| ObjectiveThe study aims to investigate the trowth and development of the maxillary sagittal and vertical changes in the unoperates incomplete cleft palate patients. We comared the cephalometric images of patients in the primary dentition period (2 to 4 years) and permanent dentition period (>14 years) with those of normal group, in order to know their differences during the second- and the third-rapid growth period. The data obtained provide valuable information for surgical repairment and orthodontic treatment.Materials and MethodsThe sample consisted of 36 unoperated incomplete cleft palate patients in the Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University.18 patients in the primary dentition group (2 to 4 years old), including 11 males and 7 females, had average age of 3 years and 6 months; 18 patients(over 14 years old) in the permanent dentition group, including 8 males and 10 females, had average age of 20 years and 3 months.40 children, students and adults with normal maxillofacial morphology, who live or attend school in Zhengzhou are in control group.There were 20 persons in each control group, The gender and age of control group were exactly same as those of patients group. The standard lateral skull X-ray film of each subject was shot by the same physician, scanned by the transmission-type X-ray scanner and eventually formed digital image. These images were thansferred to the computer and measured by the physician at the same time on the same computer. Aijian cephalometric analysis system DentiExpert 2.2(Shanghai Aijian Software Co., Ltd) was used. Angle of convexity, angle of SNA, angle of ANB, Ptm-A NS (vertical), S-Ptm (vertical), N-ANS, N-Me, S-Ar and S-Go were measured respectively. These data are corresponding to the maxillary protrusion, maxllary length and maxillary height, etc. The relevant angle, line spacing and line spacing ratio were measured and compared among patients of primary dentition and permanent dentition, as well as their corresponding normal groups.Results1. Comparison between primary dentition patients and control persons:SNA angle and Ptm-ANS(vertical) value, two of the indicators in evaluating maxillary sagittal development, are smaller in patients than these of control. Statistical difference is observed for SNA angle and Ptm-ANS(vertical) only. No significant statistical difference is displayed by other data.2. Comparison between permanent dentition patients and control persons:SNA angle, ANB angle, convexity and Ptm-ANS(vertical) value of the permanent dentition group patients are smaller than these of normal persons. In addition, significant statistical difference is observed. No obvious abnormal maxillary vertical development is shown in these patients.3. Comparing between primary dentition and permanent dentition patients:values of SNA angle in permanent dentition patients are significantly greater than those of primary dentition patients. Maxillary length and individual face height increase obviously; However, values of ANB angle, convexity, N-ANS/N-Me and S-Ar/S-Go in permanent dentition patients are sighificantly less than these of primary dentition patients. Conclusions1. Compared with control group, the unoperated in complete cleft palate patients in primary dentition period already display obvious maxillary retrusion, maxillary length reduction and sagittal developmental disorders. The overall growth pattern in the maxillofacial region is maintained in the following growth stage.2. Because of the accelernting growth of mandibular and restriction of maxillary development (curtailed length of the maxilla), the unoperated incomplete cleft palate patients in the permanent dentition period(>14years) appear to develop type III Malocclusion tendency in the sagittal development. Moreover,maxillary retrusion and concaved facial contour have developed obviously.3. Form peimary dentition period to permanent dentition period, maxillary parts of patients grow rapidly; Meanwhile, maxillary deformities become serious as indicated by the significant increment of maxillary length and individual face height.4. Compared with primary dentition period patients, permanent dentition patients have significantly reduced values of ANB angle, convexity, N-ANS/N-Me and S-Ar/S-Go. These results show that during the development to the adult, the lower-face grows faster than the middle-face, especially in the former and bottom parts, which is in consistent with the important principles of facial growth and development of normal persons.5. The measured vertical maxillary development indicators of both primary dentition or permanent dentition patients show no statistical difference, suggesting that the maxillary vertical development of the unoperated incomplete cleft palate patients have no obvious abnormalities. |
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