Palatal shape Dotaz Zobrazit nápovědu
OBJECTIVES: To demonstrate the advantages of dense surface models in the evaluation of surgical-assisted rapid maxillary expansion's effect (SARME) on palatal morphology. Furthermore, we compared the palatal surface before (T1) and after (T2) therapy with controls. SETTING AND SAMPLE POPULATION: Surgical-assisted rapid maxillary expansion's effect group of 15 adult patients (Le Fort I and midpalatal sagittal osteotomy, hyrax screw) and 50 adult individuals. Patients were treated in General Faculty Hospital, Prague. MATERIALS AND METHODS: Eighty plaster casts were digitized using a three-dimensional laser scanner and evaluated using traditional and geometric morphometrics. RESULTS: An unpaired Student's t-test on the controls and the SARME T1 group revealed significant differences in all width measurements. Between the controls and the SARME T2 group, significant differences were only related to the interdental angle between the first molars and particularly to the palatal height. The most remarkable differences between the pre- and post-treatment palatal morphology were a widening of the dental arch and buccal shift of the lateral teeth associated with apparent flattening of the alveolar crest. CONCLUSIONS: Dense surface model provided descriptive visualization of the treatment effect and was helpful in the evaluation of palatal shape variability including detection of the most difficult patients. Correction of the dental arch width discrepancy by SARME was successfully achieved. After therapy, palatal shape variability of most of the patients was comparable to the variability of the control group.
- MeSH
- lidé MeSH
- maxila MeSH
- moláry MeSH
- techniky palatinální expanze * MeSH
- zubní oblouk chirurgie MeSH
- zuby MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Facial development of patients with unilateral complete cleft lip and palate (UCLP) is associated with many problems including deformity of the palate. The aim of this study was to evaluate palatal morphology and variability in patients with UCLP compared with Czech norms using methods of geometric morphometrics. The study was based on virtual dental cast analysis of 29 UCLP patients and 29 control individuals at the age of 15 years. The variability of palatal shape in UCLP patients was greater than that in nonclefted palates. Only 24% of clefted palates fell within the variability of controls. The palatal form of UCLP patients (range from 11.8 to 17.2 years) was not correlated with age. Compared with control palates, palates of UCLP patients were narrower, more anteriorly than posteriorly. Apart from the praemaxilla region, they were also shallower, and the difference increased posteriorly. The UCLP palate was characterised by the asymmetry of its vault. The maximum height of the palatal vault was anterior on the clefted side, whereas it was posterior on the nonclefted side. The slope of the UCLP palate was more inclined compared with the control group. The praemaxilla was therefore situated more inferiorly.
- MeSH
- anatomická variace MeSH
- anatomická značka patologie MeSH
- dítě MeSH
- kefalometrie metody MeSH
- lidé MeSH
- maxila patologie MeSH
- mladiství MeSH
- patro patologie MeSH
- počítačové zpracování obrazu metody MeSH
- rozštěp patra patologie MeSH
- rozštěp rtu patologie MeSH
- uživatelské rozhraní počítače MeSH
- věkové faktory MeSH
- zákroky plastické chirurgie metody MeSH
- zobrazování trojrozměrné metody MeSH
- zubní modely MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
Cílem naší studie bylo posoudit tvar a rozměry horního a dolního oblouku u pacientů s rozštěpem po chirurgicko- ortodontické léčbě. Dále porovnat tyto výsledky s hodnotami naměřenými u náhodně vybraného vzorku mladé dospělé plně ozubené zdravé populace a pacientů s ortodontickou anomálií bez rozštěpu před léčbou, těsně po léčbě a s odstupem 5 let. K tomuto měření jsme použili přístroj Orthoscope a počítačovou analýzu obrazu. Prokázali jsme, že moderní ortodontická terapie je schopna u pacientů s ortodontickými anomáliemi a s orofaciálními rozštěpy zvětšit horní zubní oblouk až k hodnotám, které jsou považovány za normu a vytvořit tak optimální podmínky pro následnou protetickou terapii, je-li jí zapotřebí.
The aim of the work was to evaluate the shape and dimension of upper and lower arch in patients with cleft palate after a surgical-orthodontic therapy. We also compared these results with values measured in a randomly selected sample of a young adult population and patients with orthodontic anomaly without cleft palate before the treatment, immediately after therapy and after a lapse of time of 5 years. The measurement employed the Orthoscope apparatus and computing analysis of the image. It has been demonstrated that in patients with orthodontic anomalies and orofacial cleft palate, modern orthodontic therapy is capable of enlarging the upper dental arch to values, which are considered as standard and to create optimal conditions for subsequent prosthetic therapy, if necessary.
Alveolar bone grafting (ABG) is a critical surgical intervention in patients with a cleft of the alveolus, aimed at reconstructing the alveolar ridge to facilitate proper eruption, periodontal support, and alignment of adjacent permanent teeth. The optimal timing for ABG remains debated, with late secondary ABG between the ages of 9 and 11 being widely adopted. This study compared the palatal shapes of 28 children at a mean age of 9.5 years (SD = 0.7) who underwent early secondary ABG at a mean age of 2.1 years (SD = 0.6) or 33 children at a mean age of 10.8 years (SD = 1.5) who underwent late secondary ABG at a mean age of 8.6 years (SD = 1.3) to 60 non-cleft controls at a mean age of 8.6 years (SD = 1.2). The palatal shapes were captured with 239 landmarks digitized on the palate on a digital model. Utilizing geometric morphometric methods, i.e., generalized Procrustes superimpositions, principal component analysis, and permutation tests, we assessed the impact of ABG timing on palatal morphology. The first five principal components (PCs) explained 64.1% of the total shape variability: PC1 = 26.1%; PC2 = 12%; PC3 = 11.9%; PC4 = 7.8%; and PC5 = 6.4%. The Procrustes distance between both cleft groups and the control group was more than twice as large as the Procrustes distance between the early ABG and late ABG groups. Nonetheless, all intergroup differences were statistically significant. Our findings suggest that early ABG has a limited negative effect on palatal shape, providing comparable outcomes to late ABG. The study highlights the potential suitability of early ABG, challenging conventional practices and encouraging further exploration into its long-term effects on maxillary growth.
- Publikační typ
- časopisecké články MeSH
Bilateral complete cleft lip and palate (BCLP) is the most severe of the common orofacial clefts and is associated with the greatest deformity during development. The aim of this study was to use geometric morphometrics to evaluate palatal shape and size variability in patients with BCLP in comparison to nonclefted Czech boys. The variability of palatal size and shape in BCLP patients was greater when compared with the nonclefted population. Though palate variability in BCLP was wide, nonclefted palatal shapes were generally different (a high, wide and vaulted palate) and fell almost outside the range of BCLP variability. The palatal size and shape of BCLP patients (range from 12.1 to 16.5 years) was not correlated with age. A comparison of the mean shapes of the clefted and nonclefted groups showed that the BCLP palate is flatter and narrower. The most notable size difference was found in the area between the maxilla and premaxilla. This phenomenon is associated with the persisting separation of the premaxilla from the rest of the palate. The shape of the palatal configuration of the premaxilla and adjacent area was concave in the nonclefted group and convex in BCLP patients.
- MeSH
- analýza hlavních komponent metody MeSH
- analýza metodou konečných prvků MeSH
- anatomická značka patologie MeSH
- chirurgické laloky MeSH
- dítě MeSH
- kefalometrie metody MeSH
- lasery MeSH
- lidé MeSH
- maxila patologie MeSH
- mladiství MeSH
- ortodoncie korekční metody MeSH
- patro patologie MeSH
- počítačové zpracování obrazu metody MeSH
- rozštěp patra patologie terapie MeSH
- zákroky plastické chirurgie metody MeSH
- zobrazování trojrozměrné metody MeSH
- zubní modely MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- MeSH
- antropometrie metody MeSH
- diagnostické techniky a postupy * přístrojové vybavení trendy využití MeSH
- diagnostické vybavení trendy využití MeSH
- diagnostické zobrazování metody trendy využití MeSH
- jazyk anatomie a histologie patofyziologie patologie MeSH
- lidé MeSH
- patro anatomie a histologie patofyziologie patologie MeSH
- ultrasonografie metody využití MeSH
- ústní a čelistní systém * anatomie a histologie patofyziologie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
Studie se zabývá detekcí a hodnocením zmén, k nimž dochází po ukončení vývoje chrupu na horním zubním oblouku a na patře. Jako modelová situace byla analyzována ortodonticky indikovaná neextrakční terapie nedostatku místa v horním zubním oblouku po ukončení vývoje dentice. K hodnocení patrového reliéfu byla použita metoda profilometrie, která se v ortodont/cké diagnostice u nás zatím nepoužívá. Vedle předpokládaného rozvinutí a zvětšení horního zubního oblouku jsme nalezli v klenbé patra i zmény reliéfu svědčící o pozitivní reakci na expanzní terapii.
The changes of upper dental arch and palate during treatment after finished development of the dentition are studied and evaluated. The non-extraction orthodontic treatment of the lack of space in the upper dental arch was adopted as the model situation and became the subject of our analysis. To assess the profile of the palate the method of profilometry was chosen. This method is not commonly used in orthodontic diagnostics in our country yet. Besides the expected upper dental arch expansion and widening, the changes in the profile of the hard palate were also encountered. These changes are the evidence of a positive response to the expansion therapy.
- MeSH
- lidé MeSH
- ortodoncie korekční metody využití MeSH
- patro růst a vývoj MeSH
- zubní oblouk patologie MeSH
- Check Tag
- lidé MeSH
The degree of deviation of palatal shape from the norm may reflect facial growth disturbance in cleft lip and palate (CLP). The objective of this study was to compare the palatal morphology in children treated with different surgical protocols. Palatal shape was assessed with geometric morphometrics (GM) including Procrustes superimposition, principal component analysis (PCA), and permutation tests with 10,000 permutations, in 24 children treated with two-stage repair with a late palatoplasty (Prague group; mean age at assessment 8.9 years), 16 children after two-stage repair with early palatoplasty (Bratislava group; mean age 8.2 years), and 53 children treated with a one-stage repair (Warsaw group, mean age 10.3 years). The non-cleft control group comprised 60 children at 8.6 years. The first five principal components (PCs) accounted for a minimum of 5% of the total shape variability (65.9% in total). The Procrustes distance was largest for the Prague vs. Control pair and smallest for the Prague vs. Bratislava pair. Nonetheless, all intergroup differences were statistically significant (p < 0.01). One can conclude that variations in palatal shape roughly correspond to cephalometric and dental arch relationship findings from prior research. Among the children who underwent a one-stage repair of the complete cleft, their palatal morphology most closely resembled that of the non-cleft controls. Conversely, children who received late palatoplasty exhibited the greatest degree of deviation.
- Publikační typ
- časopisecké články MeSH
