Immediate and late follow-up effects of class III early correction in cleft lip and palate patients treated with maxillary protraction

C. Miranda, Rodrigo Matos de Souza, G. C. Venezian, C. Franzini, W. Custódio
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Abstract

Abstract Introduction There is no consensus about the immediate and latte follow-up effects of maxillary protraction in cleft lip and palate patients. Objective To evaluate the stability of Class III early treatment in cleft lip and palate patients through maxillary expansion and protraction. Material and method The sample consists in three lateral cephalometric radiographs of 28 patients (mean pre-treatment age of 6.7±1.8 years) who presented cleft lip and palate and were treated with maxillary expansion and Petit facial mask. The angular (SNA, SNB, ANB, SN.GoGn, FMA, Z Angle) and linear (overjet, Co-A, Co-Gn, Nperp-A, Nperp-Pg, AO-BO) cephalometric measures were evaluated through the Dolphin® software, in three moments: T0 (initial), T1 (after treatment), and T2 (follow-up). Data were submitted to the analysis of variance (ANOVA) and Tukey-Kramer test. The correlation between cephalometric measures and patient’s age was determined by Pearson’s chi-squared test. Result The SNA, ANB, and AO-BO measures increased considerably (p<0.05), and they did not present any differences compared to the initial ones after the follow-up time. The overjet measure increased (p<0.05) after treatment and, even with its decrease at the follow-up time, it was still higher than at the beginning (p<0.05). The Z angle showed improvement with treatment and remained stable at the follow-up time. Conclusion After treatment (maxillary expansion associated with protraction), there was a skeletal pattern improvement. During the follow-up period, those alterations decreased to a measure close to the beginning. There was an improvement in the dental pattern and facial profile that continued in the follow-up period.
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上颌前伸治疗唇腭裂患者III类早期矫治的即时及后期随访效果
摘要简介对于唇腭裂患者上颌牵伸术的即时和即时随访效果尚无共识。目的探讨上颌扩张和前伸术早期治疗唇腭裂的稳定性。材料与方法对28例唇腭裂患者(平均术前年龄6.7±1.8岁)行上颌扩张+小面膜治疗,3张侧位头颅x线片。角(SNA SNB ANB SN)通过Dolphin®软件在三个时刻(T0(初始)、T1(治疗后)和T2(随访)评估GoGn、FMA、Z角)和线性(overjet、Co-A、Co-Gn、Nperp-A、Nperp-Pg、AO-BO)的头部测量指标。数据进行方差分析(ANOVA)和Tukey-Kramer检验。头颅测量与患者年龄的相关性通过Pearson卡方检验确定。结果SNA、ANB、AO-BO指标均显著升高(p<0.05),随访时间后与初始值比较无显著差异。治疗后复喷量增高(p<0.05),虽随随访时间降低,但仍高于治疗前(p<0.05)。Z角随治疗而改善,随访时保持稳定。结论治疗后(上颌扩张伴上颌前伸),骨骼形态得到改善。在随访期间,这些变化减少到接近开始的程度。在随访期间,患者的牙齿形态和面部轮廓都有所改善。
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