Grünheid Thorsten, Larson Chad E, Larson Brent E
Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn.
Private practice, Rochester, Minn.
Am J Orthod Dentofacial Orthop. 2017 Feb;151(2):267-276. doi: 10.1016/j.ajodo.2016.06.043.
During adolescence, increasing interdigitation of the midpalatal suture increases resistance to rapid maxillary expansion (RME); this decreases its skeletal effect. In this study, we aimed at determining whether a novel measure of midpalatal suture maturity, the midpalatal suture density ratio, can be used as a valid predictor of the skeletal response to RME.
The midpalatal suture density ratio, chronologic age, cervical vertebral maturation, and the stage of midpalatal suture maturation were assessed before treatment for 30 patients (ages, 12.9 ± 2.1 years) who underwent RME as part of comprehensive orthodontic treatment. Measurements on cone-beam computed tomography scans were used to determine the proportions of prescribed expansion achieved at the greater palatine foramina, the nasal cavity, and the infraorbital foramina.
There was a statistically significant negative correlation between the midpalatal suture density ratio and both the greater palatine foramina and the infraorbital foramina (r = -0.7877 and -0.3647, respectively; P <0.05). In contrast, chronologic age, cervical vertebral maturation, and stage of midpalatal suture maturation were not significantly correlated to any of the assessed measures of skeletal expansion (r range, -0.2209 to 0.0831; P >0.05).
The midpalatal suture density ratio has the potential to become a useful clinical predictor of the skeletal response to RME. Conversely, chronologic age, cervical vertebral maturation, and stage of midpalatal suture maturation cannot be considered useful parameters to predict the skeletal effects of RME.
在青春期,腭中缝的交错增加会增强对上颌快速扩弓(RME)的阻力,这会降低其骨骼效应。在本研究中,我们旨在确定一种新的腭中缝成熟度测量指标——腭中缝密度比,是否可作为RME骨骼反应的有效预测指标。
对30例(年龄12.9±2.1岁)接受RME作为综合正畸治疗一部分的患者,在治疗前评估其腭中缝密度比、实足年龄、颈椎成熟度和腭中缝成熟阶段。利用锥形束计算机断层扫描测量结果来确定在腭大孔、鼻腔和眶下孔处达到的规定扩弓比例。
腭中缝密度比与腭大孔和眶下孔处的扩弓比例之间存在统计学上的显著负相关(r分别为-0.7877和-0.3647;P<0.05)。相比之下,实足年龄、颈椎成熟度和腭中缝成熟阶段与任何评估的骨骼扩弓测量指标均无显著相关性(r范围为-0.2209至0.0831;P>0.05)。
腭中缝密度比有可能成为RME骨骼反应的有用临床预测指标。相反,实足年龄、颈椎成熟度和腭中缝成熟阶段不能被视为预测RME骨骼效应的有用参数。