通过锥形束计算机断层扫描评估接受外科辅助快速上颌扩弓(SARME)的患者腭中缝区域的开口模式和骨新生情况。

Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME) through cone beam computed tomography.

作者信息

Salgueiro Daniel Gomes, Rodrigues Vitor Hugo Leite de Oliveira, Tieghi Neto Victor, Menezes Carolina Carmo de, Gonçales Eduardo Sanches, Ferreira Júnior Osny

机构信息

Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, BR.

Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of São Paulo, Bauru, BR.

出版信息

J Appl Oral Sci. 2015 Jul-Aug;23(4):397-404. doi: 10.1590/1678-775720140486.

Abstract

Surgically assisted rapid maxillary expansion (SARME) is the treatment of choice to adult patients even with severe transversal maxillary discrepancies. However, the adequate retention period to achieve the bone remodeling, thus assuring treatment stability, is controversial.Objective To evaluate the opening pattern and bone neoformation process at the midpalatal suture in patients submitted to surgically assisted (SARME) through cone beam computed tomography (CBCT).Material and Methods Fourteen patients were submitted to SARME through subtotal Le Fort I osteotomy. Both the opening pattern and the mean bone density at midpalatal suture area to evaluate bone formation were assessed pre- and post-operatively (15, 60 and 180 days) through CBCT.Results Type I opening pattern (from anterior to posterior nasal spine) occurred in 12 subjects while type II opening pattern (from anterior nasal spine to transverse palatine suture) occurred in 2 individuals. The 180-day postoperative mean (PO 180) of bone density value was 49.9% of the preoperative mean (Pre) value.Conclusions The opening pattern of midpalatal suture is more related to patients' age (23.9 years in type I and 33.5 years in type II) and surgical technique. It was not possible to observe complete bone formation at midpalatal suture area at the ending of the retention period studied (180 days).

摘要

外科辅助快速上颌扩弓(SARME)是成年患者即使存在严重上颌横向差异时的首选治疗方法。然而,为实现骨重塑从而确保治疗稳定性的足够保持期仍存在争议。目的 通过锥形束计算机断层扫描(CBCT)评估接受外科辅助快速上颌扩弓(SARME)患者的腭中缝开口模式和骨新形成过程。材料与方法 14例患者通过不完全Le Fort I截骨术接受SARME治疗。通过CBCT在术前及术后(15天、60天和180天)评估腭中缝区域的开口模式和平均骨密度以评价骨形成情况。结果 12例患者出现I型开口模式(从鼻前棘至后鼻棘),2例患者出现II型开口模式(从鼻前棘至横腭缝)。术后180天骨密度值的平均值为术前平均值的49.9%。结论 腭中缝的开口模式与患者年龄(I型为23.9岁;II型为33.5岁)及手术技术的关系更为密切。在所研究的保持期(180天)结束时,未观察到腭中缝区域完全的骨形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a5d/4560500/8e58f13a2ca6/1678-7757-jaos-23-4-0397-gf01.jpg

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