title: How should postoperative palatal contraction be inhibited following palatoplasty? Dental arch development due to artificial antimolding action and natural molding action: clinical trial.
abstract: Push back palatoplasty induces postoperative contraction and collapse of the dental arch. To inhibit collapse, 2 kinds of intersegment fixation plate, segment yoking plates, were applied. In one method, the segments were fixed with a resin plate onto the mucoperiosteal flap by 2 screws to fix palatal bone for 6 months (PB resin group, number of patients = 11). In the other method, the segments were fixed with a titanium plate by 2 screws onto the palatal bone under the mucoperiosteal flap until 4 years of age (PB titanium group, n = 10). Operation by conventional push back palatoplasty (PB Group, n = 25) was used as a control. Consecutive plaster models were measured by 3-dimensional laser scanner from at palatoplasty up to 4 years of age. In the PB resin group, the anticontraction effect worked only at the early postoperative stage. At 4 years of age, the narrowest intercanine width due to segment rotation caused by medial shift of the cleft side canine point and lateral shift of the cleft side tuberosity point was observed. As a result, a V-shaped dental arch developed. In the PB titanium group, the widest intercanine width due to a rigid anticontraction effect was observed at 4 years of age. Three push back methods demonstrated different arch morphologies due to each rigidity of the plate.
authors.affiliation: Department of Oral and Maxillofacial Regeneration, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan. kitagawa@dent.osaka-u.ac.jp
authors.forename: Taiji
authors.initials: T
authors.lastname: Kitagawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kohara
authors.forename: Taiji
authors.initials: T
authors.lastname: Sohmura
authors.forename: Junzo
authors.initials: J
authors.lastname: Takahashi
authors.forename: Akifumi
authors.initials: A
authors.lastname: Enomoto
authors.forename: Emiko
authors.initials: E
authors.lastname: Tanaka
authors.forename: Tokuzo
authors.initials: T
authors.lastname: Matsuya
authors.forename: Mikihiko
authors.initials: M
authors.lastname: Kogo
mesh_terms: D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D003724:Dental Arch / Q000503:physiopathology; D017266:Dental Prosthesis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008445:Maxillofacial Development / Q000502:physiology; D019647:Oral Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications