| Objective: To study the variations of perioral force and dental arch morphology between unilateral complete cleft lip and palate(UCLP)patients and skeletal type Ⅲ patients,To explore the relationship between the variations,and to analyze the role of perioral force in the occurrence and development of malocclusion by comparing the difference of perioral force and dental arch morphology between UCLP patients,skeletal type Ⅲ non-cleft lip and palate patients and normal children in mixed dentition stage.Methods: 20 UCLP patients(14 males and 6 females)and 21 skeletal type Ⅲ non-cleft lip and palate patients(12 males and 9 females)of the same age were selected as experimental group and 20 normal children(14 males and 6 females)of the same age were selected as control group.The perioral force and the width and length of dental arch were measured in the three groups.Perioral muscle pressure acquisition system was used to measure the perioral force of each subject at rest position.The measurement sites included bilateral maxillary central incisors,canines or deciduous canines,first premolars or deciduous molars,and first permanent molars.The upper mandibular plaster model of each subject was obtained,and the width and length of the dental arch were measured on the model with an electronic vernier caliper.SPSS 19.0 statistical software was used to analyze the data,Univariate analysis of variance was used to compare the differences among the three groups.LSD test was used to compare the differences of perioral force and dental arch morphology between the healthy side /the negative side of UCLP patients and skeletal type Ⅲ non-cleft lip and palate patients and normal children,and between the UCLP patients and skeletal type Ⅲ non-cleft lip and palate patients.The relationship between the differences was analyzed.Results:1.Difference of perioral forceThe results of comparison among three groups of maxillary perioral force were as follows:(1)The lip-cheek and lingual perioral force of the fissure side in UCLP group and skeletal type Ⅲ group were greater than those of the normal group,and the fissure side of UCLP group was larger than that of the skeletal type Ⅲ group(P < 0.05);(2)the lip-cheek and lingual perioral force of the non-fissure side in UCLP group was also greater than that of the normal group,and the lingual side of the non-fissure side in UCLP group was larger than that of skeletal type Ⅲ group(P < 0.05).The perioral force was greater than that of skeletal type Ⅲ(P < 0.05);But except that the lip perioral force ofupper central incisors was greater than that of skeletal type Ⅲ group(P < 0.05),there was no significant difference in the other lip and buccal sites between skeletal type Ⅲ group and UCLP group(P > 0.05).Comparisons among three groups of mandibular oral circumferential force:(1)Contrast of lip and buccal side: the lip and buccal circumferential force of UCLP group and skeletal type Ⅲ group were less than normal group(P < 0.05).There was no significant difference between UCLP group and skeletal type Ⅲ group(P > 0.05).Except for lower incisor lip UCLP group,it was smaller than skeletal type Ⅲ group(P < 0.05).(2)Lingual comparison: The lingual perioral force of lower incisor in UCLP group and skeletal type Ⅲ group was larger than that in normal group,and the UCLP group was larger than that in skeletal type Ⅲ group(P < 0.05).There was no significant difference among the other Measurement sites(P > 0.05).2.Difference of dental archThe results of comparison among three groups were as follows:(1)The width of each segment and length of the upper dental arch in the fissure side of UCLP group and the skeletal type Ⅲ group were less than those in the normal group,and the fissure side of UCLP group was smaller than that in the skeletal type Ⅲ group(P < 0.05);(2)The width and length of the middle and posterior segments of the upper dental arch in the non-fissure side of UCLP group were smaller than those in the normal group(P < 0.05);and the length of the upper dental arch in the non-fissure side of UCLP group was shorter than that in the skeletal type Ⅲ group.But there was no significant difference in the width of posterior segment between the UCLP group and the skeletal type Ⅲ group(P > 0.05).The width of anterior segment of upper dental arch was the largest in UCLP group,the second in normal group and the smallest in skeletal type Ⅲ group(P < 0.05).The results of comparison among the three groups were as follows: The width and length of lower dental arch in UCLP group and skeletal type Ⅲ group were larger than those in normal group(P < 0.05),but there was no significant difference between UCLP group and skeletal type Ⅲ group(P > 0.05).Conclusion:1.Compared with the normal group,UCLP and skeletal type Ⅲ patients had greater perioral force of maxillary lip cheek and Lingual muscle,lower buccal mouth,greater lingual mouth force of lower central incisor,smaller width and length of upper dental arch,and larger width of lower dental arch and length of mandible.2.The upper arch length of UCLP patients is shorter than that of skeletal type Ⅲ patients and the cleft side arch is narrower.It is related to the high perioral force on the lip and buccal side of the fissure.The reason for the increase of perioral force may be thescar contracture in the lip operation area.3.The relationship between perioral force and dental arch morphology in UCLP patients and skeletal type Ⅲ patients.Reducing perioral force with muscle functional appliance has positive effect on the prevention and treatment of dental arch deformity.At the same time,adjusting the shape of dental arch and the position of jaw is conducive to achieving internal and external balance of perioral force. |
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