Şahbaz Emir Bahman, Cesur Emre, Altuğ Ayşe Tuba, Ergül Kutay Can, Karasu Hakan Alpay, Memikoğlu Ufuk Toygar
Department of Orthodontics, Private Practice, Ankara, Turkey.
Department of Orthodontics, Medipol Mega University Hospital, İstanbul, Turkey.
Turk J Orthod. 2019 Jun;32(2):96-104. doi: 10.5152/TurkJOrthod.2019.18060. Epub 2019 Jun 1.
The purpose of the present study was to evaluate skeletal and soft tissue changes with surgically assisted rapid maxillary expansion (SARME) and intermaxillary Class III elastics.
A total of 15 patients (mean age: 19.58 years) were included in the study. Each patient underwent SARME with the use of Class III elastics (500 g) applied through miniscrews to stimulate maxillary advancement. Lateral cephalograms and posteroanterior radiographs obtained before treatment (T1), after SARME and elastic use (T2), and after treatment (T3) were analyzed to determine the changes in each phase of treatment. Planimeter was used to evaluate facial soft tissue changes. Wilcoxon signed-rank test was used to evaluate the changes that occur during treatment.
SARME provided permanent and efficient maxillary expansion at both skeletal and dental levels (p<0.01). Maxillary skeletal (ANS-Ver and U1i-Ver; p<0.01) and soft tissue (Pr-Ver, Sn-Ver, and ULA-Ver; p<0.01) variables and superior upper labial area (Area 1; p<0.05) increased due to maxillary dental and skeletal changes. Superior lower labial area (Area 3; p<0.05) decreased as a result of slight increase in facial height and changes in maxillary-mandibular incisor relationship at the end of the treatment.
The results suggest that the improvement in the facial profiles of the patients is related to the significant increase in the bony and dental support of the upper lip region together with the contribution of the superior lower lip area.
本研究旨在评估外科辅助快速上颌扩弓（SARME）联合Ⅲ类颌间牵引对骨骼和软组织变化的影响。
本研究共纳入15例患者（平均年龄：19.58岁）。每位患者均接受了SARME治疗，并通过微型螺钉施加Ⅲ类牵引（500g）以刺激上颌前突。分析治疗前（T1）、SARME及牵引治疗后（T2）和治疗结束后（T3）获得的头颅侧位片和正位片，以确定治疗各阶段的变化。使用面积计评估面部软组织变化。采用Wilcoxon符号秩检验评估治疗期间发生的变化。
SARME在骨骼和牙齿水平均实现了永久性且有效的上颌扩弓（p<0.01）。由于上颌牙齿和骨骼的变化，上颌骨骼（前鼻棘-垂直距和上中切牙长轴-垂直距；p<0.01）、软组织（软组织前点-垂直距、鼻根点-垂直距和上唇突点-垂直距；p<0.01）变量以及上唇上部面积（区域1；p<0.05）均增加。治疗结束时，由于面部高度略有增加以及上颌-下颌切牙关系的改变，下唇上部面积（区域3；p<0.05）减小。
结果表明，患者面部轮廓的改善与上唇区域骨和牙齿支撑的显著增加以及下唇上部面积的贡献有关。
