Farronato G, Giannini L, Galbiati G, Maspero C
Department of Orthodontics, University of Milan, Milan, Italy.
Minerva Stomatol. 2012 Mar;61(3):45-55.
The aim was to compare the skeletal and dental effects of a new type of a modified Hyrax rapid palatal expander with vestibular arm with the Hyrax expander in patients with maxillary asymmetric deficiencies.
This study includes 50 growing patients in early mixed dentition, suffering from a maxillary narrowness combined with the exfoliation of one or more deciduous teeth, a monolateral or bilateral crossbite and a deviation of the upper midline. Twenty-five patients were treated with a modified Hyrax expander and 25 patients with a Hyrax expander (RME). Dental casts and posteroanterior radiographs were obtained before treatment [T0] and six months after maxillary expansion [T1]. Measurements of intermolar width, intercanine width, arch length, arch perimeter, space between lateral incisor and I deciduous molar, and midline discrepancy were made with a digital calliper on photocopies taken from the dental casts. Cephalometric tracing on frontal teleradiographies were evaluated.
Results showed no statistically significant differences between T0 and T1 in the modified RME appliance and the RME except lateral drift of incisor and space between lateral incisor and first deciduous molar. The modified RME permitted to obtain the restoration of the coincidence of the midlines of almost 5/6 mm and to create 7 to 9 mm of space in the canine area.
both the appliances are effective in correcting maxillary narrowness but the modified hyrax expander represents the best choice for the correction of upper midline deviations, and to restore the correct symmetry of dental midlines.
比较一种新型改良的带前庭臂的Hyrax快速腭扩展器与Hyrax扩展器对上颌不对称性缺陷患者骨骼和牙齿的影响。
本研究纳入50名处于乳牙混合早期的生长发育期患者,这些患者存在上颌狭窄并伴有一颗或多颗乳牙脱落、单侧或双侧反咬合以及上颌中线偏移。25名患者使用改良的Hyrax扩展器进行治疗,25名患者使用Hyrax扩展器(快速上颌扩展器)。在治疗前[T0]以及上颌扩展6个月后[T1]获取石膏模型和正位X线片。使用数字卡尺对从石膏模型上复印的图像进行测量,测量指标包括磨牙间宽度、尖牙间宽度、牙弓长度、牙弓周长、侧切牙与第一乳磨牙之间的间隙以及中线差异。对正位远距离X线片进行头影测量分析。
结果显示,改良快速上颌扩展器和快速上颌扩展器在T0和T1之间,除了切牙的侧向漂移以及侧切牙与第一乳磨牙之间的间隙外,没有统计学上的显著差异。改良快速上颌扩展器能够使中线重合恢复近5/6毫米,并在尖牙区域创造7至9毫米的间隙。
两种矫治器在纠正上颌狭窄方面均有效,但改良的Hyrax扩展器是纠正上颌中线偏差以及恢复牙中线正确对称性的最佳选择。