Frühbehandlung von Kindern mit Lippen-Kiefer-Gaumen-Spalten—kieferorthopädische Aspekte

Abstract

Maxillary alveolar arch morphology and growth was studied in 15 children with complete unilateral cleft lip and palate treated with passive orthopaedic plates. Nine patients were treated to the "Zurich concept" and compared to six children who had lip surgery and primary bone-grafting at about six months of age and complete palate closure at 18 months. Maxillary alveolar arch morphology was described at birth, at six months, at 18 months and at 4.5 years. After early orthopaedic treatment the alveolar and palatal cleft width decreased significantly, the major segment was relocated into a more normal position and the midline deviation was reduced, whereas the minor segment rotated towards the palate.

Two- or Three-Dimensional Cast Analysis in Patients with Cleft Lip and Palate?

“…These changes were shown to follow a similar pattern in cleft lip and palate patients within the 1st year of life, despite different therapeutic procedures. For example, the cleft width decreases significantly, the jaw midline adjusts, the alveolar arch length increases markedly, and the alveolar arch width remains approximately constant [19,23,32,34,40]. If account were taken in the present study only of the mean values of the sample survey, this reaction pattern could also be extracted using a very simple two-dimensional measuring process.…”

“…Lebensjahrs trotz verschiedener therapeutischer Maßnahmen im Durchschnitt nach ähnlichem Muster ablaufen. So verringert sich die Spaltbreite signifikant, die Kiefermitte stellt sich ein, die Alveolarbogenlänge nimmt deutlich zu, und die Alveolarbogenbreite bleibt annähernd konstant [19,23,32,34,40]. Bezieht man sich in der vorliegenden Studie ausschließlich auf die Aussage der Mittelwerte der Stichprobe, so konnte dieses Reaktionsmuster mit einer sehr einfachen zweidimensionalen Messmethode ebenfalls extrahiert werden.…”

“…Cast analyses introduced to date to describe morphological changes in edentulous jaws have been based on the two-or three-dimensional registration of landmarks on the mucosal relief [1,8,21,22,26,27,33,47,48,50]. The measurements have been carried out either directly on the cast [1,8,26,27,46,50] or indirectly using photographs [12,23], photocopies [21,48], or additionally fabricated templates [22].…”