Zeng Jingjing, Gao Xuemei
Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Int J Pediatr Otorhinolaryngol. 2013 Nov;77(11):1805-10. doi: 10.1016/j.ijporl.2013.07.028. Epub 2013 Sep 4.
The aim of this prospective study was to investigate the upper airway changes after rapid maxillary expansion utilizing CBCT.
16 children (10 male, 6 female) with a mean age of 12.73 ± 1.73 years underwent RME as part of their comprehensive orthodontic treatment with4,6-banded hyrax expanders. The screws were activated 2 turns a day. Depending on the expansion amount (2.7-6.3mm), the activation period ranged from 2 to 3 weeks. CBCT images were taken immediately before (T1) and three months after expansion (T2) in upright position, with patients' heads kept in consistent position. All CBCT data were processed with the software EZ3D2009. After orienting the CBCT images, a set of linear, area and volumetric parameters of the upper airway were measured and calculated. Student paired t test and one-way ANOVA were applied. The significance level of P<0.0033 was used according to the Bonferroni correction.
After expansion, with molar-to-molar width increasing 4.4 ± 1.3 mm and molars tipping 6.2 ± 6.2°, the nasal floor width and nasal lateral width increased 1.6, 1.5, and 1.6mm and 1.3, 1.7, and 1.4mm from the anterior to the posterior part, respectively. And there was no difference among the anterior, median and posterior part. The lower nasal volume increased 1348.5mm(3) with the percentage change being 8.1%. The pharyngeal airway showed no positive change.
RME can expand the nasal cavity and the expansion pattern may follow the parallel opening configuration. However, the influence on the pharyngeal airway is limited.
本前瞻性研究的目的是利用锥形束计算机断层扫描(CBCT)研究快速上颌扩弓后的上气道变化。
16名儿童(10名男性,6名女性),平均年龄12.73±1.73岁,接受快速上颌扩弓治疗,作为其综合正畸治疗的一部分,使用4、6带环的Hyrax扩弓器。螺钉每天旋转2圈。根据扩弓量(2.7 - 6.3毫米),激活期为2至3周。在直立位,于扩弓前即刻(T1)和扩弓后三个月(T2)拍摄CBCT图像,患者头部保持一致位置。所有CBCT数据均使用EZ3D2009软件进行处理。在对CBCT图像进行定位后,测量并计算上气道的一组线性、面积和容积参数。应用学生配对t检验和单因素方差分析。根据Bonferroni校正,使用P<0.0033的显著性水平。
扩弓后,磨牙间宽度增加4.4±1.3毫米,磨牙倾斜6.2±6.2°,鼻底宽度和鼻外侧宽度从前向后分别增加1.6、1.5和1.6毫米以及1.3、1.7和1.4毫米。并且在前部、中部和后部之间没有差异。下鼻容积增加1348.5立方毫米,百分比变化为8.1%。咽气道没有出现正向变化。
快速上颌扩弓可扩大鼻腔,扩弓模式可能遵循平行开口构型。然而,对咽气道的影响有限。