1988 年 35 巻 1 号 p. 19-38
Sixty cleft lip and palate crossbite patients from the Kurume University School of Medicine Hospital were compared with 64 non-cleft, cross bite subjects. Their facial morphologic differences were analyzed by comparing their lateral cephalograms prior to orthodontic therapy. The following results were obtained : 1. In the anterior region of the facial profile of the cleft sample, marked suppression of growth in the forward of the upper and lower jaws was observed. 2. The antero-posterior diameter of the cranial base in the cleft sample was small in the cleft compared to the control sample. Cranial base angle was somewhat flattened in the cleft sample; this effect was not significant. 3. The antero-posterior diameter of the maxilla was significantly smaller in the cleft sample; furthermore maxilla showed the lack of growth and was positioned in the upward/posterior location. 4. The following positional and morphologic changes of the mandible were observed in the cleft sample : retrusion of point B, shortening of the mandibular ramus height, and enlargement of the mandibular plane angle. 5. Thickness of the mandibular symphysis at Point B was significantly narrower while the symphysis height was significantly greater in the cleft sample. Marked lingual inclination of the symphysis was observed in the cleft sample. 6. As there was a lack of growth of the maxilla in the cleft sample, the skeletal profile of the maxillo-mandibular relationship became concave in this sample, and this condition was progressively worsening with age. All these findings suggest that for appropriate orthodontic treatment of the cleft lip and palate patient, it is necessary to guide and promote the growth of the maxilla to the forward/downward direction with the early use of orthopedic force. Furthermore, because of the distortion of the symphysis contour and its further alterations with age in the cleft sample, it will be difficult to incline the lower teeth lingually; this makes the treatment of cleft lip and palate patients much more difficult.
