Marchetti C, Pironi M, Bianchi A, Musci A
Department of Odontostomatological Sciences, University of Bologna, Italy.
J Craniomaxillofac Surg. 2009 Mar;37(2):74-8. doi: 10.1016/j.jcms.2008.08.006. Epub 2008 Dec 5.
We compared the long-term stability of surgically assisted rapid palatal expansion (SARPE) and segmental Le Fort I osteotomy (bipartition) for expanding the maxillae in adult patients.
The upper jaw plaster models of 10 patients who underwent transverse expansion of the maxillae using the SARPE technique and 10 patients who underwent Le Fort I bipartition were examined. For each patient, the intercanine and intermolar distances before expansion (T1), after expansion (T2), and 2 years after expansion (T3) were measured. Consequently, we could evaluate the degree of expansion (between T1 and T2) and the relapse distance after 2 years (between T2 and T3). The palatal stability (i.e., extent of relapse) was used to assess the outcomes in both methods.
In the SARPE group, the average increase in the intercanine and intermolar distance was +8.5 and +7mm, respectively. In the Le Fort I bipartition group, the average respective increase was +2.75 and +3.75mm. Two years after expansion, in the SARPE group, the intercanine distance decreased by 2.5mm or 28% of the overall expansion, and the intermolar distance decreased by 3.0mm or 36% of the overall expansion. In the Le Fort I bipartition group, the intercanine distance decreased by 0.25mm or 25% of the overall expansion, and the intermolar distance decreased by 0.75mm or 20% of the overall expansion.
In the patients that we assessed, there was a high relapse rate in the mean intercanine and intermolar distances 2 years following the expansion. The overall relapse rate was more pronounced in the SARPE patients, whereas the Le Fort I bipartition technique was more stable, especially in terms of the intermolar distance.
我们比较了手术辅助快速腭扩展术（SARPE）和节段性Le Fort I截骨术（二分法）在成年患者中扩展上颌骨的长期稳定性。
检查了10例采用SARPE技术进行上颌骨横向扩展的患者和10例接受Le Fort I二分法手术的患者的上颌石膏模型。对于每位患者，测量了扩展前（T1）、扩展后（T2）以及扩展后2年（T3）的尖牙间距离和磨牙间距离。因此，我们可以评估扩展程度（T1和T2之间）以及2年后的复发距离（T2和T3之间）。腭部稳定性（即复发程度）用于评估两种方法的结果。
在SARPE组中，尖牙间距离和磨牙间距离的平均增加量分别为+8.5mm和+7mm。在Le Fort I二分法组中，平均增加量分别为+2.75mm和+3.75mm。扩展后2年，在SARPE组中，尖牙间距离减少了2.5mm，占总扩展量的28%，磨牙间距离减少了3.0mm，占总扩展量的36%。在Le Fort I二分法组中，尖牙间距离减少了0.25mm，占总扩展量的25%，磨牙间距离减少了0.75mm，占总扩展量的20%。
在我们评估的患者中，扩展后2年尖牙间平均距离和磨牙间平均距离的复发率较高。SARPE患者的总体复发率更为明显，而Le Fort I二分法技术更稳定，尤其是在磨牙间距离方面。
