| Objective:Hindquarter are consistently in the treatment of patients with soft tissue defects due to the incidence of high incidence of incidence in our country: to cleft lip and palate is a kind of congenital craniofacial malformation, according to statistics about 1.625 per thousand. In rural areas and the economy is relatively backward areas, including remote mountain areas is higher than the national average level. Cleft lip and palate in children with developmental disorders, often leads to a series of associated malformations, such as maxillary development can lead to the maxillary palatal morphology and the corresponding deformity. Cleft lip and palate sequence of early treatment of the treatment is more important, because of the patient's nose, lip and palate appearance to improve the heart health is of great significance, this kind of patient is in many aspects The systematic treatment method in addition to surgery, also need to combined with other treatments, such as orthodontic treatment, repair, speech training, is a need in a multidisciplinary physicians together to help to complete the complex work of [1]. The Three Gorges Reservoir area due to economic development and educational problems, sequential therapy has been slow to develop, accept sequence in the treatment of preoperative orthodontic treatment of infants and young children is less, with the development of the smile train project, more and more children accepted surgical treatment, but early treatment of the neonatal period on the development and post surgery has a significant impact, can not be ignored, it is conducive to patients with alveolar cleft the broken section of the rotating and promote The continuity of the dental arch form, improves affected side alar collapse, correcting the nasal columella short, narrow the width of the cleft lip, reduce the difficulty of operation. This article mainly for children with cleft lip and palate of the Three Gorges Reservoir area, take preoperative nasal tooth shaping(Presurgical nasoalveolar molding, PNAM) early orthodontic treatment and to prevent nasal lip deformity aggravated, increase the difficulty of the operation, for children with post alveolar bone graft bone repair success rate provides favorable conditions for the [2], and to investigate the efficacy in the treatment of pnam. At the same time, the case of statistical data analysis of local congenital cleft lip and palate In order to evaluate the improvement of the degree of narrowing the infants in the two groups before and after 25 cases 36 61 patients may the causes and characteristics of cleft lip and palate pathogenesis and related causes. Methods:Experiment 1: in 2013 to 2015 years 6 months of Chongqing Three Gorges Central Hospital of 81 cases of cleft lip and cleft palate patients, age at diagnosis was born 6 days to 30 days(18 days). The unilateral cleft lip and palate(left and right), 20 cases of bilateral cleft lip and cleft palate patients. According to the treatment group comparison of crack width of alveolar cleft and nasal appearance effect. The specific operation method: let the children take the first low, get the oral maxillary impression of plaster mold of Caliper slightly at the beginning of making pnam appliance. The palate plate, nasal supporting parts together constitute, wearing the local nasal tissue extrusion white, and in both cheeks department to be hypoallergenic adhesive tape fixed, every 1-2 weeks to visit 1 times, the nose support height and direction of the appropriate adjustment, the palatine guard plate tissue surface morphology of continuous adjustment, until the beginning of the cleft lip surgery. Get children photos, treatment before and after the treatment of cleft lip and cleft lip surgery. Using dividers and lasts 3 times measured with required distance correction software measurement value for the uniform value. Photos are the same shooting parameters, with a left and right, respectively for fracture And non fracture side. Statistical analysis of the average value. Mode of application software of SPSS statistical 21. 0 to statistically. Measurement data with mean + standard deviation(x + s), between experiment group and control group by t test. Experiment 2: 200 cases of children with cleft lip and palate of the electronic medical record data were analyzed, summarizing the area children with cleft lip and palate incidence and possible causes. Results: after treatment of pnam, which 61 cases of unilateral three degrees of cleft lip and palate, alveolar cleft fissure mean number of narrow 3.6mm.20 cases of bilateral three degrees of cleft lip and cleft palate patients, alveolar left fissure average shrinkage small 4 70.6mm, on the right side of the average fracture reduction 4.3mm, before and after crack distance narrowed average 4.8 mm, about fracture average distance increases 1.7mm, increase in the average distance of anterior alveolar 1.3mm. Treatment after and before treatment compared, with statistical significance(P < 0.05). Nasal appearance improvement measure: overall excellent and good rate was 78. Conclusion: as soon as possible for patients with cleft lip and palate in infants underwent preoperative pnam appliance orthodontic treatment, can significantly improve the maxillary and nasal deformity level, shorten the fractured alveolar ridge distance, for the later carry out repair of cleft lip and palate provides good soft tissue support, also Reduce the operation difficulty, improve the quality of the reduction, the treatment to carry out earlier, the effect is more significant. The data analysis of the case data suggested that the regional cleft lip and palate with genetic factors, infection during pregnancy, education, smoking and other factors. |
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