@article{oai:u-ryukyu.repo.nii.ac.jp:02016225,
 author = {Nakama, Yoshihiko and Arakaki, Keiichi and Ishikawa, Taku and Nakama, Joji and Tengan, Toshimoto and Sunakawa, Hajime},
 issue = {3･4},
 journal = {琉球医学会誌 = Ryukyu Medical Journal},
 note = {We employ palatal plates (obturator) immediately after palatoplasty to close the fistula in the alveolar cleft arising from push-back surgery. The aim of the present study is to evaluate the effect of palatal plate on the velopharyngeal function and maxillofacial growth. The subjects were 115 patients who underwent palatoplasty, followed by consistent treatment. The period of time required to achieve velopharyngeal competency (VPC-T) was examined in 107 patients (14 with bilateral cleft lip and palate: BCLP, and 20 with unilateral cleft lip and palate: UCLP) who received palatal plates within 3 months after surgery to close a fistula, and 31 patients without palatal plates (9 BCLP, and 22 UCLP), and 42 patients with cleft palate who didn't receive palatal plates. For occlusal evaluation by the Goslon Yardstick method, we evaluated 30 UCLP patients (14 palatal plate wearers, and 16 non-palatal plate wearers) who underwent palatoplasty, followed by the placement of a palatal plate within 3 months postoperatively, subsequent occlusal management, and eventually achieved a II C or III A occlusal relationship. Evaluation items included: 1. velopharyngeal competency evaluation, 2. VPC-T for speech, and 3. occlusal evaluation of cases with and without a palatal plate, and the following results were obtained: 1. Velopharyngeal competency (VPC) was achieved in 93.5% of all cases we analyzed. 2. The average of VPC-T was 10.3 (BCLP) and 8.9 (UCLP) months for palatal plate wearers, and 18.8 (BCLP) and 15.1 (UCLP) months for non-palatal plate wearers. 3. palatal plate (p<0.0001) and fistula (p=0.0002) were selected for variables by logistic regression analysis, but cleft type was not. The odds ratio of palatal plate (20.978) showed strong association with VPC-T. Palatal plate attachment from an early stage may be a measure to acquire velopharyngeal function as early as possible. 4. The Goslon Yardstick scores were 2.49 for palatal plate wearers and 3.56 for non-palatal plate wearers, and 3.06 for all cases we analyzed. A palatal plate not only facilitates the acquisition of VPC, but promotes harmonized upper and lower occlusion and maxillofacial growth. This suggests the important role of the palatal plate in the esthetic improvement and acquisition of normal occlusion, which is one of the final goals of consistent treatment., 論文},
 pages = {23--34},
 title = {［原著］The effects of Palatal Plate on Velopharyngeal Function and Occlusion for Children with Cleft Lip and Palate after Primary Palatoplasty},
 volume = {28}
}