1.Meta-analysis of curative effect of distraction osteogenesis surgery on craniofacial deformity secondary to cleft lip and palate
Xuqing ZHUGE ; Qian ZHENG ; Xue XU
Chinese Journal of Tissue Engineering Research 2010;14(7):1162-1165
BACKGROUND: The repairing effect of distraction osteogenesis surgery in patients with craniofacial deformity secondary to cleft lip and palate remains unclear.OBJECTIVE: To evaluating the repairing effect of distraction osteogenesis surgery in patients with craniofacial deformity secondary to cleft lip and palate.METHODS: Databases of CNKI, Wanfang, VIP, CBM, Medline(ovid), science direct, ISI, as well as hand working were retrieved for the literatures about the curative effect of distraction osteogenesis on clef lip and palate patents with secondary craniofacial deformity which have been published. Clinical research about distraction osteogenesis used in clef lip and palate patents with secondary craniofacial deformity must have the same assignment style of investigation method and measurement indicators that include objective, design and detailed statistical method of the research. All of the findings can provide elementary data for weighted mean difference and 95% confidence interval (95%C/) or odd ratio and 95% C/. There are at least three patients included in the research and controlled by changes after operation. Meta-analysis was used to make a comprehensive quantitative analYSiS of ANB, the labial teeth overjet, SNA and nasolabial angle which are the soft or hard tissue measured by X-ray cephalometry for the forward-backward and perpendicular direction of the maxillafacial region. According to homogeneity tests, researches about ANB and overjet of the labial teeth adopted random effect model while SNA and nasolabial angle adopted fixed effect model. So total pooling weighted mean difference and its corresponding 95%CI for the models were calculated. RESULTS AND CONCLUSION: Totally 9 references and 123 patients were involved. Homogeneity test showed that, researches about ANB and overjet of the labial teeth are heterogeneous while SNA and nasolabial angle are homoeonomous. Conusarteriosus maps showed no publication bias was observed in all the literature that used in this article. Meta-analysis results showed that, the total pooled weighted mean difference of ANB, overjet of the labial teeth, SNA and nasolabial angle were below zero, all showed significant statistical difference. Meta-analysis can prove the .curative effect of extraoral support-type distraction on the craniofacial deformity secondary to cleft lip and palate. To some extent, this reseamh will provide guidance for choosing therapeutic regimen by the clinicians. After rigid external distraction by Le Fort Ⅰ ostetomy, most of the patients show great changes such as the increased SNA and ANB angle, the flatter of the upper lip curvature followed by the increased nosolabial angle, cured reverse overjet and returned normal occlusion relations.
2.Diversity research about facial morphology of unilateral complete cleft lip and palate affecting by different repair periods of palate repair.
Wenchao ZHU ; Bing SHI ; Qian ZHENG ; Yang LI ; Xuqing ZHUGE ; Xue XU
West China Journal of Stomatology 2012;30(1):68-72
OBJECTIVETo evaluate facial morphology characteristics of patients with unilateral complete cleft lip and palate (UCCLP) after cleft palate repair in different periods.
METHODS46 nonsyndromic UCCLP patients were chosen as test group and divided into three kinds (under 4-year-old, 4-7-year-old, over 7-year-old) according to periods of palate repair. 38 age and gender matched non-clefts children were involved as control group. 26 cephalometric measurements were measured to evaluate facial morphology of four groups.
RESULTSCompared with patients who received palate repair before 4-year-old, patients who received repair after 4-year-old had more protrusive ANS point (Ba-N-ANS, Ba-ANS) and less Y-axis angle. Patients who received palate repair after 7-yesr-old had greater A-PMP and ANS-PMP than patients who received palate repair before 4-year-old, patients who received palate repair before 7-year-old had smaller ANS-Me but after had no significant difference when compared with non-clefts.
CONCLUSIONWhenever palate repair is undertaken in the period of maxillary growth and development, patients' maxillary growth would be restrained, the delayed repair sample have better lower face height, maxillary protrusion, maxillary sagittal length and mandible growing direction when compared with the early repair sample, that is to say, the delayed repair sample have preferable head-face morphology.
Cephalometry ; Child ; Child, Preschool ; Cleft Lip ; Cleft Palate ; Face ; Humans ; Mandible ; Maxilla