[摘要]目的：通过比较分析术前经鼻牙槽塑形矫治器（Presurgical nasoalveolar molding，PNAM）技术治疗以及未经PNAM治疗的单侧完全性唇裂患儿术后颜面部对称性以及牙弓发育情况，探讨术前PNAM的远期影响。方法：共收集21例在安徽省儿童医院治疗的单侧完全性唇裂患儿，PNAM组8例，非PNAM组13例。对患儿进行取模和摄影测量，分别评估PNAM治疗对单侧完全性唇裂患儿牙弓形态以及鼻唇对称性的影响。结果：相较于非裂隙侧，PNAM组裂隙侧尖牙区的宽度明显缩窄（P＜0.05），非PNAM组裂隙侧各区牙弓明显缩窄，但PNAM组与非PNAM组之间各区牙弓比较，差异无统计学意义（P＞0.05）。与非PNAM组相比，PNAM组患儿的鼻底对称指数更佳（P＜0.05），其余指数的差异无统计学意义（P＞0.05）。结论：从长远来看，与非PNAM组相比，PNAM组对牙弓形态的发育影响以及鼻唇对称性无统计学差异。医师在早期选择PNAM治疗时可以不必拘于PNAM对牙弓形态的负面影响，但若想长期维持鼻部形态和唇部的对称性，仅靠术前PNAM治疗是不够的。

[关键词]术前正畸；鼻牙槽塑形矫治器（PNAM）；单侧完全性唇裂；牙弓形态；鼻唇对称性

[中图分类号]R782.21" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0073-04

Long-term Effects of Presurgical Nasoalveolar Molding on the Facial and Dental Arches of Children with Unilateral Complete Cleft Lip

XIA Lin1， WANG Xiangrong1， CHEN Jia2， YUAN Hui1

（ 1.Department of Stomatology， Anhui Provincial Children's Hospital， Hefei 230000， Anhui， China; 2.Stomatology Center， the First Affiliated Hospital of USTC， Division of Science and Technology of China， Hefei 230000， Anhui， China ）

Abstract： Objective" To investigate the long-term effects of presurgical nasoalveolar molding （PNAM） by comparing and analyzing the postoperative facial symmetry and dental arch development in children with unilateral complete cleft lip treated with and without PNAM before surgery. Methods" A total of 21 children with unilateral complete cleft lip treated in Anhui Children's Hospital were collected， 8 in the PNAM group and 13 in the non-PNAM group. The children were modeled and took photos to assess the effects of PNAM treatment on dental arch morphology as well as nasolabial symmetry in children with unilateral complete cleft lip. Results" Compared with the non-cleft side，canine to midline transverse width on the cleft side was significantly narrowed in the PNAM group （P＜0.05）， and the arch of each region on the cleft side was significantly narrowed in the non-PNAM group， but there was no significant difference in the arch of each region between the PNAM group and the non-PNAM group （P＞0.05）. Compared with the non-PNAM group， the children in the PNAM group had better nasal floor symmetry index （P＜0.05）， and the differences in the remaining indices were not statistically significant （P＞0.05）. Conclusion" From a long-term perspective，compared to the non-PNAM group ，there was no statistical difference in dental arch morphology and nasolabial symmetry in the PNAM treatment group . Doctors may not be bound to the negative effects of PNAM on dental arch morphology when choosing PNAM treatment in the early stages，and preoperative PNAM treatment alone is not sufficient if nasal morphology and lip symmetry are maintained in the long term.

Key words： preoperative orthodontics; presurgical nasoalveolar molding （ PNAM ）; unilateral complete cleft lip; dental arch morphology; nasolabial symmetry

唇腭裂是发展中国家常见的先天性颅颌面畸形的一种，在我国的发病率为0.13%～0.21%[1-2]，在全球的发病率为0.10%～0.19%[3-4]。在唇腭裂的各种表型中，单侧完全性唇裂是最严重的情况之一，它常伴有鼻部、牙槽骨及牙齿等形态及功能的异常[5]，从而影响了患儿颜面部的外观、进食、语言、牙弓形态等等。因此，越来越多的医生选择术前矫正来降低一期唇裂修复手术的难度。术前鼻牙槽塑形矫治器（PNAM）技术是一种应用于唇腭裂婴儿的一种无创术前矫正技术，特别适用于单侧完全性唇裂的患儿[6]。……