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三维计算机断层扫描监测下牙支持式和骨支持式装置在外科辅助快速上颌扩弓中的比较:横向牙齿和骨骼上颌扩弓、节段倾斜、牙齿倾斜以及前庭骨吸收

Comparison of tooth- and bone-borne devices in surgically assisted rapid maxillary expansion by three-dimensional computed tomography monitoring: transverse dental and skeletal maxillary expansion, segmental inclination, dental tipping, and vestibular bone resorption.

作者信息

Landes Constantin Alexander, Laudemann Katharina, Schübel Florian, Petruchin Oksana, Mack Martin, Kopp Stefan, Sader Robert Alexander

机构信息

Oral, Maxillofacial and Plastic Facial Surgery and Department of Diagnostic and Interventional Radiology, Dental Institute Carolinum, Goethe University Frankfurt, Germany.

出版信息

J Craniofac Surg. 2009 Jul;20(4):1132-41. doi: 10.1097/scs.0b013e3181abb430.

Abstract

Comparison of bone-borne (BB) versus tooth-borne (TB) distraction in surgically assisted rapid maxillary expansion, secondary variables were bipartite (2S) or tripartite (3S) osteotomy, pterygomaxillary osteotomy (+PP) or not (jPP), and age (920 years old [920] and G20 years old [G20]). Fifty patients received three-dimensional computed tomography examination preoperatively and after expansion; 24 had BB, and 26 had TB distraction. Predefined preoperative landmarks versus postexpansion positions were assessed in multiplanar viewing. Bone-borne devices had bigger overall skeletal and dental maxillary expansion declining from anterior to posterior, more asymmetric expansion, less vestibular bone resorption, and less dental tipping; TB devices showed similar dorsal decrease in transverse skeletal and dental maxillary expansion from anterior to posterior, more vestibular bone resorption, particularly in the premolars, and more dental tipping. Bone-borne 3S +PP G20 had the biggest decrease in transverse skeletal widening and biggest segmental outward inclination; BB 3S +PP 920 had the biggest decline in transverse dental widening; TB 2S YPP G20 had the biggest segmental inward inclination; BB 2S YPP 920 had the biggest dental tipping; BB 2S G20 had the biggest vestibular bone resorption in molars; and TB 3S 920 and BB YPP had the biggest vestibular bone resorption in premolars. There was a significant correlation between transverse widening and segmental inclination; that is, a bigger amount of transverse widening provokes less segmental inclination.

摘要

在外科辅助快速上颌扩弓中骨支持式(BB)与牙支持式(TB)扩弓的比较,次要变量包括二分法(2S)或三分法(3S)截骨、翼上颌截骨(+PP)与否(jPP)以及年龄(9至20岁[920]和大于20岁[G20])。50例患者在扩弓术前和术后接受了三维计算机断层扫描检查;24例采用BB扩弓,26例采用TB扩弓。在多平面视图中评估术前预定义的标志点与扩弓后的位置。骨支持式装置整体骨骼和上颌牙齿扩弓从前向后逐渐减小,扩弓更不对称,前庭骨吸收较少,牙齿倾斜较少;TB装置显示从前往后横向骨骼和上颌牙齿扩弓在背侧有类似的减小,前庭骨吸收更多,尤其是在前磨牙区,牙齿倾斜更多。骨支持式3S +PP G20组横向骨骼增宽减小最大,节段向外倾斜最大;BB 3S +PP 920组横向牙齿增宽减小最大;TB 2S YPP G20组节段向内倾斜最大;BB 2S YPP 920组牙齿倾斜最大;BB 2S G20组磨牙前庭骨吸收最大;TB 3S 920组和BB YPP组前磨牙前庭骨吸收最大。横向增宽与节段倾斜之间存在显著相关性;也就是说,横向增宽量越大,节段倾斜越小。

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