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使用微型种植体辅助快速腭扩展(MARPE)对成人横向牙弓狭窄进行非手术治疗。

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE).

作者信息

Brunetto Daniel Paludo, Sant'Anna Eduardo Franzzotti, Machado Andre Wilson, Moon Won

机构信息

Department of Restorative Dentistry, Dental School, Universidade Federal do Paraná, Curitiba, PR, Brazil.

Department of Pediatric Dentistry and Orthodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

出版信息

Dental Press J Orthod. 2017 Feb;22(1):110-125. doi: 10.1590/2177-6709.22.1.110-125.sar.

Abstract

INTRODUCTION

Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE).

OBJECTIVE

The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA).

METHODS

All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained.

CONCLUSION

It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

摘要

引言

上颌横向发育不足是一种在所有年龄组中都高度普遍存在的错牙合畸形,从乳牙列到恒牙列。如果不及时治疗,它会加重并演变成更复杂的错牙合畸形,阻碍面部生长发育。除了咬合方面的后果外,这种发育不足还通常会导致鼻腔狭窄,进而引发严重的呼吸问题。对于正在生长发育的患者,这种情况可以通过传统的快速腭中缝扩展术轻松解决。然而,成年患者通常需要接受更具侵入性的手术——外科辅助快速腭中缝扩展术(SARPE)。最近,研究表明,对于成年患者,可以不进行截骨术,而是使用微型种植体支抗来扩展上颌骨。这种新技术被称为微型种植体辅助快速腭中缝扩展术(MARPE)。

目的

本文的目的是展示和讨论由加利福尼亚大学洛杉矶分校(UCLA)的Won Moon博士及其同事开发的一种MARPE技术。

方法

详细描述了正确实施该技术所需的所有实验室和临床步骤。为了更好地理解,报告了一个成年患者的病例,详细说明了所有治疗进展和取得的结果。

结论

得出的结论是,对于大多数上颌横向发育不足的成年患者,所展示的技术可能是SARPE的一个有趣替代方案。该患者在接受该手术后,在咬合和呼吸方面都有显著改善,且无需任何手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a573/5398849/53f535dccf3e/2176-9451-dpjo-22-01-00110-gf1.jpg

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