Facial Morphology and Occlusion at the Stage of Early Mixed Dentition in Cleft Palate Patients Treated with Furlow Palatoplasty

Facial morphology and occlusion at the stage of early mixed dentition in cleft palate patients treated with Furlow palatoplasty were examined and compared with patients treated with the pushback procedure. The subjects selected for this study were 15 patients with a cleft of the soft palate, who wer...

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Published inJournal of Japanese Cleft Palate Association Vol. 26; no. 1; pp. 23 - 30
Main Authors HAYATSU, Makoto, HANADA, Kooji, ISHII, Kazuhiro, ASAHITO, Toshikazu, TAKAGI, Ritsuo, IIDA, Akihiko, MORITA, Shuichi, IMAI, Nobuyuki, ONO, Kazuhiro
Format Journal Article
LanguageJapanese
Published Japanese Cleft Palate Association 30.04.2001
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ISSN0386-5185
2186-5701
DOI10.11224/cleftpalate1976.26.1_23

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Abstract Facial morphology and occlusion at the stage of early mixed dentition in cleft palate patients treated with Furlow palatoplasty were examined and compared with patients treated with the pushback procedure. The subjects selected for this study were 15 patients with a cleft of the soft palate, who were divided into two different groups: The Furlow group consisted of 3 male and 5 female patients, whose cleft palates were repaired with Furlow double-opposing Z-plasty, at an average age of 1 year and 8 months, and the pushback group consisted of 2 male and 5 female patients, whose cleft palates were closed with the pushback procedure, at an average age of 1 year and 7 months. Cephalometric radiographs (mean age,8 years for the Furlow group, and 7 years and 11 months for the pushback group) and dental study casts (mean age,7 years and 10 months for the Furlow group, and 8 years for the pushback group) were analyzed. Six angles and 4 distances were measured in the cephalograms, and 9 measurements of dental arch width and 2 measurements of dental arch length, were obtained. The results indicated that midfacial growth was significantly better (angle ANB, angle NAPog, distance A' -Ptm' ) and upper dental arches were significantly larger (inter deciduous canine distance, inter first and second deciduous molar distances, dental arch length) in the Furlow group, compared with the pushback group. No subject in the Furlow group had crossbite, while in the pushback group,6 of 7 subjects had anterior and/or posterior crossbite. As Furlow palatoplasty avoids the need for a lengthening procedure that uses mucoperiosteal flaps from the hard palate, it could allow adequate maxillary growth.
AbstractList Facial morphology and occlusion at the stage of early mixed dentition in cleft palate patients treated with Furlow palatoplasty were examined and compared with patients treated with the pushback procedure. The subjects selected for this study were 15 patients with a cleft of the soft palate, who were divided into two different groups: The Furlow group consisted of 3 male and 5 female patients, whose cleft palates were repaired with Furlow double-opposing Z-plasty, at an average age of 1 year and 8 months, and the pushback group consisted of 2 male and 5 female patients, whose cleft palates were closed with the pushback procedure, at an average age of 1 year and 7 months. Cephalometric radiographs (mean age,8 years for the Furlow group, and 7 years and 11 months for the pushback group) and dental study casts (mean age,7 years and 10 months for the Furlow group, and 8 years for the pushback group) were analyzed. Six angles and 4 distances were measured in the cephalograms, and 9 measurements of dental arch width and 2 measurements of dental arch length, were obtained. The results indicated that midfacial growth was significantly better (angle ANB, angle NAPog, distance A' -Ptm' ) and upper dental arches were significantly larger (inter deciduous canine distance, inter first and second deciduous molar distances, dental arch length) in the Furlow group, compared with the pushback group. No subject in the Furlow group had crossbite, while in the pushback group,6 of 7 subjects had anterior and/or posterior crossbite. As Furlow palatoplasty avoids the need for a lengthening procedure that uses mucoperiosteal flaps from the hard palate, it could allow adequate maxillary growth.
Facial morphology and occlusion at the stage of early mixed dentition in cleft palate patients treated with Furlow palatoplasty were examined and compared with patients treated with the pushback procedure. The subjects selected for this study were 15 patients with a cleft of the soft palate, who were divided into two different groups: The Furlow group consisted of 3 male and 5 female patients, whose cleft palates were repaired with Furlow double-opposing Z-plasty, at an average age of 1 year and 8 months, and the pushback group consisted of 2 male and 5 female patients, whose cleft palates were closed with the pushback procedure, at an average age of 1 year and 7 months.Cephalometric radiographs (mean age,8 years for the Furlow group, and 7 years and 11 months for the pushback group) and dental study casts (mean age,7 years and 10 months for the Furlow group, and 8 years for the pushback group) were analyzed. Six angles and 4 distances were measured in the cephalograms, and 9 measurements of dental arch width and 2 measurements of dental arch length, were obtained. The results indicated that midfacial growth was significantly better (angle ANB, angle NAPog, distance A' -Ptm' ) and upper dental arches were significantly larger (inter deciduous canine distance, inter first and second deciduous molar distances, dental arch length) in the Furlow group, compared with the pushback group. No subject in the Furlow group had crossbite, while in the pushback group,6 of 7 subjects had anterior and/or posterior crossbite. As Furlow palatoplasty avoids the need for a lengthening procedure that uses mucoperiosteal flaps from the hard palate, it could allow adequate maxillary growth. Furlow法を施行した口蓋裂児の混合歯列前期における顎顔面形態を調査し,pushback法を行ったものと比較した.対象はFurlow法により口蓋形成手術を行った軟口蓋裂男児3名,女児5名の計8名(Furlow群)と,pushback法により口蓋形成手術を行った軟口蓋裂男児2名,女児5名の計7名(pushback群)である.手術時年齢はFurlow群では平均1歳8か月,pushback群では平均1歳7か月であった.側面頭部X線規格写真(Furlow群は平均8歳,pushback群は平均7歳11か月)および石膏歯列模型(Furlow群は平均7歳10か月,pushback群は平均8歳)を資料とし,写真分析では6項目の角度計測と4項目の距離計測を,模型分析では歯列幅径に関して9項目,長径に関して2項目の距離計測を行った.その結果,Furlow群はpushback群に比べ良好な顔の骨格型を呈しており,角ANB,角NAPo9,硬口蓋長を表す長さA'-Ptm'で両群問に統計学的有意差が認められた.また,Furlow群の上顎歯列弓はpushback群に比較して明らかに大きく,乳犬歯問幅径第一および第二乳臼歯間幅径,ならびに歯列弓長径で両群間に統計学的有意差が認められた.Furlow群では全例が交叉咬合のない正常な被蓋関係であり,それに対してpushback群では7名中6名に交叉咬合がみられ,前歯および臼歯部のものが4名,臼歯部のみのものが2名観察された.Furlow法は硬口蓋の組織を用いずに軟口蓋を延長できることから顎発育への影響が少なく,患児固有の成長を引き出すことができ,有用な手術法であることが明らかになった.
Author IMAI, Nobuyuki
ISHII, Kazuhiro
IIDA, Akihiko
ONO, Kazuhiro
ASAHITO, Toshikazu
HAYATSU, Makoto
HANADA, Kooji
TAKAGI, Ritsuo
MORITA, Shuichi
Author_FL 早津 誠
石井 一裕
高木 律男
森田 修一
飯田 明彦
花田 晃治
朝日藤 寿一
今井 信行
小野 和宏
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DocumentTitleAlternate Furlow法を施行した口蓋裂児の混合歯列前期における顎顔面形態について
pushback法施行例との比較
DocumentTitle_FL Furlow法を施行した口蓋裂児の混合歯列前期における顎顔面形態について
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References 6)高戸 毅, 伊東 優, 竹田秀円, 他: Furlow法を用いた口蓋形成術の経験, 形成外科, 33: 15-21, 1990.
4) Poole, M. D. and Numm, M.: Early experience with Furlow's cleft palate technique (abst). Br J Plast Surg, 42: 359, 1989.
14) Chen, P. K-T., Wu, J., Hung, K-F., et al: Surgical correction of submucous cleft palate with Furlow palatoplasty. Plast Reconstr Surg, 97: 1136-1146, 1996.
11)秦維郎, 田野口二三子, 酒井俊一: Furlow法による口蓋裂術後成績-手技と獲得言語の成績について-. 形成外科, 38: 707-714, 1995.
7) Spauwen, P. H. M., Goorthuis-Brouwer, S. M. and Schutte, H. K.: Cleft palate repair: Furlow versus von Langenbeck. J Cranio-Maxillo-Fac Surg, 20: 18-20, 1992.
9)北野市子, 朴 修三, 加藤光剛, 他: 当院におけるFurlow法による口蓋形成術後の言語成績. 日口蓋誌, 19: 16-21, 1994.
17) Kirschner, R. E., Wang, P., Jawad, A. F., et al: Cleft-palate repair by modified Furlow double-opposing Z-plasty: The Children's Hospital of Philadelphia experience. Plast Reconstr Surg, 104: 1998-2010, 1999.
12)井上裕史, 吉龍澄子, 日笠 壽, 他: Furlow法52例の術後成績: Pushback法との比較. 日口蓋誌, 20: 17-21, 1995.
19) Vistnes, L. M. and Jobe, R. P.: Experience with the Furlow palatoplasty. In Kernahan, D. A., Rosenstein, S. W. ed; Cleft lip and palate A system of management. 199-203, WILLIAMS & WILKINS, Baltimore, 1990.
3) Randall, P., LaRossa, D., Solomon, M., et al: Experience with the Furlow double reversing Z-plasty for cleft palate repair. Plast Reconstr Surg, 77: 569-574, 1986.
8) Horswell, B. B., Castiglione, C. L., Poole, A. E., et al: The double-reversing Z-plasty in primary palatoplasty: Operative experi- ence and early results. J Oral Maxillofac Surg, 51: 145-149, 1993.
13) McWilliams, B. J., Randall, P., LaRossa, D., et al: Speech characteristics associated with the Furlow palatoplasty as compared with other surgical techniques. Plast Reconstr Surg, 98: 610-619, 1996.
16) Lin, K. Y., Goldberg, D., Williams, C., et al: Long-term outcome analysis of two treatment methods for cleft palate: Com- bined levator retropositioning and pharyn- geal flap versus double-opposing Z-plasty. Cleft Palate-Craniofac J, 36: 73-78, 1999.
18)大久保文雄, 保阪善昭, 加藤正子, 他: 口蓋裂手術: Furlow法-粘膜弁法との比較-. 形成外科, 43: 39-45, 2000.
1) Furlow, L. T.: Cleft palate repair by double opposing Z-plasty. Plast Reconstr Surg, 78: 724-736, 1986.
5) Furlow, L. T.: Flaps for cleft lip and palate surgery. Clin Plast Surg, 17: 633-644, 1990.
10) Brothers, D. B., Dalston, R. W., Peterson, H. D., et al: Comparison of the Furlow double-opposing Z-plasty with the Wardill-Kilner procedure for isolated clefts of the soft palate. Plast Reconstr Surg, 95: 969- 977, 1995.
15) Gunther, E., Wisser, J. R., Cohen, M. A., et al: Palatoplasty: Furlow's double reversing Z-plasty versus intravelar veloplasty. Cleft Palate-Craniofac J, 35: 546-549, 1998.
2)小野和宏, 大橋 靖, 神成庸二, 他: Furlow法による口蓋形成術 第2報: 鼻咽腔閉鎖機能ならびに顎発育への影響について. 日口外誌, 41: 220-223, 1995.
References_xml – reference: 4) Poole, M. D. and Numm, M.: Early experience with Furlow's cleft palate technique (abst). Br J Plast Surg, 42: 359, 1989.
– reference: 17) Kirschner, R. E., Wang, P., Jawad, A. F., et al: Cleft-palate repair by modified Furlow double-opposing Z-plasty: The Children's Hospital of Philadelphia experience. Plast Reconstr Surg, 104: 1998-2010, 1999.
– reference: 16) Lin, K. Y., Goldberg, D., Williams, C., et al: Long-term outcome analysis of two treatment methods for cleft palate: Com- bined levator retropositioning and pharyn- geal flap versus double-opposing Z-plasty. Cleft Palate-Craniofac J, 36: 73-78, 1999.
– reference: 7) Spauwen, P. H. M., Goorthuis-Brouwer, S. M. and Schutte, H. K.: Cleft palate repair: Furlow versus von Langenbeck. J Cranio-Maxillo-Fac Surg, 20: 18-20, 1992.
– reference: 19) Vistnes, L. M. and Jobe, R. P.: Experience with the Furlow palatoplasty. In Kernahan, D. A., Rosenstein, S. W. ed; Cleft lip and palate A system of management. 199-203, WILLIAMS & WILKINS, Baltimore, 1990.
– reference: 1) Furlow, L. T.: Cleft palate repair by double opposing Z-plasty. Plast Reconstr Surg, 78: 724-736, 1986.
– reference: 13) McWilliams, B. J., Randall, P., LaRossa, D., et al: Speech characteristics associated with the Furlow palatoplasty as compared with other surgical techniques. Plast Reconstr Surg, 98: 610-619, 1996.
– reference: 5) Furlow, L. T.: Flaps for cleft lip and palate surgery. Clin Plast Surg, 17: 633-644, 1990.
– reference: 6)高戸 毅, 伊東 優, 竹田秀円, 他: Furlow法を用いた口蓋形成術の経験, 形成外科, 33: 15-21, 1990.
– reference: 18)大久保文雄, 保阪善昭, 加藤正子, 他: 口蓋裂手術: Furlow法-粘膜弁法との比較-. 形成外科, 43: 39-45, 2000.
– reference: 12)井上裕史, 吉龍澄子, 日笠 壽, 他: Furlow法52例の術後成績: Pushback法との比較. 日口蓋誌, 20: 17-21, 1995.
– reference: 11)秦維郎, 田野口二三子, 酒井俊一: Furlow法による口蓋裂術後成績-手技と獲得言語の成績について-. 形成外科, 38: 707-714, 1995.
– reference: 14) Chen, P. K-T., Wu, J., Hung, K-F., et al: Surgical correction of submucous cleft palate with Furlow palatoplasty. Plast Reconstr Surg, 97: 1136-1146, 1996.
– reference: 10) Brothers, D. B., Dalston, R. W., Peterson, H. D., et al: Comparison of the Furlow double-opposing Z-plasty with the Wardill-Kilner procedure for isolated clefts of the soft palate. Plast Reconstr Surg, 95: 969- 977, 1995.
– reference: 8) Horswell, B. B., Castiglione, C. L., Poole, A. E., et al: The double-reversing Z-plasty in primary palatoplasty: Operative experi- ence and early results. J Oral Maxillofac Surg, 51: 145-149, 1993.
– reference: 9)北野市子, 朴 修三, 加藤光剛, 他: 当院におけるFurlow法による口蓋形成術後の言語成績. 日口蓋誌, 19: 16-21, 1994.
– reference: 15) Gunther, E., Wisser, J. R., Cohen, M. A., et al: Palatoplasty: Furlow's double reversing Z-plasty versus intravelar veloplasty. Cleft Palate-Craniofac J, 35: 546-549, 1998.
– reference: 3) Randall, P., LaRossa, D., Solomon, M., et al: Experience with the Furlow double reversing Z-plasty for cleft palate repair. Plast Reconstr Surg, 77: 569-574, 1986.
– reference: 2)小野和宏, 大橋 靖, 神成庸二, 他: Furlow法による口蓋形成術 第2報: 鼻咽腔閉鎖機能ならびに顎発育への影響について. 日口外誌, 41: 220-223, 1995.
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Snippet Facial morphology and occlusion at the stage of early mixed dentition in cleft palate patients treated with Furlow palatoplasty were examined and compared with...
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SubjectTerms Cleft palate
Furlow palatoplasty
Furlow法
Maxillofacial development
口蓋裂
顎発育
Title Facial Morphology and Occlusion at the Stage of Early Mixed Dentition in Cleft Palate Patients Treated with Furlow Palatoplasty
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