Zandi Mohammad, Miresmaeili Amirfarhang, Heidari Ali
Department of Oral and Maxillofacial Surgery (Head: Mohammad Zandi, DDS, MSc.), Hamedan University of Medical Sciences, Hamedan, Iran.
Department of Orthodontics (Head: Amirfarhang Miresmaeili, DDS, MSc.), Hamedan University of Medical Sciences, Shahid Fahmideh Street, Hamedan, Iran.
J Craniomaxillofac Surg. 2014 Oct;42(7):1190-5. doi: 10.1016/j.jcms.2014.02.007. Epub 2014 Feb 22.
To evaluate and compare the short-term (post-retention) skeletal and dental changes following bone-borne and tooth-borne surgically assisted rapid maxillary expansion (SARME) using cone beam computed tomography (CBCT).
In this randomized clinical study, 30 patients with transverse maxillary deficiency underwent either tooth-borne (n = 15) or bone-borne (n = 15) SARME. Before treatment and immediately after the consolidation period, CBCT was obtained and the nasal floor width, interdental root distance, palatal bone width and interdental cusp distance were measured at first premolar and first molar regions of maxilla.
Twenty eight patients completed the study protocol. In both tooth-borne (n = 13) and bone-borne (n = 15) groups the highest degree of expansion occurred in the dental arch, followed by palatal bone, and nasal floor (V-shaped widening in coronal dimension). The amount and pattern of expansion was comparable between anterior and posterior maxillary regions in each group (parallel posteroanterior expansion) and between the two groups.
Dental and skeletal effects of tooth-borne and bone-borne devices were comparable. The overall complication rate was negligible. Selection of an expansion device should be based on each individual patient's requirements. Future long-term clinical trial studies to evaluate the stability and relapse of these two techniques are recommended.
使用锥形束计算机断层扫描(CBCT)评估和比较骨支持式和牙支持式外科辅助快速上颌扩弓(SARME)后的短期(保持期后)骨骼和牙齿变化。
在这项随机临床研究中,30例上颌横向发育不足的患者接受了牙支持式(n = 15)或骨支持式(n = 15)SARME。在治疗前和巩固期结束后立即进行CBCT扫描,并在上颌第一前磨牙和第一磨牙区域测量鼻底宽度、牙间牙根距离、腭骨宽度和牙间牙尖距离。
28例患者完成了研究方案。在牙支持式(n = 13)和骨支持式(n = 15)两组中,扩弓程度最高的是牙弓,其次是腭骨和鼻底(冠状面呈V形增宽)。每组上颌前后部区域之间(前后平行扩弓)以及两组之间的扩弓量和模式具有可比性。
牙支持式和骨支持式装置的牙齿和骨骼效果具有可比性。总体并发症发生率可忽略不计。扩弓装置的选择应基于每个患者的需求。建议未来进行长期临床试验研究,以评估这两种技术的稳定性和复发情况。