Tong Fei, Liu Fen, Liu Jiali, Xiao Chang, Liu Jian, Wu Jianyong
Orthodontic Department of Affiliated Stomatological Hospital of Nanchang University, Nanchang, China.
Orthodontic Department of Affiliated Stomatological Hospital of Nanchang University, Nanchang, China.
Am J Orthod Dentofacial Orthop. 2017 Jan;151(1):132-142. doi: 10.1016/j.ajodo.2016.06.030.
The purpose of this study was to evaluate the effects of a newly designed magnetic palatal expansion appliance with a reactivation system.
A magnetic palatal expansion appliance was designed based on the repulsion forces of neodymium-iron-boron magnets combined with a reactivation system. Eighteen prepubertal male beagle dogs were assigned randomly to the magnetic expansion (ME) group, the mechanical screw expansion (SE) group, or the control group. Two pairs of nonmagnetic metal bone marker implants were inserted into palatal bone bilaterally 3 mm lateral to the midpalatal suture and in line with the first and fourth premolars, respectively, in each dog. The 6 animals in each group received (1) newly designed magnetic expanders, (2) jackscrew expanders, or (3) no expansion appliance. Expansion was stopped after 4 weeks when 6 mm of activation was achieved in the 2 treated groups. Three-dimensional evaluations of dental and skeletal effects were performed with cone-beam computed tomography. Histologic examinations were conducted using light microscopy to observe morphologic changes in the midpalatal suture after hematoxylin and eosin staining.
The absolute transversal changes of both treated groups before and after expansion were significantly greater than those in the control group in all parameters (P <0.001). The differences of the distances of bilateral canines in the ME group were significantly greater than in the SE group (1.04 ± 0.16 mm; P <0.001); the differences of the distances between implants adjacent to the first premolars (0.77 ± 0.06 mm; P <0.001) and the distances between implants adjacent to the fourth premolars (0.37 ± 0.06 mm; P <0.001) in the SE group were significantly greater than in the ME group. Histologic observations of the palatal sutures in the ME and SE groups, when compared with the control group, showed widening of the sutures and many fibroblasts in an active, proliferative state. Counts of osteoblasts were increased in both expansion groups. Counts of osteoclasts were increased in the SE group.
Both appliances expanded the maxilla effectively and induced processes of bone remodeling of the midpalatal sutures during expansion. The new magnetic palatal expansion appliances produced a smaller skeletal effect and a greater dental effect than did the mechanical screw palatal expansion appliances.
本研究的目的是评估一种新设计的带有再激活系统的磁性腭扩展矫治器的效果。
基于钕铁硼磁体的斥力并结合再激活系统设计了一种磁性腭扩展矫治器。18只青春期前雄性比格犬被随机分为磁性扩展(ME)组、机械螺旋扩展(SE)组或对照组。在每只犬的腭中缝两侧分别向外侧3 mm、与第一和第四前磨牙连线处双侧植入两对非磁性金属骨标记物。每组6只动物分别接受(1)新设计的磁性扩展器、(2)螺旋扩弓器或(3)不使用扩展矫治器。当两个治疗组实现6 mm的激活量后,4周后停止扩展。使用锥形束计算机断层扫描对牙齿和骨骼效应进行三维评估。进行苏木精-伊红染色后,用光镜进行组织学检查以观察腭中缝的形态变化。
在所有参数方面,两个治疗组扩展前后的绝对横向变化均显著大于对照组(P<0.001)。ME组双侧尖牙间距离的差异显著大于SE组(1.04±0.16 mm;P<0.001);SE组中与第一前磨牙相邻的种植体间距离(0.77±0.06 mm;P<0.001)和与第四前磨牙相邻的种植体间距离(0.37±0.06 mm;P<0.001)的差异显著大于ME组。与对照组相比,ME组和SE组腭缝的组织学观察显示缝增宽,有许多处于活跃增殖状态的成纤维细胞。两个扩展组的成骨细胞计数均增加。SE组的破骨细胞计数增加。
两种矫治器均能有效扩展上颌骨,并在扩展过程中诱导腭中缝的骨重塑过程。新型磁性腭扩展矫治器比机械螺旋腭扩展矫治器产生的骨骼效应更小,牙齿效应更大。