両側性唇顎口蓋裂児の顎裂幅と上顎歯槽弓の成長変化の関連性について

口蓋裂手術の予後を決定するものとして多くの因子が関与しており,元々の顎裂の重症度もその一因子と考えられる.そこで今回われわれは,上顎歯槽模型による両側唇顎口蓋裂児の顎裂幅の程度と上顎歯槽弓形態の成長変化の関連性についてに比較検討を行った.対象は当院で治療を行った両側唇顎口蓋裂患者のうち,口蓋形成術前,乳歯列期に適切な上顎歯槽模型を採取し得た患者10例とした.左右の顎裂幅の合計が,10mm以下の群(A群)5例と10mm以上の群(B群)5例に分けて比較検討を行った.口蓋形成術前ではB群はA群に比較して,前方歯槽幅は有意に小さく,後方歯槽幅径,前後径,前方部前後径は明らかな差は認めなかったが,乳歯列...

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Published in昭和医学会雑誌 Vol. 70; no. 1; pp. 82 - 89
Main Authors 宇田川, 晃一, 倉林, 仁美, 野田, 真喜, 鈴木, 啓之, 保阪, 善昭
Format Journal Article
LanguageJapanese
Published 昭和大学学士会 28.02.2010
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ISSN0037-4342
2185-0976
DOI10.14930/jsma.70.82

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Abstract 口蓋裂手術の予後を決定するものとして多くの因子が関与しており,元々の顎裂の重症度もその一因子と考えられる.そこで今回われわれは,上顎歯槽模型による両側唇顎口蓋裂児の顎裂幅の程度と上顎歯槽弓形態の成長変化の関連性についてに比較検討を行った.対象は当院で治療を行った両側唇顎口蓋裂患者のうち,口蓋形成術前,乳歯列期に適切な上顎歯槽模型を採取し得た患者10例とした.左右の顎裂幅の合計が,10mm以下の群(A群)5例と10mm以上の群(B群)5例に分けて比較検討を行った.口蓋形成術前ではB群はA群に比較して,前方歯槽幅は有意に小さく,後方歯槽幅径,前後径,前方部前後径は明らかな差は認めなかったが,乳歯列期では,両群間のすべての項目において明らかな差を認めないという結果となった.今回のわれわれの研究からは,顎裂幅の程度による上顎歯槽弓の成長変化に与える影響は少ないと考えられた.
AbstractList 口蓋裂手術の予後を決定するものとして多くの因子が関与しており,元々の顎裂の重症度もその一因子と考えられる.そこで今回われわれは,上顎歯槽模型による両側唇顎口蓋裂児の顎裂幅の程度と上顎歯槽弓形態の成長変化の関連性についてに比較検討を行った.対象は当院で治療を行った両側唇顎口蓋裂患者のうち,口蓋形成術前,乳歯列期に適切な上顎歯槽模型を採取し得た患者10例とした.左右の顎裂幅の合計が,10mm以下の群(A群)5例と10mm以上の群(B群)5例に分けて比較検討を行った.口蓋形成術前ではB群はA群に比較して,前方歯槽幅は有意に小さく,後方歯槽幅径,前後径,前方部前後径は明らかな差は認めなかったが,乳歯列期では,両群間のすべての項目において明らかな差を認めないという結果となった.今回のわれわれの研究からは,顎裂幅の程度による上顎歯槽弓の成長変化に与える影響は少ないと考えられた.
Author 宇田川, 晃一
保阪, 善昭
野田, 真喜
鈴木, 啓之
倉林, 仁美
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  fullname: 鈴木, 啓之
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References 10) 神成庸二,大橋 靖:両側性唇顎口蓋裂児の顎発育に関する研究 ―Hotz床併用二段階口蓋形成手術例について―.口科誌 43:423-439.1994
20) Shaw WC, Dahl E, Asher-McDade C, et al: A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 5. General discussion and conclusions. Cleft Palate Craniofac J 29: 413-418, 1992.
6) Sillman JH: Dimensional changes of the dental arches: longitudinal study from birth to 25 years. Am J Orthod 50: 824-842, 1964.
7) Kramer GJ, Hoeksma JB and Prahl-Andersen B: Early palatal changes after initial palatal surgery in children with cleft lip and palate. Cleft Palate Craniofac J 33: 104-111, 1995.
18) Gaggl A, Schultes G, Feichtlinger M, et al: Differences in cephalometric and occlusal outcome of cleft palate patients regarding different surgical techniques. J Craniomaxillofac Surg 31: 20-26, 2003.
11) Peltomaki T, Vendittelli BL, Grayson BH, et al: Associations between severity of clefting and maxillary growth in patients with unilateral cleft lip and palate treated with infant orthopedics. Cleft Palate Craniofac J 38: 582-586, 2001.
5) Heidbuchel KL, Kuijpers-Jagtman AM, Kramer GJ, et al: Maxillary arch dimensions in bilateral cleft lip and palate from birth until four years of age in boys. Cleft Palate Craniofac J 35: 233-239, 1997.
17) Lehner B, Wiltfang J, Strobel-Schwarthoff K, et al: Influence of early hard palate closure in unilateral and bilateral cleft lip and palate on maxillary transverse growth during the first four years of ages. Cleft Palate Craniofac J 40: 126-130, 2003.
23) Millard DR and Latham RA: Improved primary surgical and dental treatment of clefts. Plast Reconstr Surg 86: 856-871, 1990.
1) Mulliken JB: Principle and techniques of bilateral complete cleft lip repair. Plas Reconstr Surg 75: 477-485, 1985.
14) 平川 崇:異なる術式の口蓋形成術が片側性唇顎口蓋裂患者の顎顔面の成長発達に及ぼす影響.―push-back法,二段階口蓋形成法,頬筋粘膜弁法と非裂者の比較―.昭和歯会誌 22:22-30,2002
13) Millard DR, Latham R, Huifen X, et al: Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. Plast Reconstr Surg 103: 1630-1644, 1999.
2) 土佐泰祥,保阪善昭:硬口蓋前方骨膜を温存した粘膜骨膜弁変法.PEPARS 11:14-21,1996
21) 難波雄哉,村永卓生,西野冽子:臨床的評価からみた唇・口蓋裂に由来する上顎劣成長の原因因子について.形成外科 31:778-784,1988
19) Roberts CT, Semb G and Shaw WC: Strategies for the advancement of surgical methods in cleft lip and palete. Cleft Palate Craniofac J 28: 141-149, 1991.
24) 渡邉哲平,近藤優子,藤原慎視,ほか:片側性口唇・口蓋裂児の顎裂の重篤度と上顎骨歯槽幅径の成長変化の関連性.日口蓋誌 34:191,2009
12) Honda Y, Suzuki A, Ohishi M, et al: Longitudinal study on the changes of maxillary arch dimensions in Japanese children with cleft lip and/or palate: infancy to 4 years of age. Cleft Palate Craniofac J 32: 149-155, 1995.
8) Heidbuchel KL and Kuijpers-Jagtman AM: Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients from 3 to 17 years of age. Cleft Palate Craniofac J 34: 21-26, 1996.
16) Peyton WT: The dimensions and growth of the palate in the normal infant and in the infant with gross maldevelopment of the upper lip and palate. Arch Surg 22: 704-737, 1931.
3) Wardill WEM: The technique of operation for cleft palate. Br J Surg 25: 117-130, 1937.
9) 湖城秀久:乳児の歯列成長発育に関する研究 ―上,下顎歯槽部および口蓋部の三次元的計測―.小児歯誌 26:112-130,1988
15) Huddart AG: Maxillary arch dimensions in bilateral cleft lip and palate subjects. Cleft Palate J 7: 139-155, 1970.
4) 大竹浩信:両側性完全唇顎口蓋裂患者に関する形態学的研究.(口唇,口蓋形成術後における上顎歯槽弓の経時的変化)愛知学院大歯会誌 36:721-730,1998
22) Robertson NRE and Fish J: Early dimensional changes in the arches of cleft palatechildren. Am J Orthod 67: 290-303, 1975.
References_xml – reference: 4) 大竹浩信:両側性完全唇顎口蓋裂患者に関する形態学的研究.(口唇,口蓋形成術後における上顎歯槽弓の経時的変化)愛知学院大歯会誌 36:721-730,1998.
– reference: 13) Millard DR, Latham R, Huifen X, et al: Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. Plast Reconstr Surg 103: 1630-1644, 1999.
– reference: 18) Gaggl A, Schultes G, Feichtlinger M, et al: Differences in cephalometric and occlusal outcome of cleft palate patients regarding different surgical techniques. J Craniomaxillofac Surg 31: 20-26, 2003.
– reference: 5) Heidbuchel KL, Kuijpers-Jagtman AM, Kramer GJ, et al: Maxillary arch dimensions in bilateral cleft lip and palate from birth until four years of age in boys. Cleft Palate Craniofac J 35: 233-239, 1997.
– reference: 6) Sillman JH: Dimensional changes of the dental arches: longitudinal study from birth to 25 years. Am J Orthod 50: 824-842, 1964.
– reference: 24) 渡邉哲平,近藤優子,藤原慎視,ほか:片側性口唇・口蓋裂児の顎裂の重篤度と上顎骨歯槽幅径の成長変化の関連性.日口蓋誌 34:191,2009.
– reference: 20) Shaw WC, Dahl E, Asher-McDade C, et al: A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 5. General discussion and conclusions. Cleft Palate Craniofac J 29: 413-418, 1992.
– reference: 21) 難波雄哉,村永卓生,西野冽子:臨床的評価からみた唇・口蓋裂に由来する上顎劣成長の原因因子について.形成外科 31:778-784,1988.
– reference: 8) Heidbuchel KL and Kuijpers-Jagtman AM: Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients from 3 to 17 years of age. Cleft Palate Craniofac J 34: 21-26, 1996.
– reference: 22) Robertson NRE and Fish J: Early dimensional changes in the arches of cleft palatechildren. Am J Orthod 67: 290-303, 1975.
– reference: 7) Kramer GJ, Hoeksma JB and Prahl-Andersen B: Early palatal changes after initial palatal surgery in children with cleft lip and palate. Cleft Palate Craniofac J 33: 104-111, 1995.
– reference: 11) Peltomaki T, Vendittelli BL, Grayson BH, et al: Associations between severity of clefting and maxillary growth in patients with unilateral cleft lip and palate treated with infant orthopedics. Cleft Palate Craniofac J 38: 582-586, 2001.
– reference: 1) Mulliken JB: Principle and techniques of bilateral complete cleft lip repair. Plas Reconstr Surg 75: 477-485, 1985.
– reference: 10) 神成庸二,大橋 靖:両側性唇顎口蓋裂児の顎発育に関する研究 ―Hotz床併用二段階口蓋形成手術例について―.口科誌 43:423-439.1994.
– reference: 9) 湖城秀久:乳児の歯列成長発育に関する研究 ―上,下顎歯槽部および口蓋部の三次元的計測―.小児歯誌 26:112-130,1988.
– reference: 17) Lehner B, Wiltfang J, Strobel-Schwarthoff K, et al: Influence of early hard palate closure in unilateral and bilateral cleft lip and palate on maxillary transverse growth during the first four years of ages. Cleft Palate Craniofac J 40: 126-130, 2003.
– reference: 14) 平川 崇:異なる術式の口蓋形成術が片側性唇顎口蓋裂患者の顎顔面の成長発達に及ぼす影響.―push-back法,二段階口蓋形成法,頬筋粘膜弁法と非裂者の比較―.昭和歯会誌 22:22-30,2002.
– reference: 15) Huddart AG: Maxillary arch dimensions in bilateral cleft lip and palate subjects. Cleft Palate J 7: 139-155, 1970.
– reference: 19) Roberts CT, Semb G and Shaw WC: Strategies for the advancement of surgical methods in cleft lip and palete. Cleft Palate Craniofac J 28: 141-149, 1991.
– reference: 23) Millard DR and Latham RA: Improved primary surgical and dental treatment of clefts. Plast Reconstr Surg 86: 856-871, 1990.
– reference: 12) Honda Y, Suzuki A, Ohishi M, et al: Longitudinal study on the changes of maxillary arch dimensions in Japanese children with cleft lip and/or palate: infancy to 4 years of age. Cleft Palate Craniofac J 32: 149-155, 1995.
– reference: 2) 土佐泰祥,保阪善昭:硬口蓋前方骨膜を温存した粘膜骨膜弁変法.PEPARS 11:14-21,1996.
– reference: 3) Wardill WEM: The technique of operation for cleft palate. Br J Surg 25: 117-130, 1937.
– reference: 16) Peyton WT: The dimensions and growth of the palate in the normal infant and in the infant with gross maldevelopment of the upper lip and palate. Arch Surg 22: 704-737, 1931.
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SubjectTerms 両側唇顎口蓋裂
顎成長
顎裂幅
Title 両側性唇顎口蓋裂児の顎裂幅と上顎歯槽弓の成長変化の関連性について
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