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