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回顾性 CBCT 分析骨支抗与牙支抗快速上颌扩展后气道容积的变化。

Retrospective CBCT analysis of airway volume changes after bone-borne vs tooth-borne rapid maxillary expansion.

出版信息

Angle Orthod. 2019 Jul;89(4):566-574. doi: 10.2319/070818-507.1. Epub 2019 Feb 15.

Abstract

OBJECTIVES

To compare changes in upper airway volume after maxillary expansion with bone- and tooth-borne appliances in adolescents and to evaluate the dentoskeletal effects of each expansion modality.

MATERIALS AND METHODS

This retrospective study included 36 adolescents who had bilateral maxillary crossbite and received bone-borne maxillary expansion (average age: 14.7 years) or tooth-borne maxillary expansion (average age: 14.4 years). Subjects had two cone beam computed tomography images acquired, one before expansion (T) and a second after a 3-month retention period (T). Images were oriented, and three-dimensional airway volume and dentoskeletal expansion were measured. Analysis of variance was used to test for differences between the two expansion methods for pretreatment, posttreatment, and prepost changes. Paired -tests were used to test for significance of prepost changes within each method.

RESULTS

Both groups showed significant increase only in nasal cavity and nasopharynx volume ( < .05), but not oropharynx and maxillary sinus volumes. Intermolar and maxillary width increased significantly in both groups ( < .05); however, the buccal inclination of maxillary molars increased significantly only in the tooth-borne group ( < .05). There was no significant difference between tooth- and bone-borne expansion groups, except for the significantly larger increase in buccal inclination of the maxillary right first molar after tooth-borne expansion.

CONCLUSIONS

In adolescents, both tooth- and bone-borne RME resulted in an increase in nasal cavity and nasopharynx volume, as well as expansion in maxillary intermolar and skeletal widths. However, only tooth-borne expanders caused significant buccal tipping of maxillary molars.

摘要

目的

比较青少年上颌骨扩弓时骨支和牙支矫治器对上气道容积的改变,并评估每种扩弓方式的牙颌骨效应。

材料和方法

本回顾性研究纳入了 36 名双侧上颌骨后牙反颌的青少年患者,他们分别接受了骨支上颌扩弓(平均年龄:14.7 岁)或牙支上颌扩弓(平均年龄:14.4 岁)。在扩弓前(T)和 3 个月保持期后(T)各采集了 1 次锥形束 CT 图像。对图像进行定向,测量三维气道容积和牙颌骨扩张情况。采用方差分析比较两种扩弓方法的治疗前、治疗后和治疗前后变化的差异。采用配对 t 检验比较每种方法治疗前后的变化。

结果

两组均仅显示鼻腔和鼻咽腔容积显著增加(<0.05),但口咽腔和上颌窦容积无明显变化或增加。两组间磨牙间宽度和上颌宽度均显著增加(<0.05);然而,仅牙支组上颌磨牙颊倾度显著增加(<0.05)。牙支和骨支扩弓组之间无显著差异,除牙支扩弓后上颌右侧第一磨牙颊倾度显著增加外。

结论

在青少年中,牙支和骨支 RME 均可增加鼻腔和鼻咽腔容积,并增加上颌间宽度和骨宽度。然而,仅牙支扩弓器可导致上颌磨牙颊倾显著。

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