外科辅助上颌扩弓术（SARME）中一期牙支持式牵张成骨与二期骨支持式牵张成骨的对比

One-stage tooth-borne distraction versus two stage bone-borne distraction in surgically assisted maxillary expansion (SARME).

作者信息

Seeberger Robin, Abe-Nickler Dorothee, Hoffmann Jürgen, Kunzmann Kevin, Zingler Sebastian

机构信息

Oral-Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of Oral and Maxillofacial Surgery, Teaching Hospital of Frankfurt University Medical Center, Bad Homburg, Germany.

Resident, Department of Oral and Maxillofacial Surgery, University Hospital Lübeck, Lübeck, Germany.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Dec;120(6):693-8. doi: 10.1016/j.oooo.2015.07.009. Epub 2015 Jul 22.

DOI:10.1016/j.oooo.2015.07.009

PMID:26340898

Abstract

OBJECTIVE

To evaluate and compare the effects of tooth-borne and bone-borne distraction devices in surgically assisted maxillary expansion (SARME) on dental and skeletal structures.

STUDY DESIGN

A sample of 33 skeletally mature patients with transverse maxillary deficiencies was examined with cone beam computed tomography (CBCT) before and 3 months after surgery. Fourteen patients were treated with tooth-borne devices and 19 patients with bone-borne devices.

RESULTS

Dental crown expansion in the first premolars did not differ significantly between the two groups, and median expansion was 5.55 mm (interquartile range [IQR] 5.23) in the tooth-borne device group and 4.6 mm (IQR 3.4) in the bone-borne device group. In the first molars, crown expansion and lateral tipping were significantly greater in the tooth-borne device group (P ≤ .02). The median skeletal nasal isthmus increase was significantly more in the bone-borne device group at 3.0 mm than in the tooth-borne device group at 0.98 mm (P ≤ .02).

CONCLUSIONS

Both tooth-borne and bone-borne devices are effective treatment modalities to correct maxillary transverse deficiencies. Bone-borne devices produced greater widening of the skeletal nasal floor and fewer dental side effects in the first molars.

摘要

目的

评估并比较牙支持式和骨支持式牵张装置在外科辅助上颌扩弓（SARME）中对牙齿和骨骼结构的影响。

研究设计

对33例骨骼成熟的上颌横向发育不足患者在手术前及术后3个月进行锥形束计算机断层扫描（CBCT）检查。14例患者采用牙支持式装置治疗，19例患者采用骨支持式装置治疗。

结果

两组第一前磨牙牙冠扩弓情况无显著差异，牙支持式装置组的中位扩弓量为5.55 mm（四分位数间距[IQR] 5.23），骨支持式装置组为4.6 mm（IQR 3.4）。在第一磨牙中，牙支持式装置组的牙冠扩弓和侧向倾斜明显更大（P≤0.02）。骨支持式装置组的中位骨性鼻峡增加量为3.0 mm，显著多于牙支持式装置组的0.98 mm（P≤0.02）。