Park Jung Jin, Park Young-Chel, Lee Kee-Joon, Cha Jung-Yul, Tahk Ji Hyun, Choi Yoon Jeong
Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.
Graduate of Harvard School of Dental Medicine, Harvard University, Boston, MA, USA.
Korean J Orthod. 2017 Mar;47(2):77-86. doi: 10.4041/kjod.2017.47.2.77. Epub 2017 Jan 25.
The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT).
This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired -test or Wilcoxon signed-rank test according to normality of the data.
The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement ( < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively ( < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of 1.1°-2.9°.
Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.
本研究旨在通过锥形束计算机断层扫描（CBCT）评估年轻成人在微型螺钉辅助快速腭扩展（MARPE）后的骨骼和牙-牙槽变化。
这项回顾性研究纳入了14例接受MARPE治疗的上颌横向发育不足患者（平均年龄20.1岁；范围16 - 26岁）。使用扩展前后获取的CBCT图像评估骨骼和牙-牙槽变化。根据数据的正态性，使用配对t检验或Wilcoxon符号秩检验进行统计分析。
腭中缝分离，MARPE后上颌出现具有统计学意义的侧向移动（P < 0.05）。一些标志点向前或向上移动了小于1 mm的临床无关距离。向上方向的扩展量减少，在牙冠、牙骨质釉质界、上颌基骨和颧弓水平处的值分别为5.5、3.2、2.0和0.8 mm（P < 0.05）。颊侧骨厚度和牙槽嵴高度分别减少了0.6 - 1.1 mm和1.7 - 2.2 mm，前磨牙和磨牙出现了1.1° - 2.9°的颊侧倾斜。
我们的结果表明，MARPE是一种在年轻成人中无需手术即可矫正上颌横向发育不足的有效方法。
