Mason Martina, Spolaor Fabiola, Guiotto Annamaria, De Stefani Alberto, Gracco Antonio, Sawacha Zimi
Department of neuroscience, School of Dentistry, University of Padua, Via Giustiniani 5, 35128 Padova, Italy.
Department of engineering, University of Padua, Italy.
Int Orthod. 2018 Mar;16(1):158-173. doi: 10.1016/j.ortho.2018.01.003. Epub 2018 Feb 14.
The purpose of this study was to evaluate the effects of the rapid palatal expansion (RPE) on posture and gait analysis in subjects with maxillary transverse discrepancies.
Forty-one patients between 6 and 12 years were divided into 3 groups: 10 control subjects (Cs), 16 patients with unilateral posterior crossbite (CbMono), 15 patients with maxillary transverse discrepancy and no crossbite (Nocb). Every subject underwent gait analysis and posturographic examination in order to evaluate the presence of balance alterations before (T0) and after (T4) RPE application. The examinations were performed through a six-cameras stereophotogrammetric system (60-120Hz, BTS S.p.A.) synchronized with two force plates (FP4060, Bertec Corp.). Romberg test was performed on a force plate, and the statokinesiogram and joint kinematics were evaluated. One-way Anova was performed among the variables after evidence of normal distribution (Levene's test for equality of variances) and Kruskal-Wallis test (P<0.05), in order to compare the three groups of subjects. While paired t-test was performed, or Kruskal-Wallis test, instead when comparing pre- and post-RPE application within the same group of subjects (P<0.05). Tamane T2 or Bonferroni correction was applied where needed.
The posturographic analysis reveal significant differences across the 3 population: 95% power frequency in medio-lateral and antero-posterior direction in T0, median frequency in medio-lateral direction in T0, mean power frequency in medio-lateral direction in T0. Significant differences were also registered in the three-dimensional joints kinematics variables, mainly between Cs and Cbmono in T0 and T4 and between Cbmono and Nocb in T4.
A detectable correlation between dental occlusion and body posture is shown in this study that confirms another benefit of the RPE. This was mainly revealed in the dynamic posture where modifications at the mandibular level affect the whole body.
本研究旨在评估快速腭扩展（RPE）对上颌横向差异患者姿势和步态分析的影响。
41名6至12岁的患者分为3组：10名对照受试者（Cs），16名单侧后牙反合患者（CbMono），15名上颌横向差异但无反合患者（Nocb）。每位受试者在RPE应用前（T0）和应用后（T4）均接受步态分析和姿势描记检查，以评估平衡改变情况。检查通过与两个测力台（FP4060，Bertec公司）同步的六相机立体摄影测量系统（60 - 120Hz，BTS S.p.A.）进行。在测力台上进行Romberg试验，并评估静态运动图和关节运动学。在变量呈现正态分布证据后（Levene方差齐性检验）进行单因素方差分析，以及Kruskal - Wallis检验（P<0.05），以比较三组受试者。而在同一组受试者内比较RPE应用前后时进行配对t检验或Kruskal - Wallis检验（P<0.05）。必要时应用Tamane T2或Bonferroni校正。
姿势描记分析显示三组人群存在显著差异：T0时在内外侧和前后方向的95%功率频率、T0时在内外侧方向的中位数频率、T0时在内外侧方向的平均功率频率。在三维关节运动学变量中也记录到显著差异，主要在T0和T4时Cs与CbMono之间以及T4时CbMono与Nocb之间。
本研究显示牙合与身体姿势之间存在可检测的相关性，证实了RPE的另一益处。这主要在动态姿势中得以体现，下颌水平的改变会影响全身。
