Diagnostic system of bone defect and scar tissue distribution in cleft lip and palate patients by using laser device

许多研究者报道腭裂的手术修复会抑制上颌生长，并导致腭裂患者牙弓扭曲和中脸后缩。特别是，术后腭骨的粘骨膜脱落和瘢痕组织是这些生长问题的主要因素。腭裂瘢痕组织的分布对腭裂生长发育的研究具有重要意义，对腭裂的诊断、治疗规划和预后预测具有重要意义。然而，很难从视觉上识别疤痕组织，也没有可靠的方法来确定疤痕组织的面积。为了解决这一问题，应用激光多普勒流量计对瘢痕组织与正常腭组织进行了区分。研究瘢痕组织分布对牙弓形成和上颌生长的影响。得到了以下结果：按压腭大孔后，非腭裂患者整个腭表面组织血流量减少，而腭裂患者腭前部组织血流量不变。组织学观察表明，基于疤痕组织与正常组织之间循环条件的差异，激光多普勒血流法可以有效地识别在原始表面产生的疤痕组织。腭裂患者的瘢痕组织分布分为四种类型，每种类型都具有牙弓变形的特征。瘢痕组织分布与上颌生长无明显相关性。

Many investigators have reported that surgical repair of palatal clefts inhibits maxillary growth, and produces a distortion of the dental arch and a retrusion of the mid-face in cleft palate patients. Especially, mucoperiosteal denudation of palatal bone and scar tissue following the surgery are the major factors of these growth problems. The information about the scar tissue distributions on palates is important to growth studies of cleft palates and useful for orthodontic diagnosis, treatment planning and prognosis. However, it is difficult to identify the scar tissue visually, and there is no reliable method to determine scar tissue areas. To solve the problem, the laser doppler flowmeter was applied to differentiate the scar tissue from normal palate tissue. And effects of the scar tissue distributions on dental arch form and maxillary growth were investigated in this study. The following results were obtained.1. By pressing larger palatine foramen, decrease in tissue blood flow was found on entire palatal surface in non-cleft subjects, but tissue blood flow was unchanged in the anterior portion of palates of cleft palate patients.2. Histological obseservations suggested that the laser doppler flowmetry was effective to identify the scar tissue produced on the raw surface, based on the difference in circulatory conditions between the scar tissue and normal tissue.3. The scar tissue distributions of cleft palate patients were divided into four types, and each type has a characteristic feature of a dental arch deformity.4. There was no evident correlation between the scar tissue distributions and the maxillary growth.