Sommerlad-Furlow法修复腭裂术后儿童上颌牙弓发育影响因素的研究

doi:10.7518/hxkq.2024.2024094

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (2): 197-203.doi: 10.7518/hxkq.2024.2024094

Sommerlad-Furlow法修复腭裂术后儿童上颌牙弓发育影响因素的研究

王珏¹(), 李媛媛¹, 吴敏¹, 石冰¹, 郑谦¹, 刘人恺²(), 李承浩¹()

^1.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院唇腭裂外科，成都 610041
^2.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院儿童口腔科，成都 610041

收稿日期:2024-03-18 修回日期:2024-09-25 出版日期:2025-04-01 发布日期:2025-03-25
通讯作者: 刘人恺,李承浩 E-mail:752080920@qq.com;79295389@qq.com;leechenghao@scu.edu.cn
作者简介:王珏，住院医师，硕士，E-mail：752080920@qq.com
基金资助:
四川省科技厅中央引导地方科技发展项目(2023ZYD-0111);时代天使隐形矫治科研专项基金(21H0900);四川大学华西口腔医院临床研究项目(LCYJ-MS-202306)

Factors influencing maxillary dental arch development in children after Sommerlad-Furlow palatoplasty

Wang Jue¹(), Li Yuanyuan¹, Wu Ming¹, Shi Bing¹, Zheng Qian¹, Liu Renkai²(), Li Chenghao¹()

^1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^2.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2024-03-18 Revised:2024-09-25 Online:2025-04-01 Published:2025-03-25
Contact: Liu Renkai,Li Chenghao E-mail:752080920@qq.com;79295389@qq.com;leechenghao@scu.edu.cn
Supported by:
Central Guidance for Local Technological Development Foundation from Science & Technology Department of Sichuan Province(2023ZYD0111);Angelalign Research Fund for Invisalign(21H0900);Clinical Research Program of West China Hospital of Stomatology, Sichuan University(LCYJ-MS-202306)

摘要/Abstract

摘要：

目的研究0~6岁腭裂患者经Sommerlad-Furlow（SF）法腭裂修复术后上颌牙弓的发育变化影响因素。方法纳入18月龄前行SF法腭裂一期整复的患者共183例，术后在不同年龄段随访并收集上颌牙弓数字化模型，使用3-matic Research 12.0测量牙弓及腭弓的长度和宽度，探究SF法腭裂修复术后患者0~6岁上颌牙弓的发育变化规律，以及性别、年龄、腭裂类型和松弛切口对上颌牙弓发育的影响。结果 SF法腭裂修复术后，0~2岁与3~6岁上颌牙弓长度及宽度部分指标差异有统计学意义（P<0.05），3~6岁各年龄段指标间差异无统计学意义；男性后牙弓宽度及后腭弓宽度大于女性（P=0.001），男性前牙弓长度及全牙弓长度小于女性（P<0.05）；相较于单纯腭裂组，单侧唇裂伴腭裂组牙弓长度更短（P<0.01），而后腭弓更宽（P<0.01）；有无硬腭松弛切口组间上颌牙弓的各指标差异无统计学意义。结论影响0~6岁SF法腭裂修复术后儿童牙弓宽度的主要因素是性别和年龄，而影响牙弓长度的主要因素是年龄和腭裂类型。

关键词: 腭裂, Sommerlad-Furlow法腭裂修复术, 鼻咽旁松弛切口, 上颌牙弓

Abstract:

Objective This study aims to investigate factors influencing dental arch development in patients aged 0-6 years with cleft palate after Sommerlad-Furlow (SF) palatoplasty. Methods A total of 183 patients who underwent primary SF repair for cleft lip and palate before 18 months of age were included. Follow-ups were conducted at different ages, and digital dental casts of the maxillary dental arch were obtained using 3-matic Research 12.0 software. The length and width of the dental arch and palate were measured to explore developmental changes in the maxillary dental arch of the patients after the procedure. The study also investigated the influence of gender, age, cleft palate type, and relaxation incision on maxillary dental arch development. Results After SF, maxillary dental arch measurements showed statistically significant differences between children aged 0-2 years and those aged 3-6 years (P<0.05). However, no statistically significant differences were observed among different age groups within the 3-6 years range. Statistically significant differences were detected between males and females, with males having greater width of the posterior dental arch and palate (P=0.001) and shorter length of the anterior dental arch and entire dental arch (P<0.05). The unilateral cleft lip and palate group had shorter dental arch length (P<0.01) and wider posterior palate (P<0.01) than the cleft palate only group. Maxillary dental arch measurements had no statistically significant differences between groups with or without a relaxing incision. Conclusion Gender and age influence the width of the maxillary dental arch in children aged 0-6 years after SF, while age and cleft palate type affect dental arch length.

Key words: cleft palate, Sommerlad-Furlow palatoplasty, nasopharyngeal incision, maxillary arch

中图分类号:

R782.2⁺2

王珏, 李媛媛, 吴敏, 石冰, 郑谦, 刘人恺, 李承浩. Sommerlad-Furlow法修复腭裂术后儿童上颌牙弓发育影响因素的研究[J]. 华西口腔医学杂志, 2025, 43(2): 197-203.

Wang Jue, Li Yuanyuan, Wu Ming, Shi Bing, Zheng Qian, Liu Renkai, Li Chenghao. Factors influencing maxillary dental arch development in children after Sommerlad-Furlow palatoplasty[J]. West China Journal of Stomatology, 2025, 43(2): 197-203.

图/表 5

图 1

表 1

图 2

图 3

图 4

参考文献 34

1	Kulesa-Mrowiecka M, Lipowicz A, Marszałek-Kruk BA, et al. Characteristics of factors influencing the occurrence of cleft lip and/or palate: a case analysis and literature review[J]. Children (Basel), 2024, 11(4): 399.
2	Allori AC, Mulliken JB, Meara JG, et al. Classification of cleft lip/palate: then and now[J]. Cleft Palate Craniofac J, 2017, 54(2): 175-188.
3	Applebaum SA, Aronson S, Termanini KM, et al. Evidence-based practices in cleft palate surgery[J]. Plast Reconstr Surg, 2024, 153(2): 448e-461e.
4	Fitzpatrick B, Coad J, Sell D, et al. Assessing speech at three years of age in the cleft palate population: a sco-ping review of assessment practices[J]. Int J Lang Commun Disord, 2020, 55(2): 165-187.
5	Vyas RM, Najjar W, Losee JE, et al. Cleft Summit 2022: the impact of a unified voice[J]. Cleft Palate Craniofac J, 2024. doi: 10.1177/10556656241242699 .
6	Davis MJ, Roy MG, Burns HR, et al. Velopharyngeal insufficiency following furlow versus straight line repair with intravelar veloplasty: a single-institution experience[J]. J Craniofac Surg, 2023. doi: 10.1097/SCS.00000000-00009874 .
7	Peyvasteh M, Askarpour S, Moradi N, et al. Comparison of the outcomes of surgical repair of cleft palate performed by modified Von Langenbeck and Bardach (Two-Flap palatoplasty) methods[J]. World J Plast Surg, 2023, 12(3): 94-99.
8	吴敏, 尹恒, 陈丽先, 等. 腭裂一期修复术后伤口愈合不良的风险因素分析[J]. 华西口腔医学杂志, 2023, 41(6): 719-724.
	Wu M, Yin H, Chen LX, et al. Analysis of risk factors affecting poor wound healing after primary cleft palate surgery[J]. West China J Stomatol, 2023, 41(6): 719-724.
9	Shi B, Losee JE. The impact of cleft lip and palate repair on maxillofacial growth[J]. Int J Oral Sci, 2015, 7(1): 14-17.
10	Normando AD, da Silva Filho OG, Capelozza Filho L. Influence of surgery on maxillary growth in cleft lip and/or palate patients[J]. J Craniomaxillofac Surg, 1992, 20(3): 111-118.
11	Bardach J, Kelly KM. Does interference with mucope-riosteum and palatal bone affect craniofacial growth? An experimental study in beagles[J]. Plast Reconstr Surg, 1990, 86(6): 1093-1100.
12	Kim T, Ishikawa H, Chu S, et al. Constriction of the maxillary dental arch by mucoperiosteal denudation of the palate[J]. Cleft Palate Craniofac J, 2002, 39(4): 425-431.
13	Huang H, Li J, Li C, et al. Sommerlad-Furlow modified palatoplasty: a retrospective study[J]. J Craniomaxillofac Surg, 2023, 51(4): 238-245.
14	石冰. 腭裂整复新方法的创建与应用[J]. 国际口腔医学杂志, 2014, 41(3): 249-254.
	Shi B. Innovating the method of cleft palate repair by new surgical techniques[J]. Int J Stomatol, 2014, 41(3): 249-254.
15	Ha P, Shi B, Li CH. A new technique to improve velopharyngeal dysfunction by combining the radical intra-velar veloplasty and overlapping intravelar veloplasty for primary palatoplasty[J]. Plast Reconstr Surg, 2016, 137(6): 1057e-1059e.
16	van Stein Callenfels DME, Bos A, Jonkman REG. Maxillary arch dimensions in children with unilateral cleft lip and palate receiving alveolar bone grafting[J]. Cleft Palate Craniofac J, 2023. doi: 10.1177/1055665623118-8283 .
17	Li Y, Tao H, Yao M, et al. Intraoral scanning evaluation of maxillary arch changes after modified Sommerlad palatoplasty for around three years[J]. Plast Reconstr Surg, 2024, 153(6): 1169e-1177e.
18	罗颂椒, 陈安玉, 蔡长银, 等. 正常(牙合)儿童及青少年牙(牙合)生长发育的测量研究[J]. 华西口腔医学杂志, 1984, 2(3): 129-135.
	Luo SJ, Chen AY, Cai CY, et al. A study of the measurement of occlusal growth and development in children and adolescents with normal occlusion[J]. West China J Stomatol, 1984, 2(3): 129-135.
19	李桃. 新疆乌鲁木齐市6-9岁汉族儿童牙弓和腭弓生长发育的研究[D]. 乌鲁木齐: 新疆医科大学, 2018.
	Li T. Study on the growth and development of dental arches and palatal arches in Han children aged 6-9 years in Urumqi, Xinjiang[D]. Urumqi: Xinjiang Medical University, 2018.
20	Prabhakaran S, Sriram CH, Muthu MS, et al. Dental arch dimensions in primary dentition of children aged three to five years in Chennai and Hyderabad[J]. Indian J Dent Res, 2006, 17(4): 185-189.
21	Güncü GN, Yıldırım YD, Yılmaz HG, et al. Is there a gender difference in anatomic features of incisive canal and maxillary environmental bone[J]. Clin Oral Implants Res, 2013, 24(9): 1023-1026.
22	王佳帅. 安氏Ⅰ类与Ⅱ类中国成年男女面部三维特征对比研究[D]. 西安: 第四军医大学, 2017.
	Wang JS. 3D measurements and comparisons of facial images of Chinese Hanmale and female adults with Angle ClassⅠand ClassⅡocclusion[D]. Xi’an: The Fourth Military Medical University, 2017.
23	刘侃, 刘泓虎, 周蕾, 等. 上海市正常(牙合)青年牙、牙弓、基骨的测量分析[J]. 口腔医学, 1993, 13(1): 1-3.
	Liu K, Liu HH, Zhou L, et al. Measurement and analy-sis of teeth, dental arches, and basal bones of young people with normal occlusion in Shanghai[J]. Stomatology, 1993, 13(1): 1-3.
24	Stellzig A, Basdra EK, Hauser C, et al. Factors influen-cing changes in maxillary arch dimensions in unilateral cleft lip and palate patients until six months of age[J]. Cleft Palate Craniofac J, 1999, 36(4): 304-309.
25	Singhania S, Bhojraj N. Early maxillary dentoalveolar changes in children with unilateral cleft lip and palate after palatal repair: a pilot study[J]. Cleft Palate Craniofac J, 2022, 59(12): 1546-1554.
26	邓清. 正常乳牙列的生长发育变化及对恒牙列形成的影响[J]. 现代口腔医学杂志, 2002, 16(3): 274-276.
	Deng Q. Changes in the growth and development of normal deciduous dentition and its effects on the formation of permanent dentition[J]. J Mod Stomatol, 2002, 16(3): 274-276.
27	刘洁, 彭金枫, 陆萍, 等. 物理方式加速正畸牙移动的研究进展[J]. 口腔生物医学, 2023, 14(3): 141-145.
	Liu J, Peng JF, Lu P, et al. Advances in the study of physical acceleration of orthodontic tooth movement[J]. Oral Biomed, 2023, 14(3): 141-145.
28	Mello BZF, Ambrosio ECP, Jorge PK, et al. Analysis of dental arch in children with oral cleft before and after the primary surgeries[J]. J Craniofac Surg, 2019, 30(8): 2456-2458.
29	Wada T, Mizokawa N, Miyazaki T, et al. Maxillary dental arch growth in different types of cleft[J]. Cleft Palate J, 1984, 21(3): 180-192.
30	Dou J, Huang Y, Cheng X, et al. Analysis of risk factors for velopharyngeal insufficiency and palatal fistula after Sommerlad-Furlow palatoplasty[J]. J Craniofac Surg, 2024. doi: 10.1097/SCS.0000000000010084 .
31	Capelozza Júnior L, Taniguchi SM, da Silva Júnior OG. Craniofacial morphology of adult unoperated complete unilateral cleft lip and palate patients[J]. Cleft Palate Craniofac J, 1993, 30(4): 376-381.
32	Li Y, Shi B, Song QG, et al. Effects of lip repair on maxillary growth and facial soft tissue development in patients with a complete unilateral cleft of lip, alveolus and palate[J]. J Craniomaxillofac Surg, 2006, 34(6): 355-361.
33	Koberg W, Koblin I. Speech development and maxillary growth in relation to technique and timing of palatoplasty[J]. J Maxillofac Surg, 1973, 1(1): 44-50.
34	Sakran KA, Yin J, Yang R, et al. Evaluation of late cleft palate repair by a modified technique without relaxing incisions[J]. J Stomatol Oral Maxillofac Surg, 2023, 124(4): 101403.

测量指标/mm	男（n=84）	女（n=99）	P值
前牙弓宽度	28.31±2.80	27.86±2.58	0.260
后牙弓宽度	39.86±3.27	37.71±3.05	0.001
前腭弓宽度	23.61±2.82	23.19±2.40	0.275
后腭弓宽度	31.92±3.10	30.31±2.38	0.001
前牙弓长度	6.29±1.60	6.92±1.80	0.014
全牙弓长度	20.49±2.07	21.49±2.72	0.007

[1]	孙嘉琳, 王艺儒, 石冰, 贾仲林. 1例伴有软腭裂的Muenke综合征病例报告及文献综述[J]. 华西口腔医学杂志, 2025, 43(2): 275-279.
[2]	贾思璇, 张思荻, 尤玥, 孙嘉琳, 段世均, 石冰, 贾仲林. 叉头盒E1基因与中国汉族人群非综合征型唇腭裂的关联研究[J]. 华西口腔医学杂志, 2025, 43(1): 28-36.
[3]	多力昆·吾甫尔, 地丽拜尔·依明江, 卡米力江·买买提明, 李军, 乌丽凡·托勒恒. 新疆地区人群非综合征型唇腭裂与外周血FOXN3-SIN3A复合物表达量相关性研究[J]. 华西口腔医学杂志, 2024, 42(3): 313-318.
[4]	吴敏, 尹恒, 陈丽先, 石冰, 李杨. 腭裂一期修复术后伤口愈合不良的风险因素分析[J]. 华西口腔医学杂志, 2023, 41(6): 719-724.
[5]	林兰玲, 刘皓月, 罗枭, 张翀, 景兵帅, 石冰, 李承浩. 地塞米松诱导同系新西兰仔兔先天性腭裂的转录组异质性[J]. 华西口腔医学杂志, 2023, 41(1): 37-42.
[6]	杨梦夕, 王艺儒, 殷斌, 郑谦, 石冰, 贾仲林. 可溶性环氧化物水解酶2基因与中国汉族人群非综合征型唇腭裂的关联研究[J]. 华西口腔医学杂志, 2022, 40(3): 279-284.
[7]	赵宁, 刘振国, 许尧祥, 岳金, 薛令法, 肖文林. 咽后壁瓣修复术后并发阻塞性睡眠呼吸暂停的临床研究[J]. 华西口腔医学杂志, 2021, 39(5): 566-569.
[8]	姚金凤, 邓梦昭, 谢添, 陈瞰, 王秋旭, 梁志刚. 口腔数字化设计在唇腭裂患者前牙美学修复中的应用研究[J]. 华西口腔医学杂志, 2021, 39(5): 582-590.
[9]	黄威, 李颖辉, 郭凯利, 周永川, 李向军. 唇腭裂术后瘢痕及上颌扩弓联合前牵引治疗对上颌骨发育综合影响的有限元分析[J]. 华西口腔医学杂志, 2020, 38(6): 642-646.
[10]	王希, 郭春丽, 石冰, 尹恒. 先天性腭咽闭合不全的腭咽闭合状态及语音特点分析[J]. 华西口腔医学杂志, 2020, 38(6): 662-666.
[11]	周玉兰, 朱文超, 石冰, 贾仲林. 中国西部汉族人群血小板源性生长因子C基因单核苷酸多态性与非综合征型唇腭裂相关性研究[J]. 华西口腔医学杂志, 2020, 38(4): 364-370.
[12]	马平川, 毛渤淳, 郭春丽, 于晨浩, 李若琳, 何凌, 尹恒. 汉语普通话腭裂语音数据库的搭建与应用[J]. 华西口腔医学杂志, 2020, 38(2): 149-154.
[13]	吴敏, 朱祉冰, 石冰, 龚彩霞, 张碧荷, 李杨. 华西Sommerlad-Furlow腭裂修复术后腭瘘率的研究[J]. 华西口腔医学杂志, 2020, 38(2): 166-169.
[14]	尹恒,黄汉尧,郭春丽,王希,石冰,李精韬. 5岁以下腭裂患儿术后腭咽闭合功能变化规律的研究[J]. 华西口腔医学杂志, 2020, 38(1): 48-53.
[15]	刘楚娴,李精韬,郑谦,郭春丽,尹恒. 大龄腭裂患者术后腭咽闭合功能的影响因素分析[J]. 华西口腔医学杂志, 2019, 37(6): 626-630.

Sommerlad-Furlow法修复腭裂术后儿童上颌牙弓发育影响因素的研究

Factors influencing maxillary dental arch development in children after Sommerlad-Furlow palatoplasty

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 34

相关文章 15

编辑推荐

Metrics

本文评价