Habersack Karin, Karoglan Anita, Sommer Bernhard, Benner Klaus U
Am J Orthod Dentofacial Orthop. 2007 Jun;131(6):776-81. doi: 10.1016/j.ajodo.2005.09.030.
The purpose of this study was to evaluate whether high-resolution multislice computerized tomography (CT) with multiplanar reformation and 3-dimensional (3D) imaging is helpful in demonstrating the effects on midfacial sutures induced by rapid palatal expansion (RPE), thereby appraising and corroborating the current state of the art or possibly adding new findings.
Two patients in different stages of skeletal maturity (aged 10 and 16 years) underwent CT examinations immediately after active opening with the RPE appliance.
The 3D CT imaging method proved to be valuable in visualizing skeletal effects on not only the midpalatal suture, but also adjacent sutures. It allowed precise 3D location of tooth positions. In the 3D CT images of 1 patient, the complete opening of the midpalatal suture was visible. The median dissection of the incisal foramen at the point of unification of the 2 nasopalatine channels could be visualized. Additionally, the positions of severely displaced maxillary canines could be located precisely. In the other patient, apart from the completely open midpalatal suture, the opening or widening of the internasal suture, the nasomaxillary sutures, and the frontomaxillary sutures were visible.
The 3D imaging of high-resolution multislice CT opens up a new dimension in orofacial diagnosis. Improvements of the quantity and the exactness of diagnostic parameters were attained. The imaging method is helpful and indicated in RPE patients with additional diagnostic objectives related to the development of occlusion. This imaging method is recommended in borderline cases (juvenile or adult patients with questionable sutural response) to determine whether the suture is completely open or whether surgical support is needed.
本研究的目的是评估具有多平面重建和三维(3D)成像功能的高分辨率多层计算机断层扫描(CT)是否有助于显示快速腭扩展(RPE)对中面部缝线的影响,从而评估和证实当前的技术水平,或者可能增加新的发现。
两名处于不同骨骼成熟阶段(分别为10岁和16岁)的患者在使用RPE矫治器进行主动扩开后立即接受了CT检查。
3D CT成像方法被证明不仅在可视化中腭缝的骨骼效应方面有价值,而且在可视化相邻缝线方面也有价值。它能够精确确定牙齿位置的3D坐标。在1例患者的3D CT图像中,可以看到中腭缝完全打开。在两个鼻腭管汇合处的切牙孔中位解剖结构可以可视化。此外,严重移位的上颌尖牙的位置可以精确确定。在另一名患者中,除了完全打开的中腭缝外,还可以看到鼻内缝、鼻上颌缝和额上颌缝的打开或增宽。
高分辨率多层CT的3D成像为口腔颌面诊断开辟了一个新的维度。在诊断参数的数量和准确性方面都有了提高。这种成像方法对于有与咬合发育相关的额外诊断目标的RPE患者是有帮助的且适用的。在临界病例(青少年或成年患者,缝线反应可疑)中,推荐使用这种成像方法来确定缝线是否完全打开或是否需要手术支持。