Seminars in Orthodontics最新文献

英文中文

Future Issues 未来的问题

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-11-14 DOI: 10.1053/S1073-8746(25)00130-6

引用次数: 0

FMi --- Ed Board FMi——教育局

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-11-14 DOI: 10.1053/S1073-8746(25)00128-8

引用次数: 0

FMii --- Table of Contents FMii——目录表

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-11-14 DOI: 10.1053/S1073-8746(25)00129-X

引用次数: 0

Orthodontics in oral cleft care 正畸在唇腭裂护理中的应用

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-09-24 DOI: 10.1053/j.sodo.2025.09.014

Daniela Garib

引用次数: 0

Robin sequence: a comprehensive review of etiology, diagnosis, and management 罗宾序列：一个全面的审查，病因，诊断和管理

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-09-15 DOI: 10.1053/j.sodo.2025.09.012

Cristiano Tonello , Arturo Frick Carpes , Ilza Lazarini Marques , Terumi Okada Ozawa , Nivaldo Alonso

Robin Sequence is a complex congenital condition defined by the triad of micrognathia, glossoptosis, and upper airway obstruction. This comprehensive review aims to synthesize current knowledge regarding the etiology, diverse clinical presentations, diagnostic challenges, and multidisciplinary management strategies for Robin Sequence, with a specific focus on implications relevant to orthodontic and craniofacial care. The challenge of diagnosing micrognathia and addressing the heterogeneity of associated conditions, including syndromic, isolated, and non-syndromic forms, has been approached. Diagnostic modalities, ranging from prenatal ultrasonography to polysomnography and endoscopic airway evaluation, are explored in detail, with an emphasis on their roles in assessing the severity and localization of airway compromise. The review provides a comprehensive analysis of various treatment approaches for airway obstruction and dysphagia, including prone positioning, nasopharyngeal intubation, glossopexy, mandibular distraction osteogenesis, and tracheostomy, comparing their efficacy, indications, and potential complications. Special attention is given to the impact of cleft palate, a common associated feature, on feeding and respiratory function, and its surgical repair. Understanding the nuanced interplay of anatomical and functional factors in Robin Sequence is crucial for developing individualized and effective treatment protocols, ultimately improving long-term outcomes for affected individuals.

罗宾序列是一种复杂的先天性疾病，由小颌畸形、舌光下垂和上气道阻塞三联症定义。这篇全面的综述旨在综合目前关于罗宾序列的病因、不同的临床表现、诊断挑战和多学科管理策略的知识，特别关注与正畸和颅面护理相关的影响。诊断小颌畸形的挑战和解决相关条件的异质性，包括综合征，孤立和非综合征形式，已经接近。诊断方式，从产前超声检查到多导睡眠检查和内镜气道评估，详细探讨了他们在评估气道损害的严重程度和定位中的作用。本文综合分析了各种治疗气道阻塞和吞咽困难的方法，包括俯卧位、鼻咽插管、舌固定术、下颌牵张成骨术和气管切开术，并比较了它们的疗效、适应证和潜在并发症。特别关注腭裂，一种常见的相关特征，对喂养和呼吸功能的影响，及其手术修复。了解Robin序列中解剖和功能因素的微妙相互作用对于制定个性化和有效的治疗方案至关重要，最终改善受影响个体的长期预后。

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引用次数: 0

Potential and limitations of naso-alveolar molding in patients with oral cleft 唇腭裂患者鼻牙槽成型的潜力和局限性

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-09-15 DOI: 10.1053/j.sodo.2025.09.011

R.V. Haddad , M. Saadeh , N. Abou Chebel , J.G. Ghafari

Naso-alveolar molding (NAM) has been promoted as a presurgical infant orthopedic adjunct procedure for cleft lip/palate (CL/P) to achieve improved lip closure and nasal symmetry.

Aim

to review current evidence on the benefits and practical limitations of NAM.

Results

NAM can reduce presurgical cleft severity by minimizing tissue tension during surgery, improve nasolabial form (notably nostril height, bialar width, and columellar length), and cut the need for early revisions. NAM is particularly indicated for wide unilateral and bilateral clefts. Complications are usually minor but frequent: soft-tissue irritation, intranasal inflammation, appliance instability, and parental burden for appliance management. Innovative modifications of the NAM appliance might lessen limitations.

Conclusion

NAM is an efficient orthopedic tool to improve surgical lip closure and nose form, especially with designs easily and correctly used by parents. Knowledge gaps and research priorities are identified.

鼻牙槽成型（NAM）已被推广为唇裂/腭裂（CL/P）的婴儿整形外科辅助手术，以实现改善的唇闭合和鼻对称。目的是回顾目前关于不结盟运动的益处和实际局限性的证据。结果通过减小术中组织张力，改善鼻唇形态（特别是鼻孔高度、双鼻翼宽度和小柱长度），减少早期修复的需要，可以降低手术前唇裂的严重程度。NAM特别适用于单侧和双侧宽唇裂。并发症通常轻微但频繁：软组织刺激，鼻内炎症，矫治器不稳定，以及父母管理矫治器的负担。NAM设备的创新修改可能会减少限制。结论nam是一种改善手术唇闭合和鼻形的有效矫形工具，其设计易于家长正确使用。确定了知识差距和研究重点。

引用次数: 0

Early Secondary Alveolar Bone Grafting in Cleft Lip and Palate at 5 Years of Age: Clinical Rationale, Benefits, and Protocol 5岁唇腭裂早期继发性牙槽骨移植：临床原理、益处和方案

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-08-22 DOI: 10.1053/j.sodo.2025.08.007

Bruno Grollemund , Bieke kreps , Caroline Dissaux , Aurélie Majourau-Bouriez

Secondary alveolar bone grafting (SABG) is a cornerstone in the comprehensive management of patients with cleft lip and palate (CLP), essential for optimizing orthodontic outcomes and supporting esthetic and functional dental rehabilitation. While SABG has traditionally been performed between 9 and 11 years of age, an increasing number of multidisciplinary cleft teams, particularly in France, have adopted the Talmant protocol, which advocates for earlier grafting at 4 to 6 years of age. When performed prior to the eruption of permanent maxillary incisors and following orthodontic maxillary expansion when indicated, early SABG offers distinct advantages, including optimal surgical access, improved periodontal support, facilitated tooth eruption, and simplified orthodontic mechanics, without negatively impacting maxillary growth. However, specific challenges such as variable cooperation of younger patients, and considerations related to long term bone volume preservation in large clefts when permanent lateral incisors are congenitally missing must be acknowledged. This paper outlines the clinical rationale, indications, benefits, and limitations of early SABG and presents a detailed, patient-centered protocol built upon interdisciplinary collaboration between surgeons and orthodontists. Clinical cases are included to illustrate the protocol's practical implementation and long-term outcomes.

继发性牙槽骨移植（SABG）是唇腭裂（CLP）患者综合治疗的基石，对于优化正畸结果和支持牙齿美观和功能康复至关重要。虽然SABG传统上是在9至11岁之间进行的，但越来越多的多学科唇裂团队，特别是在法国，采用了Talmant方案，该方案主张在4至6岁时进行早期移植。如果在上颌恒切牙出牙之前进行，并在指征时进行正畸上颌扩张，早期SABG具有明显的优势，包括最佳手术通道，改善牙周支持，促进牙齿出牙，简化正畸力学，而不会对上颌生长产生负面影响。然而，具体的挑战，如年轻患者的可变合作，以及考虑到当永久侧切牙先天性缺失时，大裂的长期骨体积保存必须得到承认。本文概述了早期SABG的临床原理、适应症、益处和局限性，并提出了一个详细的、以患者为中心的方案，建立在外科医生和正畸医生之间跨学科合作的基础上。包括临床病例，以说明该方案的实际实施和长期结果。

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引用次数: 0

Obstructive sleep apnea and upper airway morphophysiology in orofacial clefts 腭裂患者阻塞性睡眠呼吸暂停与上呼吸道形态生理的关系

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-08-20 DOI: 10.1053/j.sodo.2025.08.005

Ivy Kiemle Trindade-Suedam , Thiago Henrique dos Santos Antunes Albertassi , Marcela Cristina Garnica-Siqueira , Sergio Henrique Kiemle Trindade

Objectives

This review aimed to synthesize evidence on the anatomical and functional characteristics of the upper airway in individuals with cleft lip and palate (CLP), explore how alterations relates to occurrence of obstructive sleep apnea (OSA), and examined the efficacy and clinical applicability of diagnostic and therapeutic strategies, focusing on implications for interdisciplinary clinical practice.

Methods

This critical narrative review was conducted using a literature search performed between April and May 2025 in the databases PubMed, Scopus, and Embase. Studies published from 2020 to 2025 were prioritized, and earlier references were included to provide essential conceptual or methodological background. Main descriptors and keywords included: Obstructive Sleep Apnea, Cleft Lip, Cleft Palate, Upper Airways, Craniofacial Morphology, Cone-Beam Computed Tomography (CBCT), Computational Fluid Dynamics (CFD), and Polysomnography.

Results

Individuals with CLP often present reduced airway volume and increased risk for OSA. Anatomical changes increase airflow resistance; however, surgical interventions such as orthopedic maxillary expansion and orthognathic surgery may improve airway dimensions and sleep quality. Combining clinical assessment, CBCT, CFD, and polysomnography allows for an overall evaluation of individuals.

Conclusion

Management of OSA should be integrated into the craniofacial rehabilitation protocol for individuals with CLP and other craniofacial anomalies. Emerging technologies, such as digital sleep monitoring combined with artificial intelligence and assessment of upper airway dimensions, support early diagnosis, risk stratification, and the development of individualized therapeutic strategies.

目的本综述旨在综合唇腭裂（CLP）患者上气道解剖和功能特征的证据，探讨其改变与阻塞性睡眠呼吸暂停（OSA）发生的关系，并检查诊断和治疗策略的疗效和临床适用性，重点关注跨学科临床实践的意义。方法采用PubMed、Scopus和Embase数据库于2025年4月至5月间进行的文献检索进行批判性叙述性综述。优先考虑2020年至2025年发表的研究，并包括较早的参考文献，以提供必要的概念或方法背景。主要描述词和关键词包括：阻塞性睡眠呼吸暂停、唇裂、腭裂、上呼吸道、颅面形态学、锥束计算机断层扫描（CBCT）、计算流体动力学（CFD）和多导睡眠图。结果CLP患者通常表现为气道体积减小，阻塞性睡眠呼吸暂停的风险增加。解剖改变增加气流阻力；然而，外科干预，如矫形上颌扩张和正颌手术可能改善气道尺寸和睡眠质量。结合临床评估、CBCT、CFD和多导睡眠图，可以对个体进行全面评估。结论对于CLP及其他颅面异常患者，应将OSA的治疗纳入颅面康复方案。新兴技术，如结合人工智能和上呼吸道维度评估的数字睡眠监测，支持早期诊断、风险分层和个性化治疗策略的发展。

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引用次数: 0

Balancing benefits and risks: Analyzing the short-term and long-term effects of presurgical infant orthopedic (PSIO) treatment in UCLP patients 平衡收益与风险：分析UCLP患者术前婴儿骨科（PSIO）治疗的短期和长期效果

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-08-19 DOI: 10.1053/j.sodo.2025.08.004

Puneet Batra , Aditya Talwar , Isha Duggal

Cleft lip and palate (CLP) are among the most common congenital craniofacial anomalies, presenting functional and aesthetic challenges that require a multidisciplinary treatment approach from infancy through adulthood. Presurgical infant orthopaedics (PSIO) are the early nonsurgical alveolar molding techniques to guide the growth and alignment of the maxillary segments before primary surgical repair, using appliances or taping techniques to improve cleft morphology and assist in lip repair.

The current review describes the development of PSIO in the early treatment of patients with cleft lip and palate anomaly, highlighting both its potential advantages and concerns. PSIO has been shown to facilitate surgical repair, improve nasal symmetry, columella lengthening, improve alveolar segments, and decrease the need for secondary surgical procedures. However, in addition to the continuous discussions about its effectiveness, there are still concerns with compliance, cost, and outcome variability, especially with the long-term effects of PSIO on speech development, facial growth, and psychosocial outcomes being debatable.

The present article enumerates contemporary practices and emerging trends, emphasizing the need for standardized protocols and robust evidence elaborating on the impact of PSIOs on facial growth, speech development, and psychosocial well-being. Ultimately, providing a balanced synthesis of current knowledge and outline future directions for individualized approaches supported by advances in digital technologies and personalized care to optimize treatment strategies in patients with cleft lip and palate.

唇腭裂（CLP）是最常见的先天性颅面畸形之一，表现出功能和美学上的挑战，需要从婴儿期到成年期的多学科治疗方法。手术前婴儿矫形术（PSIO）是早期的非手术牙槽成型技术，用于在初次手术修复前指导上颌节段的生长和排列，使用矫治器或胶带技术来改善唇裂形态并协助唇部修复。本文综述了PSIO在早期治疗唇腭裂患者中的发展，强调了其潜在的优势和值得关注的问题。PSIO已被证明可以促进手术修复，改善鼻对称性，延长鼻小柱，改善肺泡节段，减少二次手术的需要。然而，除了对其有效性的持续讨论之外，仍存在对依从性，成本和结果可变性的担忧，特别是PSIO对语言发育，面部生长和心理社会结果的长期影响存在争议。本文列举了当代实践和新兴趋势，强调需要标准化的协议和强有力的证据来阐述psio对面部生长、语言发育和社会心理健康的影响。最终，在数字技术和个性化护理进步的支持下，提供当前知识的平衡综合和概述个性化方法的未来方向，以优化唇腭裂患者的治疗策略。

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引用次数: 0

Evidence based orthodontics – a narrative roadmap for contemporary clinical practise cleft lip and palate 基于证据的正畸-当代唇腭裂临床实践的叙事路线图

IF 2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-08-17 DOI: 10.1053/j.sodo.2025.08.006

Agneta Linder Aronson Karsten

To give birth to a child with a cleft of the lip, alveolus and/or palate is for many parents unexpected and the parents will experience different feelings the first days after delivery. Therefore, it is important that the medical and dental proffessions have evidence based treatments to offer. In many countries it is up to the parents to seek for information and treatments, whereas in other countries, there are multidisciplinary teams taking care of the planning, surgical reconstructions and other treatments eg. orthodontics from birth till adulthood. The goals for these teams are that the child breathes, eats, speaks, and feels well, have good craiofacial growth, a functional occlusion, a nice smile and a good self-esteem.

对于许多父母来说，生下一个唇裂、肺泡和/或腭裂的孩子是出乎意料的，父母在分娩后的第一天会有不同的感受。因此，医学和牙科专业提供基于证据的治疗是很重要的。在许多国家，寻求信息和治疗取决于父母，而在其他国家，有多学科团队负责计划，手术重建和其他治疗。从出生到成年的牙齿矫正。这些小组的目标是孩子呼吸，吃饭，说话，感觉良好，颅面发育良好，功能闭塞，笑容灿烂，自尊心强。

引用次数: 0

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