02 Original 2011(1)-10web1.dent.cmu.ac.th/cmdj/fulltext/fulltext_2554_32_1_285.pdf¡. ∑—πµ...
Transcript of 02 Original 2011(1)-10web1.dent.cmu.ac.th/cmdj/fulltext/fulltext_2554_32_1_285.pdf¡. ∑—πµ...
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º≈°√–∑∫®“°§«“¡Àπ“√‘¡Ω望°µàÕº≈¢Õß°“√ª≈Ÿ° °√–¥Ÿ°‡∫â“øíπ„πºŸâªÉ«¬ª“°·À«à߇楓π‚À«à¥â“π‡¥’¬«
·∫∫¡∫Ÿ√≥å: √–‡∫’¬∫«‘∏’ ‰ø‰π∑å ‡Õ≈‘‡¡πµå Effects of Lip Thickness on Alveolar Bone Grafting
Outcomes in Patients with Complete Unilateral Cleft Lip and Palate: Finite Element Analysis
»‘√‡»√…∞å ¡ß§≈Õÿª∂—¡¿å1, ∏ß™—¬ øÕß¡ÿ∑√2, ¡“√»√’ ™—¬«√«‘∑¬å°ÿ≈3 1π—°»÷°…“À≈—ߪ√‘≠≠““¢“∑—πµ°√√¡®—¥øíπ ¿“§«‘™“∑—πµ°√√¡®—¥øíπ·≈–∑—πµ°√√¡”À√—∫‡¥Á° §≥–∑—πµ·æ∑¬»“µ√å ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à
2¿“§«‘™“«‘»«°√√¡‡§√◊ËÕß°≈ §≥–«‘»«°√√¡»“µ√å ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à 3¿“§«‘™“∑—πµ°√√¡®—¥øíπ·≈–∑—πµ°√√¡”À√—∫‡¥Á° §≥–∑—πµ·æ∑¬»“µ√å ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à
Siraseth Mongkolupatham1, Thongchai Fongsamootr2, Marasri Chaiworawitkul3 1Postgraduate student in Orthodontics, Department of Orthodontics and Pediatric Dentistry,
Faculty of Dentistry, Chiang Mai University2Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University
3Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University
™¡.∑—πµ“√ 2554; 32(1) : 93-103 CM Dent J 2011; 32(1) : 93-103
Corresponding Author:
¡“√»√’ ™—¬«√«‘∑¬å°ÿ≈ ºŸâ™à«¬»“µ√“®“√¬å ¿“§«‘™“∑—πµ°√√¡®—¥øíπ·≈–∑—πµ°√√¡ ”À√—∫‡¥Á° §≥–∑—πµ·æ∑¬»“µ√å ¡À“«‘∑¬“≈—¬‡™’¬ß„À¡à
Marasri ChaiworawitkulAssistant Professor, Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand.E-Mail: [email protected]
∫∑«‘∑¬“°“√ Original Article
∫∑§—¥¬àÕ ß“π«‘®—¬π’È ‡ªìπ°“√»÷°…“π”√àÕ߇æ◊ËÕÀ“§«“¡
—¡æ—π∏å¢Õߧ«“¡Àπ“√‘¡Ω望°·≈–º≈¢Õß°“√ª≈Ÿ°
°√–¥Ÿ°‡∫â“øíπ„πºŸâªÉ«¬ª“°·À«à߇楓π‚À«à¥â“π‡¥’¬«
·∫∫¡∫Ÿ√≥å ‚¥¬Õ“»—¬¿“æ√—ß’ 2 ™π‘¥ §◊Õ ¿“æ√—ß’
°—¥∫ ·≈–¿“æ√—ß’°–‚À≈°»’√…–¥â“π¢â“ߢÕߺŸâªÉ«¬
10 √“¬ °àÕπ°“√ª≈Ÿ°°√–¥Ÿ°‡∫â“øíπ 1 ‡¥◊Õπ·≈–À≈—ß
°“√ª≈Ÿ°°√–¥Ÿ° 1 ªï ‚¥¬«—¥°“√‡ª≈’ˬπ·ª≈ßÕ—µ√“à«π
§«“¡Ÿß¢Õß°√–¥Ÿ°∑’˪≈Ÿ° ·≈–„™â«‘∏’‰ø‰π∑å ‡Õ≈‘‡¡πµå
“¡¡‘µ‘‡æ◊ËÕÀ“§«“¡—¡æ—π∏å¢Õߧ«“¡Àπ“√‘¡Ω望°
Abstract Objective of this pilot study was to define a
relationship of upper lip thickness and alveolar
bone grafting outcomes in patients with complete
unilateral cleft lip and palate. Occlusal
topographic radiographs and lateral cephalo-
grams, at 1 month and 1 year after alveolar bone
grafting of 10 patients were assessed to evaluate
changes of grafted bone height percentages.
Three-dimensional finite element models were
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94 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 95 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
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‡µÕ√å (Computerized Tomography scan) æ∫«à“ºŸâªÉ«¬
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√—°…“ °“√ª≈Ÿ°°√–¥Ÿ°„πºŸâªÉ«¬ª“°·À«à߇楓π‚À«à¡’®ÿ¥
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°√–¥Ÿ°∑’Ë¥’∑’ Ëÿ¥∑’Ëπ”¡“ª≈Ÿ°§◊Õ°√–¥Ÿ°–‚æ° (iliac
bone)(8)
°“√ª≈Ÿ°°√–¥Ÿ°π‘¬¡·∫à߉¥â‡ªìπ 3 √–¬– ‰¥â·°à
√–¬–ª∞¡¿Ÿ¡‘ √–¬–∑ÿµ‘¬¿Ÿ¡‘·≈–√–¬–µµ‘¬¿Ÿ¡‘ (Primary,
secondary and tertiary bone graft) °“√ª≈Ÿ°°√–¥Ÿ°
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”§—≠∑“ß∂‘µ‘ ´÷ËßÕ¥§≈âÕß°—∫º≈°“√«‘‡§√“–Àå¥â«¬
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°√–∑”µàÕ¢“°√√‰°√∫π¡“° ®“°º≈°“√»÷°…“®÷ß√ÿª
‰¥â«à“§«“¡Àπ“¢Õß√‘¡Ω望°Õ“®¡’º≈µàÕ°“√ª≈Ÿ°°√–¥Ÿ°
‡∫â“øíπ
§””§—≠: ª“°·À«à߇楓π‚À«à, §«“¡Àπ“√‘¡Ω望°,
‰ø‰π∑å ‡Õ≈‘‡¡πµå
created to reveal a relationship of lip thickness
and force loaded on the maxilla. The results
showed a statistically significant correlation
between lip thickness and postsurgical graft
alveolar bone height ratio: the less lip thickness,
the less alveolar bone graft height remaining.
Moreover, a finite element study result also
indicated that the less lip thickness, the more
loaded force on maxilla. These concluded that lip
thickness might be a factor affecting alveolar
bone grafting outcomes.
Keywords: Cleft, Lip thickness, Finite element
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94 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 95 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
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®“° Bergland ·≈–§≥–) Figure 1 Bergland’s scale of bone height
(modified from Bergland et al. 2003)(14)
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96 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 97 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
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headgear ·≈– facemask µàÕ¢“°√√‰°√∫π‚¥¬„™â«‘∏’‰ø
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96 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 97 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
π§√‡™’¬ß„À¡à„π™à«ßªï æ.». 2547 ∂÷ß 2551 ‚¥¬¿“æ∂à“¬
√—ß’Õß¡‘µ‘·≈–‚¥¬«‘∏’‰ø‰π∑å ‡Õ≈‘‡¡πµå
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°≈ÿࡵ—«Õ¬à“߇ªìπºŸâªÉ«¬ª“°·À«à߇楓π‚À«à∑’ˉ¡à¡’
°≈ÿà¡Õ“°“√º‘¥ª°µ‘Õ◊Ëπ ™π‘¥¡∫Ÿ√≥å¥â“π‡¥’¬« (non
syndromic complete unilateral cleft lip and palate)
∑’Ë¡’Õ“¬ÿ√–À«à“ß 8 -14 ªï ®”π«π 10 √“¬ ´÷Ë߉¥â√—∫°“√
ºà“µ—¥ª≈Ÿ°°√–¥Ÿ°®“°‚√ß欓∫“≈¡À“√“™π§√‡™’¬ß„À¡à
„π™à«ßªï æ.». 2547 ∂÷ß 2551 ¡’√–‡∫’¬πª√–«—µ‘¡∫Ÿ√≥å
·≈–‰¥â√—∫°“√ºà“µ—¥‚¥¬»—≈¬·æ∑¬åºŸâ‡™’ˬ«™“≠ 2 ∑à“π
¥â«¬‡∑§π‘§‡¥’¬«°—π ®“°π—Èππ”¿“æ∂à“¬√—ß’°–‚À≈°
»’√…–¥â“π¢â“ß°àÕπ°“√ª≈Ÿ°°√–¥Ÿ° 1 ‡¥◊Õπ·≈–À≈—ߪ≈Ÿ°
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¿“æ√—ß’°—¥∫À≈—ߪ≈Ÿ°°√–¥Ÿ° 1 ‡¥◊Õπ ·≈–À≈—ߪ≈Ÿ°
°√–¥Ÿ° 1 ªï¡“À“§à“√âÕ¬≈–¢Õߧ«“¡Ÿß°√–¥Ÿ°∑’Ë≈¥≈ß
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°√√‰°√∫π¢ÕߺŸâªÉ«¬ª“°·À«à߇楓π‚À«à™à«ßÕ“¬ÿ 8-14
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‚Àπ¥‡Õ≈‘‡¡π∑å (element) ·≈–§ÿ≥¡∫—µ‘°“¬¿“æ„Àâ°—∫
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(load) ∑’Ë¡ÿ¡ª“°∑”¡ÿ¡ 30 Õß»“°—∫·π«§«“¡¬“«¢Õß√‘¡
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Õ¬à“ßπâÕ¬ 7 «—π °“√ª√–‡¡‘π‚¥¬°“√«—¥¿“æ√—ß’·µà≈–
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·µà≈–¿“æµâÕß¡’§«“¡·µ°µà“ߢÕß°“√«—¥µâÕ߉¡à‡°‘π 0.5
¡.¡. ¡‘©–π—Èπ°“√®–∑”«—¥§√—Èß∑’Ë“¡·≈â«π”‰ªÀ“§à“‡©≈’ˬ
¢Õß¿“æ√—ß’π—Èπ ¿“æ∂à“¬√—ß’√—ß’°–‚À≈°»’√…–¥â“π¢â“ß
®–π”¡“«—¥§«“¡Àπ“¢Õß√‘¡Ω望°‚¥¬«‘∏’¢Õß Filho
·≈–§≥–(8) ‚¥¬≈“°‡âπ N-Pog §«“¡Àπ“¢Õß√‘¡Ω望°
À“§à“‚¥¬«—¥√–¬–®“°¢Õ∫√‘¡Ω望° (vermillion border)
µ—Èß©“°¡“¬—߇âπ¥—ß°≈à“«®√¥º‘«øíπ¥â“π„°≈â√‘¡Ω望°
(√Ÿª∑’Ë 2)
√Ÿª∑’Ë 2 °“√«—¥§«“¡Àπ“√‘¡Ω望° (¥—¥·ª≈ß®“° Filho
·≈–§≥–) Figure 2 Measurement of upper lip thickness : a)
Illustrated N-Pog line and a line tangent
to it, b) Lip thickness measurement in
lateral cephalometric radiographs
(modified from Filho et al. 2003)(8)
¿“æ√—ß’°—¥∫∂Ÿ°π”¡“ª√–‡¡‘π‚¥¬¥—¥·ª≈ß®“°«‘∏’
¢Õß Long ·≈–§≥–(16) ‚¥¬≈“°‡âπ·∫àߧ√÷Ëß√“°øíπµ“¡
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∑—ÈßÕß∑’ËÕ¬Ÿà√–À«à“ß™àÕß‚À«à ®“°π—Èπ≈“°‡âπ¡¡ÿµ‘‡™◊ËÕ¡
°÷Ëß°≈“߬եøíπ ·∫àߧ√÷Ë߇âπ¡¡ÿµ‘∑—ÈßÕß·≈â«≈“°‡âπ
‡™◊ËÕ¡√–À«à“ß®ÿ¥·∫àߧ√÷Ëß∑—ÈßÕߥ—ß°≈à“« «—¥√–¬–®“°®ÿ¥
°÷Ëß°≈“ߢÕ߇âπ∑’ˇ™◊ËÕ¡ª≈“¬√“°øíπ¡“¬—ß—π°√–¥Ÿ° ®–
‰¥â√–¬–§«“¡Ÿß¢Õß°√–¥Ÿ° ®“°π—Èππ”§à“∑’ˉ¥â‰ªÀ“√
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98 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 99 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
¥â«¬§«“¡¬“«¢Õßøíπµ—¥´’Ë°≈“ß ®–‰¥â√âÕ¬≈–Õ—µ√“à«π
¢Õß√–¥—∫§«“¡Ÿß°√–¥Ÿ°∑’Ë≈¥≈ß (√Ÿª∑’Ë 3)
À≈—ß®“°«‘‡§√“–Àå¿“√–·√ß°√–∑”¥â«¬«‘∏’‰ø‰π∑å ‡Õ
≈‘‡¡πµå·≈â« ·√ß≈—æ∏å∑’ˉ¥â®–∂Ÿ°π”‰ª§”π«≥‡æ◊ËÕÀ“§à“
π‘«µ—πµàÕæ◊Èπ∑’Ë ‚¥¬§”π«≥®“°·√ß≈—æ∏å∫π‚Àπ¥ 10
‚Àπ¥ æ◊Èπ∑’Ë∑’˧√Õ∫§≈ÿ¡‚Àπ¥¥—ß°≈à“«®–∂Ÿ°«—¥«à“¡’æ◊Èπ∑’Ë
‡∑à“„¥ ®“°π—Èππ”·√ß≈—æ∏å∑’Ë°√–∑”∫πæ◊Èπ∑’Ë¥—ß°≈à“«¡“
§”π«≥À“§à“‡©≈’ˬ ·≈–𔉪§”π«≥„π¢—ÈπµÕπµàÕ‰ª
ª√‘¡“≥§à“‡©≈’ˬ·√ß≈—æ∏å´÷Ëß¡’Àπ૬‡ªìπ π‘«µ—πµàÕ
æ◊Èπ∑’Ë ®“°¿“√–·√ß°√–∑”∑—Èß 3 §à“¥—ß°≈à“« ∂Ÿ°π”‰ª„™â
‡ªìπ·√ß°√–∑”¢Õß·∫∫®”≈Õß°√–¥Ÿ°¢“°√√‰°√∫π ·∫∫
®”≈Õß™‘Èππ’È∂Ÿ°¬÷¥µ“¬µ—«∑’Ë∫√‘‡«≥¥â“πÀ≈—ߥâ“π∫π ‰°≈
®“°æ◊Èπ∑’Ë∑’Ë„à¿“√–·√ß (√Ÿª∑’Ë 5) ·√ß°√–∑”∑—Èß 3 √–¥—∫
‰¥â·°à ·√߇∫“ ª“π°≈“ß·≈–Àπ—°∂Ÿ°„à„π∑‘»∑“ߥ—π¢“
°√√‰°√‰ª∑“ߥâ“πÀ≈—ß (¥â“π‡æ¥“π) ®“°π—È𫑇§√“–Àå
º≈≈—æ∏å¥â«¬«‘∏’‰ø‰π∑å ‡Õ≈‘‡¡πµå
√Ÿª∑’Ë 3 °“√«—¥Õ—µ√“à«π¢Õß√–¥—∫§«“¡Ÿß°√–¥Ÿ° (¥—¥
·ª≈ß®“° Long ·≈–§≥–) Figure 3 Measurement of grafted bone height
ratio (Modified from Long, 1995)(16)
°“√«‘‡§√“–Àå∑“ß∂‘µ‘ °“√§”π«≥§«“¡Àπ“√‘¡Ω望°·≈–Õ—µ√“à«π¢Õß
√–¥—∫§«“¡Ÿß°√–¥Ÿ°„π™àÕß‚À«à„™â∂‘µ‘·∫∫æ√√≥π“
«‘∏’°“√«—¥§«“¡Àπ“√‘¡Ω望°„π¿“æ∂à“¬√—ß’√—ß’°–‚À≈°
»’√…–¥â“π¢â“ß®–∂Ÿ°π”¡“À“§à“‡©≈’ˬº≈µà“ß√–À«à“ߧà“
‡©≈’ˬ¢ÕßÕߪ√–™“°√·∫∫®—∫§Ÿà (Paired t-test) §«“¡
—¡æ—π∏å¢Õߧ«“¡Àπ“√‘¡Ω望°°—∫Õ—µ√“à«π§«“¡Ÿß
°√–¥Ÿ°„π™àÕß‚À«à„™â§à“—¡ª√–‘∑∏‘ÏÀ—¡æ—π∏å (correlation
coefficient) ™π‘¥ Kendall’s Tau ‚¥¬∑—ÈßÀ¡¥„™â
‚ª√·°√¡§”π«≥∂‘µ‘”‡√Á®√Ÿª
°“√»÷°…“¥â«¬‰ø‰π∑å ‡Õ≈‘‡¡πµå
¢—Èπ·√°√â“ß·∫∫®”≈Õß√‘¡Ω望°´÷Ëß∂Ÿ°√â“ߢ÷Èπ¥â«¬
‚ª√·°√¡√â“ß¿“æ«—µ∂ÿ 3 ¡‘µ‘ °”Àπ¥®ÿ¥¬÷¥µ“¬µ—«∑’˺‘«
√‘¡Ω望°¥â“π„°≈â‡æ¥“π ·√ß°√–∑”∂Ÿ°°”Àπ¥„Àâ∑’Ë¡ÿ¡
ª“°∑”¡ÿ¡ 30 Õß»“°—∫·π«¬“«¢Õß√‘¡Ω望° (√Ÿª∑’Ë 4)
·√ß°√–∑”∑’Ë„Àâ¡’ª√‘¡“≥µà“ß°—π 3 √–¥—∫ °≈à“«§◊Õ ·√ß
‡∫“¡’§à“ 599.02 π‘«µ—π ·√ߪ“π°≈“ß¡’§à“ 1,118 π‘«µ—π
·≈–·√ßÀπ—°¡’§à“ 1,677.1 π‘«µ—π
√Ÿª∑’Ë 4 ·∫∫®”≈Õ߉ø‰π∑å‡Õ≈‘‡¡πµå¢Õß √‘¡Ω望° „Àâ·√ß
∑”¡ÿ¡ 30 Õß»“ Figure 4 Finite element’s lip model with loaded
forces at 30 degrees.
√Ÿª∑’Ë 5 º≈≈—æ∏å∑’ˉ¥â®“°°“√°”Àπ¥·√ß∑”¡ÿ¡ 30 Õß»“
—߇°µ·√ß≈—æ∏å¡’∑‘»‰ª¥â“π‡æ¥“π Figure 5 Palatal direction of lip force after 30-
degree force load.
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98 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 99 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
º≈°“√»÷°…“ °“√»÷°…“¿“æ∂à“¬√—ß’
§«“¡Àπ“√‘¡Ω望°°àÕπ·≈–À≈—ߪ≈Ÿ°°√–¥Ÿ°¡’§à“
‡©≈’ˬ 12.8 ·≈– 13.5 ¡.¡. µ“¡≈”¥—∫ ·¡â«à“§à“‡©≈’ˬÀ≈—ß
°“√ª≈Ÿ°°√–¥Ÿ°®–‡æ‘Ë¡¢÷Èπ 0.7 ¡.¡. ·µà‡¡◊ËÕ𔉪À“
§”π«≥À“º≈µà“ß√–À«à“ß§à“‡©≈’ˬ¢ÕßÕߪ√–™“°√·∫∫
®—∫§Ÿà ‰¡àæ∫§«“¡·µ°µà“ßÕ¬à“ß¡’𗬔§—≠∑’Ë P=0.05
Õ—µ√“à«π¢Õß√–¥—∫§«“¡Ÿß°√–¥Ÿ°≈¥≈ß √âÕ¬≈– 34.35
¿“¬À≈—ߪ≈Ÿ°°√–¥Ÿ°‰ª 1 ªï Õ—µ√“°“√≈¥≈ߟßÿ¥Õ¬Ÿà∑’Ë
√âÕ¬≈– 103.5 ·≈–µË”ÿ¥∑’Ë √âÕ¬≈– 0.49 ·≈–æ∫«à“¡’°“√
≈¥≈ßÕ¬à“ß¡’𗬔§—≠∑’Ë P=0.05 (µ“√“ß∑’Ë 1)
µ“√“ß∑’Ë 1 Õ—µ√“à«π¢Õß√–¥—∫§«“¡Ÿß°√–¥Ÿ°À≈—ߪ≈Ÿ° 1
‡¥◊Õπ·≈– 1 ªï Table 1 Percentages of bone height remaining
after 1 month and 1 year after grafting.
≈”¥—∫ À≈—ß 1 ‡¥◊Õπ (%) À≈—ß 1 ªï (%) ≈¥≈ß (%)
1 134.62 31.11 -103.50
2 55.56 37.29 -18.27
3 75.76 44.44 -31.31
4 48.98 46.94 -2.04
5 86.79 42.86 -43.94
6 67.39 13.33 -54.06
7 -19.51 -20.00 -0.49
8 24.00 18.00 -6.00
9 61.54 52.00 -9.54
10 107.69 33.33 -74.36
‡©≈’ˬ 64.282 29.93 -34.35
°“√«‘‡§√“–Àå—¡ª√–‘∑∏‘ÏÀ—¡æ—π∏å
À≈—ß®“°«‘‡§√“–Àå¢âÕ¡Ÿ≈¥â«¬‚ª√·°√¡«‘‡§√“–Àå
¢âÕ¡Ÿ≈∂‘µ‘ ‡æ◊ËÕÀ“§«“¡—¡æ—π∏å√–À«à“ߧ«“¡Àπ“√‘¡
Ω望°°—∫Õ—µ√“à«π¢Õß√–¥—∫§«“¡Ÿß°√–¥Ÿ°¥â«¬∂‘µ‘
Kendall’s Tau æ∫«à“¡’§«“¡—¡æ—π∏å√–¥—∫ª“π°≈“ß∑’Ë
§à“ª√–‘∑∏‘¿“槫“¡—¡æ—π∏å 0.566 ∑’Ë P-value 0.025
°“√»÷°…“¥â«¬«‘∏’‰ø‰π∑å ‡Õ≈‘‡¡πµå
º≈∑’ˉ¥â®“°°“√«‘‡§√“–Àå·∫∫®”≈Õß√‘¡Ω望°‚¥¬„Àâ
·√ß°√–∑” 30 Õß»“∑’Ë¡ÿ¡ª“° æ∫«à“·√ß≈—æ∏å¡’∑‘»∑“߉ª
¥â“π‡æ¥“π ‚¥¬·√ß°√–∑”‡∫“¡’·√ß≈—æ∏宓° 10 ‚Àπ¥
√«¡ 719.6871 π‘«µ—π æ◊Èπ∑’˧√Õ∫§≈ÿ¡ 10 ‚Àπ¥¥—ß°≈à“«
¡’¢π“¥ 1.74 µ√¡¡. ¥—ßπ—Èπª√‘¡“≥·√ßµàÕæ◊Èπ∑’Ë®÷߇∑à“°—∫
413.61328 π‘«µ—πµàÕµ√¡¡. ·≈–‡¡◊ËÕπ”·√ß°√–∑”π’ȉª„à
„π·∫∫®”≈Õߢ“°√√‰°√∫π æ∫«à“¡’°“√‡§≈◊ËÕπ∑’Ë¢Õß
°√–¥Ÿ°¢“°√√‰°√¡“°∑’Ëÿ¥‡∑à“°—∫ 1.505848 ¡.¡. (√Ÿª∑’Ë 6)
·∫∫®”≈Õß√‘¡Ω望°¿“√–·√ß°√–∑”ª“π°≈“ß∂Ÿ°
§”π«≥∑’Ë∂“𖇥’¬«°—π ·√ß≈—æ∏å∑’ˉ¥â‡∑à“°—∫ 870.62338
π‘«µ—πÀ√◊Õ 500.3582644 π‘«µ—πµàÕµ√¡¡. ·≈–‡¡◊ËÕπ”·√ß
°√–∑”‰ª„à„Àâ°—∫·∫∫®”≈Õߢ“°√√‰°√∫π·≈â« æ∫«à“¡’
°“√‡§≈◊ËÕπ∑’Ë¢Õß‚Àπ¥¡“°∑’Ëÿ¥‡∑à“°—∫ 1.821663 ¡.¡.
(√Ÿª∑’Ë 6)
·∫∫®”≈Õß√‘¡Ω望°¿“√–·√ß°√–∑”Àπ—°∂Ÿ°§”π«≥
∑’Ë∂“𖇥‘¡‡™àπ‡¥’¬«°—π ·√ß≈—æ∏å∑’ˉ¥â‡∑à“°—∫ 4,141.923
π‘«µ—π À√◊Õ 2,380.415517 π‘«µ—πµàÕµ√.¡¡. ·≈–‡¡◊ËÕπ”
·√ß°√–∑”‰ª„à„Àâ°—∫·∫∫®”≈Õߢ“°√√‰°√∫π·≈â« æ∫
«à“¡’°“√‡§≈◊ËÕπ∑’Ë¢Õß‚Àπ¥¡“°∑’Ëÿ¥‡∑à“°—∫ 8.66643 ¡.¡.
(√Ÿª∑’Ë 6)
√Ÿª∑’Ë 6 °“√‡’¬√Ÿª¢Õß·∫∫®”≈Õߢ“°√√‰°√∫π∑’Ë¿“√–·√ß
‡∫“ ª“π°≈“ß·≈–Àπ—°µ“¡≈”¥—∫ Figure 6 Displacement of cleft maxilla models
after light, medium and heavy load.
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100 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 101 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
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¥â“π¢â“ß·≈–¿“æ√—ß’°—¥∫¢ÕߺŸâªÉ«¬ª“°·À«à߇楓π
‚À«à´÷Ë߉¥â√—∫°“√ª≈Ÿ°∂à“¬°√–¥Ÿ° ‚¥¬‡ªìπ¿“æ√—ß’ 2 ¡‘µ‘
∑’ Ë„™â°—π·æ√àÀ≈“¬ ·¡â«à“¿“æ√—ß’ 3 ¡‘µ‘®–‰¥â√—∫°“√
¬Õ¡√—∫«à“·¡à𬔰«à“ ·µà°“√„™âß“π¬—߉¡à‡ªìπ∑’Ë·æ√à
À≈“¬π—° ·≈–„𧫓¡‡ªìπ®√‘ß¿“æ√—ß’ 2 ¡‘µ‘¬—ß¡’°“√„™â
ß“π„π°“√∂à“¬¿“æ√—ß’∑—Ë«‰ª(33) ªí≠À“∑’Ëæ∫„π°“√»÷°…“
§√—Èßπ’ȧ◊Õ¿“æ√—ß’‰¡à™—¥‡®π ∑”„À⺟⫑®—¬«—¥√–¬–∑“߉¥â
§≈“¥‡§≈◊ËÕπ ºŸâ«‘®—¬‰¥â欓¬“¡≈¥§«“¡º‘¥æ≈“¥∑’ˇ°‘¥
¢÷Èπ¥â«¬°“√«—¥√–¬–∑“ß¿“æ√—ß’´È”Õߧ√—Èß ·≈–À“°¡’
§à“·µ°µà“ß°—π¡“°°«à“ 0.5 ¡¡. ºŸâ«‘®—¬®–«—¥§√—Èß∑’Ë“¡
·≈–π”§à“Õߧà“∑’Ë„°≈⇧’¬ß°—π¡“À“§à“‡©≈’ˬ√–¬–∑“ß
„π°“√»÷°…“§√—Èßπ’È æ∫°“√≈–≈“¬¢Õß°√–¥Ÿ°∑’˪≈Ÿ°
≈¥≈ßÀ≈“¬√–¥—∫ µ—Èß·µà√âÕ¬≈– 0.49 ∂÷ß 103.50 ´÷Ëß
“‡Àµÿ∑’Ë°àÕ„À⇰‘¥°“√≈–≈“¬¢Õß°√–¥Ÿ°ª√–°Õ∫‰ª¥â«¬
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·≈–·æ∑¬å§π‡¥’¬«°—π Lilja ·≈–§≥–(35) æ∫«à“°“√¢÷Èπ
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°√–¥Ÿ°‡™àπ°—π Gundlach ·≈–§≥–(36) æ∫«à“°“√ª≈Ÿ°
°√–¥Ÿ°‚ª√àß„πæ◊Èπ∑’Ë‚À«à„πºŸâªÉ«¬Õ“¬ÿ√–À«à“ß 7-8 ªï‡ªìπ
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4 ªïÀ≈—ß®“°ª≈Ÿ°°√–¥Ÿ°°≈ÿà¡∑’Ë¡’Õ“¬ÿπâÕ¬¡’√–¥—∫¢Õ∫
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ª≈“¬√“°·≈–¿“æ√—ß’°—¥∫ ‡æ◊ËÕÀ“§«“¡—¡æ—π∏å¢Õß
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π”ªí®®—¬π’È¡“‡ªìπµ—«·ª√„π°“√»÷°…“ „πªï 2005 Brock
·≈–§≥–(38) æ∫§«“¡Àπ“√‘¡Ω望°‰¥â√—∫º≈°√–∑∫®“°
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‡Õ°“√Õâ“ßÕ‘ß 1. Gabka J. : Aetiology and statistics of harelips
and cleft palate. Wallace AB, ed. Transactions
of the International Society of Plastic
Surgeons and Congress : 1960, at Livingstone
Edinburgh.
2. Bianchi DW, Crombleholme TM, DíAlton
ME. Fetology : Diagnosis and management
of the fetal patient. New York: Mc Graw-Hill;
2000: 198-207.
3. Tan KI. Incidence and epidemiology of cleft
lip / palate in Singapore. Ann Acad Med
Singapore 1988; 17: 311-4.
4. Chuangsuwanich A, Aojanepong C. Epide-
miology of cleft lip and palate in Thailand.
Ann Plast Surg 1998; 41: 7-10.
5. Waitzman AA, Posnick JC, Armstrong DC,
Pron GE. Craniofacial skeletal measurements
based on computed tomography: Part II.
Normal values and growth trends. Cleft Palate
Craniofac J 1992; 29(3): 118-28.
6. Harris EF, Hullings JG. Delayed dental
development in children with isolated cleft lip
and palate. Arch Oral Biol 1990; 35: 469ñ73.
7. Ranta R. A review of tooth formation in
children with cleft lip/palate. Am J Orthod
Dentofacial Orthop 1986; 90: 11-8.
8. Filho OGS, Neto JV, Filho LC, Freitas JAS.
Influence of lip repair on craniofacial
morphology of patients with complete
bilateral cleft lip and palate. Cleft Palate
Craniofac J 2003; 40(2): 144-53.
9. Barry LE. Alveolar cleft bone grafting (Part I):
Primary bone grafting. J Oral Maxillofac Surg
1996; 54(1): 74-82.
10. Dewinter G. Dental abnormalities, bone graft
quality, and periodontal conditions in patients
with unilateral cleft lip and palate at different
phases of orthodontic treatment. Cleft Palate
Craniofac J 2003; 40(4): 343-50.
11. Brattström V, McWilliams J. The influence of
bone grafting age on dental abnormalities and
alveolar bone height in patients with unilateral
cleft lip and palate. Eur J Orthod 1989; 11:
351ñ8.
12. Silva Filho OG, Lauris RCMC, Capelozza
Filho L, Semb G. Craniofacial morphology in
adult patients with unoperated complete
bilateral cleft lip and palate. Cleft Palate
Craniofac J 1998; 35: 111-9.
13. Batra PA, Sharma JB, Duggal RC, Hariparka
SH. Secondary bone grafting in cleft lip and
palate with eruption of tooth into the graft: A
case report. J Indian Soc Pedod Prev Dent
2004; 22(1): 8-12.
14. Bergland O, Semb G, Abyholm FE. Elimi-
nation of the residual alveolar cleft by
secondary bone grafting and subsequent
orthodontic treatment. Cleft Palate J. 1986;
23: 175-205.
15. Helms JA, Speidel TM, Denis KL. Effect of
timing on long-term clinical success of
alveolar cleft bone grafts. Am J Orthod
Dentofacial Orthop 1987; 92: 232-40.
16. Long RE, Sprangler BE, Yow M. Cleft width
and secondary alveolar bone graft success.
Cleft Palate J 1995; 35: 420-6.
-
102 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 103 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
17. Witherow H, Cox S, Jones E, Carr R,
Waterhouse N. A new scale to assess radio-
graphic success of secondary alveolar bone
grafts. Cleft Palate Craniofac J 2002: 39(3):
255-60.
18. Broadbent BH. A new X-ray technique and its
application in orthodontics. Angle Orthod
1931: 45-60.
19. Athanasiou AE. Orthodontic cephalometry. 1st
ed. London: Mosby; 1997.
20. Papadopoulos MA, Jannowitz C, Boettcher P,
Henke J, Stolla R, Zeilhofer HF, Kovacs L,
Erhardt W, Biemer E, Papadopulos NA.
Three-dimensional fetal cephalometry: An
evaluation of the reliability of cephalometric
measurements based on three-dimensional CT
reconstructions and on dry skulls of sheep
fetuses. J Cranio Maxill Surg 2005; 33(4):
229-37.
21. Waitzman AA, Posnick JC, Armstrong DC
and Pron GE. Craniofacial skeletal
measurements based on computed
tomography: Part III. Normal values and
growth trends. Cleft Palate Craniofac J 1992;
29: 118-28.
22. ∏ß™—¬ øÕß¡ÿ∑√. «‘∏’‰ø‰πµå‡Õ≈‘‡¡πµå‡∫◊ÈÕßµâπ.
‡™’¬ß„À¡à: À®°. ¥“√“«√√≥°“√æ‘¡æå, 2549: 3-6 23. Zienkiewicz OC. The finite element method in
engineering science. 1st ed. London: McGraw-
Hill; 1977.
24. Jones ML, Hickman J, Middleton J, Knox J
and Volp C. A validated finite element method
study of orthodontic tooth movement in the
human subject. J Orthod 2001; 28(1), 29-38.
25. Williams KR, Edmondson JT, Morgan G,
Jones ML, Richmond S. Orthodontic move-
ment of a canine into an adjoining extraction
site. J Biomed Eng 1986; 8: 115-20.
26. Nyashin MY, Pechenov VS and Rammer-
storfer FG. Determination of optimal
orthodo-ntic forces. Russ J Biomechanics
1997; 1(1-2): 84-96.
27. Katada H, Katada H, Isshiki Y. Changes in
orthodontic cephalometric reference points on
application of orthopedic force to jaw: three-
dimensional finite element analysis. Bull
Tokyo Dent Coll 2005; 46(3): 59-65.
28. Chang YI, Shin SJ, Baek SH. Three-
dimensional finite element analysis in distal
en masse movement of the maxillary dentition
with the multiloop edgewise archwire. Eur J
Orthod 2004; 26(3): 339-45.
29. Rudolph DJ. Willes PMG, Sameshima GT. A
finite element model of apical force distri-
bution from orthodontic tooth movement.
Angle Orthod 2001; 71(2): 127-31.
30. Zhao L, Patel PK. : Three dimensional finite
element analysis of axillary palate with a
unilateral cleft. ISB 20th Congress - ASB 29th
Annual Meeting 31 July-5 August 2005, at
Cleveland, Ohio.
31. Pegoretti A. Finite element analysis of glass
fibre reinforced composite endodontic post.
Biomaterials 2002; 23(13): 2667-82.
32. Basu S. A three-dimensional model of human
lip motion. Master of Engineering in
Electrical Engineering and Computer Science.
Massachusetts Institute of Technology, 1997.
33. Van der Meij AJ, Baart J, Prahl-Andersen B,
Valk J, KostensePJ, Tuinzing DB. Computed
tomography in evaluation of early secondary
bone grafting. Int J Oral Maxillofac Surg
1994; 23: 132-6.
34. Van der Meij AJ, Baart JA, Prahl-Andersen B,
Kostense PJ, van der Sijp JR, and Tuinzing
DB. Outcome of bone grafting in relation to
cleft width in unilateral cleft lip and palate
patients. Oral Surg Oral Med Oral Pathol
Oral Radiol Endod 2003; 96(1): 19-25.
-
102 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554 103 CM Dent J Vol. 32 No. 1 January-June 2011™¡. ∑—πµ“√ ªï∑’Ë 32 ©∫—∫∑’Ë 1 ¡.§.-¡‘.¬. 2554
35. Lilja J, Kalaaji A, Friede H, Elander A.
Combined bone grafting and delayed closure
of the hard palate in patients with unilateral
cleft lip and palate: Facilitation of lateral
incisor eruption and evaluation of indicators
for timing of the procedure. Cleft Palate
Craniofac J 2000; 37(1): 98-105.
36. Gundlach KK, Behlfelt K, Pfeifer G. The
maxillary arch in 8-and 16-year old patients
with complete unilateral clefts treated
according to the Hamburg regimen. In: Pfeifer
G, ed: Craniofacial abnormalities and clefts of
lip, alveolus and palate; Vol I. George Thieme
Verlag, Stuttgart: 1991: 256-257.
37. Enemark H, Sindet-Pedersen S, Bundgaard M.
Long-term results after secondary bone
grafting of alveolar clefts. J Oral Maxillofac
Surg 1987; 45(11): 913-8.
38. Brock RA 2nd, Taylor RW, Buschang PH,
Behrentsd RG. Ethnic differences in upper
lip response to incisor retraction. Am J Orthod
Dentofacial Orthop 2005; 127(6): 683-91.
39. Normando ADC, Silva Filho OG and
Capelozza Filho L. Influence of surgery on
maxillary growth in cleft lip and/or palate
patients. J Cranio Maxill Surg 1992; 20(3):
111-8.
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The Vision of the Faculty of Dentistry, Chiang Mai University
“To achieve quality academic and research work at the international level,
and produce dental graduates with a good knowledge
and sense of community service”
£ Odontology and Oral
Pathology
£ Dental Radiology
£ Oral Surgery
£ Restorative Dentistry
£ Pedodontics
£ Prosthodontics
£ Orthodontics
£ Periodontology
£ Community Dentistry
£ General Dentistry
Departments
TeachingPrograms Available and Degrees Offered
£ Undergraduate Program The faculty offers a six-year program leading to a Doctor of Dental Surgery
Degree (D.D.S.). Currently there are approximately 500 students working
towards this degree.
£ Graduate Programs
! There is a graduate program leading to Higher Graduate Diploma in
Dentistry.
! There are three more graduate programs leading to Master’s degrees in
Dentistry, Orthodontics, and Periodontology.
! There is also one Doctor of Philosophy Program in Dentistry (Ph.D.)