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应用牙支抗和牙骨支抗扩弓器对上颌骨扩弓后骨皮质骨板和牙根长度的锥形束 CT 评估。

Cone-beam computed tomography evaluation of bone plate and root length after maxillary expansion using tooth-borne and tooth-tissue-borne banded expanders.

机构信息

Department of Orthodontics, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Advanced Dental Education Program in Orthodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif.

出版信息

Am J Orthod Dentofacial Orthop. 2018 Oct;154(4):504-516. doi: 10.1016/j.ajodo.2017.12.018.

Abstract

INTRODUCTION

The objective of this research was to evaluate the buccal bone plate and root length of maxillary permanent first molars using cone-beam computed tomography after maxillary expansion with different activation protocols.

METHODS

Cone-beam computed tomography images of growing patients were obtained from the orthodontic department of Pontifical Catholic University of Rio Grande do Sul in Brazil. The groups were Haas-type 2/4 turns, Haas-type 4/4 turns, hyrax-type 2/4 turns, and hyrax-type with alternate rapid maxillary expansions and constrictions (alt-RAMEC) 4/4 turns a day. Tooth length, periodontal insertion, alveolar bone thickness, and intermolar distances were evaluated. The data at the start of treatment and 6 months later were compared using generalized linear models. The intergroup differences were determined by univariate analysis of variance with the Bonferroni adjustment.

RESULTS

Tooth length was significantly shortened after expansion in all groups (-0.28 to -0.51 mm), except for the alt-RAMEC group. Bone level variables (bone level and bone level at the tooth tip) changed statistically in all groups, except for the Haas 4/4 turns group. There was significant periodontal attachment loss after rapid maxillary expansion with the hyrax/alt-RAMEC (5.09 mm). The hyrax/alt-RAMEC and hyrax groups had more dehiscences, fenestrations, and exposures of the root.

CONCLUSIONS

The consequence of rapid maxillary expansion using the hyrax was alveolar bone resorption, especially in the hyrax/alt-RAMEC group, whereas the Haas expander caused mild root resorption.

摘要

简介

本研究旨在通过锥形束 CT 评估上颌恒磨牙在使用不同激活方案扩弓后的颊侧骨板和根长。

方法

本研究从巴西Pontifical Catholic University of Rio Grande do Sul 的正畸科获取生长患者的锥形束 CT 图像。组间比较使用 Haas 型 2/4 圈、Haas 型 4/4 圈、Hyrax 型 2/4 圈和 Hyrax 型 4/4 圈,每日交替快速扩弓和缩窄(alt-RAMEC)。评估牙长、牙周附着、牙槽骨厚度和磨牙间距离。使用广义线性模型比较治疗开始和 6 个月后的数据。使用单因素方差分析和 Bonferroni 调整确定组间差异。

结果

除 alt-RAMEC 组外,所有组的牙长在扩弓后均显著缩短(-0.28 至-0.51mm)。除 Haas 4/4 圈组外,所有组的骨水平变量(骨水平和牙尖处的骨水平)均发生统计学变化。Hyrax/alt-RAMEC 组的牙周附着明显丧失(5.09mm)。Hyrax/alt-RAMEC 和 Hyrax 组的根裂、根开窗和根暴露更多。

结论

Hyrax 快速扩弓导致牙槽骨吸收,尤其是在 Hyrax/alt-RAMEC 组,而 Haas 扩弓器导致轻度牙根吸收。

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