Angle Orthod. 2019 Sep;89(5):713-720. doi: 10.2319/070518-504.1. Epub 2019 Mar 21.
To assess alterations in respiratory muscle strength and inspiratory and expiratory peak flow, as well as skeletal and dental changes in patients diagnosed with transverse maxillary deficiency before and after microimplant-assisted rapid maxillary expansion (MARPE).
Twenty patients (13 female and 7 male) were assessed by respiratory tests in three different periods: T0 initial, T1 immediately after expansion, and T2 after 5 months. Tests included: maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), oral expiratory peak flow, and inspiratory nasal flow. Cone-beam computed tomography measurements were performed in the maxillary arch, nasal cavity, and airway before and immediately after expansion.
There was a significant increase in MIP between T0 and T2 and MEP between T0 and T1 (<.05). Oral and nasal peak flow increased immediately after and 5 months later, especially in patients with initial signs of airway obstruction (<.05). In addition, after expansion there was a significant enlargement of the nasal cavity, alveolar bone, and interdental widths at the premolar and molar region. Molars tipped buccally (<.05) but no difference was found in premolar inclination. MARPE increased airway volume significantly.
Skeletal changes promoted by MARPE directly affected airway volume, resulting in a significant improvement in muscle strength and nasal and oral peak flow.
评估诊断为横向上颌骨发育不全的患者在微种植体辅助快速上颌扩张(MARPE)前后呼吸肌力量、吸气和呼气峰流速以及骨骼和牙齿的变化。
20 名患者(13 名女性和 7 名男性)在三个不同时期进行了呼吸测试:T0 初始、T1 扩张后立即和 T2 后 5 个月。测试包括:最大吸气压力(MIP)和最大呼气压力(MEP)、口腔呼气峰流速和吸气鼻流量。在扩张前和扩张后立即进行了上颌弓、鼻腔和气道的锥形束计算机断层扫描测量。
MIP 在 T0 与 T2 之间以及 MEP 在 T0 与 T1 之间均有显著增加(<.05)。口腔和鼻腔峰流速在扩张后立即和 5 个月后增加,特别是在初始气道阻塞迹象的患者中(<.05)。此外,扩张后鼻腔、牙槽骨和前磨牙和磨牙区域的牙间隙明显增大。磨牙向颊侧倾斜(<.05),但前磨牙倾斜无差异。MARPE 显著增加了气道容积。
MARPE 引起的骨骼变化直接影响气道容积,导致肌肉力量和鼻腔及口腔峰流速显著改善。