Pereira Max Domingues, Koga Alexandre Fukuzo, Prado Gabriela Pereira Ribeiro, Ferreira Lydia Masako
Division of Plastic Surgery (Craniomaxillofacial Sector), Federal University of São Paulo (UNIFESP).
Division of Plastic Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil.
J Craniofac Surg. 2018 Mar;29(2):275-278. doi: 10.1097/SCS.0000000000004079.
The current study aimed at comparing the number and type of undesired outcomes during and after the maxillary expansion performed with HYRAX and HAAS expanders. A total of 90 patients (41 males and 49 females, 45.6% and 54.4%, respectively) aged 18 to 59 (mean age of 26.1; standard deviation [SD] = 7.4) underwent subtotal Le Fort I osteotomy and pterygomaxillary disjunction following surgically assisted rapid maxillary expansion (SARME) carried out using HAAS (n = 29; 48.3% male and 51.7% female; mean age = 27: SD = 7.7) and HYRAX (n = 61; 44.3% male and 55.7% female; mean age = 26; SD = 7.2) expanders. Post-SARME dento-gingival, radiographic, and clinical undesired outcomes were evaluated. A total of 16 (17.8%) patients experienced at least 1 undesired outcome-7 (7.8%) and 9 (10.0%) in HAAS and HYRAX group, respectively. The most common undesired outcomes were radiographic asymmetric expansion-2 (2.2%) and 3 (3.3%) in HAAS and HYRAX group, respectively-followed by pain during out-of-clinic expansion 4 (4.4%) in HAAS group only-dental darkening 5 (5.5%) in HYRAX group, only, requiring root canal treatment, and local infection-2 (2.2%), 1 in each HAAS and HYRAX groups. Excepting for complications arising from the acrylic stop plate in HAAS expander, the number and severity of complications observed in the current study did not differ due to the use of HAAS and HYRAX appliances to perform maxillary expansion. Hygiene issues do not rule out the use of HAAS. The wider maxillary expansion performed, the more frequent are the cases of asymmetric expansion.
本研究旨在比较使用HYRAX扩弓器和HAAS扩弓器进行上颌扩弓期间及之后出现的不良后果的数量和类型。共有90例患者(41例男性和49例女性,分别占45.6%和54.4%),年龄在18至59岁之间(平均年龄26.1岁;标准差[SD]=7.4),在使用HAAS扩弓器(n=29;48.3%为男性,51.7%为女性;平均年龄=27岁;SD=7.7)和HYRAX扩弓器(n=61;44.3%为男性,55.7%为女性;平均年龄=26岁;SD=7.2)进行外科辅助快速上颌扩弓(SARME)后,接受了Le Fort I型次全截骨术和翼上颌离断术。对SARME后的牙-牙龈、影像学和临床不良后果进行了评估。共有16例(17.8%)患者经历了至少1种不良后果,HAAS组和HYRAX组分别有7例(7.8%)和9例(10.0%)。最常见的不良后果是影像学不对称扩弓,HAAS组和HYRAX组分别有2例(2.2%)和3例(3.3%),其次是仅HAAS组有4例(4.4%)在门诊外扩弓期间出现疼痛,仅HYRAX组有5例(5.5%)牙齿变黑,需要进行根管治疗,以及局部感染,HAAS组和HYRAX组各有2例(2.2%)和1例。除了HAAS扩弓器的丙烯酸止动板引起的并发症外,本研究中观察到的并发症数量和严重程度因使用HAAS和HYRAX矫治器进行上颌扩弓而没有差异。卫生问题并不排除使用HAAS。上颌扩弓越宽,不对称扩弓的情况就越频繁。