)位片顯示牽引組腭咽部軟組織較正頜組有良好的適應(yīng)性變化。
[Abstract]:Objective: cleft lip and palate is the most common congenital malformation in oral and maxillofacial region.In order to change the facial shape of the patients, patients with primary dentition and mixed dentition in the period of rapid growth and development can use orthodontic anterior traction to promote the growth and development of the middle face.Orthognathic surgery was used to correct maxillofacial malformations in patients with stable growth and development.No matter how the maxilla is moved forward, the depth of pharynx cavity increases because the soft palate appuration moves forward with the maxilla, which may lead to the change of palatopharynx structure, secondary velopharyngeal insufficiency or exacerbation of the existing palatopharynx insufficiency.The effect of maxillary anterior displacement on the palatopharynx structure in patients with cleft lip and palate has become a routine treatment method, which can change the facial shape and restore the occlusal function in patients with cleft lip and palate, but the effect of maxillary anterior displacement on the structure of palatopharynx remains to be explored.In this study, the changes of palatopharynx structure before and after maxillary anterior displacement were studied, which provided a theoretical basis for the sequence therapy of cleft lip and palate.Methods: in this study, 10 patients with maxillary hypoplasia were treated with maxillary LeFort type 鈪，

本文編號：1742136