A randomised prospective clinical trial into the effect of infant orthopaedics on maxillary arch dimensions in unilateral cleft lip and palate (Dutchcleft)
A randomised prospective clinical trial into the effect of infant orthopaedics on maxillary arch dimensions in unilateral cleft lip and palate (Dutchcleft)
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DOI：
10.1034/j.1600-0722.2001.00056.x
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发表时间：
2001-10-01
影响因子：
1.9
通讯作者：
Prahl-Andersen, B
中科院分区：
文献类型：
--
作者：
Prahl, C;Kuijpers-Jagtman, AM;Prahl-Andersen, B
本研究的目的是评估婴儿矫形术（IO）对单侧唇腭裂（UCLP）婴儿上颌骨尺寸的影响。该研究设计是一项前瞻性双臂随机对照试验，平行于三个参与的学术腭裂中心。通过计算机化平衡分配方法分配治疗。一组（IO+）在出生后的第一年内佩戴被动上颌钢板，另一组（IO-）没有。上颌铸件，在出生时，并在15，24，48，78周进行了数字化三维。关闭唇前，IO（+）组的牙槽嵴、腭中嵴和后裂宽度的减小程度明显大于IO（-）组。关闭下唇后，IO（-）组的HB间隙宽度减小更明显。直到软腭关闭，腭穹隆的斜坡被IO显着平坦。得出的结论是，IO上颌骨弓的尺寸，不超过手术软腭关闭持续的只是暂时的影响。因此，婴儿整形外科作为一种工具，以改善上颌牙弓的形式可以放弃。然而，其他结果变量，如面部和牙齿的外观，语音效果和成本效益需要进一步调查，以评估婴儿骨科的综合效果。
Aim of the study was to evaluate the effect of infant orthopaedics (IO) on maxillary dimensions in infants with unilateral cleft lip and palate (UCLP). The study design was a prospective two-arm randomised controlled trial in parallel with three participating academic Cleft Palate Centres. Treatment was assigned by means of a computerised balanced allocation method. One group (IO+) wore passive maxillary plates during the first year of life, the other group (IO-) did not. Maxillary casts, made at birth, and at 15, 24, 48, 78 wk were digitised three-dimensionally. Before lip closure alveolar, midpalatal and posterior cleft width of reduced significantly more in IO(+) than in IO(-). After lip closure, the alveolar HB cleft width reduced significantly more in IO(-). Until soft palate closure the slope of the palatal vault flattened significantly by IO. It is concluded that IO only has a temporary effect on maxillary arch dimensions that does not last beyond surgical soft palate closure. Therefore, infant orthopaedics as a tool to improve maxillary arch form could be abandoned. However, other outcome variables like facial and dental appearance, speech outcome, and cost-effectiveness need to be investigated further in order to assess the comprehensive effect of infant orthopaedics.