Cleft Lip, Alveolus And Palate Research Articles

口唇形成術後の経時的形態変化 術式改良前後の結果の比較について

Anthropometric analysis was carried out on the facial soft tissue of unilateral cleft lip (and palate) patients who underwent surgical operations for lip repair during 1986-1990, and the data were compared with those for cases operated during 1981-1986.The methods of measurement and analysis were the same as described previously (J. Jpn. Cleft Palate Assoc. No.13, p47-71, 1988). Fourteen points were selected, and the patient's face was marked. The deviation of the alar base and the columellar base was estimated by using a sliding caliper directly on the patient's face before and directly after surgery, and 2 weeks, 1 month and 3 months after the operation. The subjects consisted of 25 CL (cleft lip with or without alveolar cleft) and 30 CLP (cleft lip, alveolus and palate) patients.The results were as follows:1. The position of the columellar base was nearer the midline than that in the previous cases 3 months after the operation.2. In patients with narrow cleft width, both lateral nasal alae were shifted in a more symmetrical position than in previous cases.3. The downward deviation of the alar base on the cleft side was corrected into a symmetrical position 3 months after the operation.4. The marginal length of the naris on the cleft side was longer than that of the noncleft side 3 months after the operation. But the difference between the both sides was less than that in previous cases.

The significance of alveolar bone in periodontal disease

The periodontal conditions in 19 patients with unilateral cleft lip, alveolus and palate (CLAP) and in 6 patients with bilateral CLAP, were evaluated in 1979 and re-examined in 1987. During these 8 years, these patients were not subjected to any professionally supervised maintenance care program. Pronounced plaque accumulation and high frequency of gingival units exhibiting bleeding on probing were noted in the majority of the patients both in 1979 and 1987, documenting inadequate oral hygiene standards with resulting inflammatory reactions of the periodontal tissues. Progression of periodontal disease over time was assessed as loss of clinical attachment and loss of alveolar bone height. The periodontal destruction was not found to be more severe at cleft sites with a long connective tissue attachment than at control sites not affected by cleft defects. It was concluded that sites with a long supracrestal connective tissue attachment do not seem to be more prone to periodontal destruction, induced by bacterial infection, than sites with a normal length of the supraalveolar fibrous attachment. The results also show that the alveolar bone height, as visualized in radiographs at sites with alveolar defects, is of limited value for the diagnosis of the degree of periodontal destruction at such sites.