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皮质切开术辅助成人上颌快速扩弓和牙槽嵴增高:一项具有 7 年随访的跨学科病例报告。

Corticotomy-assisted adult rapid maxillary arch expansion and ridge augmentation: An interdisciplinary case report with 7-year follow-up.

机构信息

Private practice, San Juan, Puerto Rico.

Graduate Orthodontics, University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico; Department of Orthodontics, University of Alabama School of Dentistry, Birmingham, Ala; Private practice, Guaynabo, Puerto Rico.

出版信息

Am J Orthod Dentofacial Orthop. 2019 Aug;156(2):266-274. doi: 10.1016/j.ajodo.2018.02.018.

Abstract

Adult orthodontic treatment involving maxillary transverse deficiency is a challenge for an interdisciplinary team. Surgically assisted rapid palatal expansion to segment the maxilla was once the treatment of choice, but the invasiveness, bone deficiency, and gingival recession hindered its acceptance. Corticotomy-assisted rapid maxillary arch expansion with ridge augmentation has the advantage of augmenting alveolar bony housing to accommodate and facilitate tooth movement. This approach was used to correct a severely constricted maxilla with bilateral posterior crossbite and anterior crowding in a 46-year-old man. Treatment time was 14 months. The accelerated arch expansion overcame the crossbite in 7 months, increasing intercanine distance by 5.2 mm and intermolar distance by 9.8 mm. Subsequent implant prosthesis was able to be restored in a functional normal occlusion. Satisfactory and stable clinical outcome was followed for 7 years. Corticotomy-assisted rapid maxillary arch expansion with alveolar bone augmentation is a novel and effective interdisciplinary approach for correcting adult maxillary transverse deficiency. Well controlled prospective clinical trails are warranted for further investigation.

摘要

成人正畸治疗上颌横向不足是一个跨学科团队的挑战。外科辅助快速腭扩张术将上颌分段曾经是首选的治疗方法,但由于其侵袭性、骨量不足和牙龈退缩,限制了其接受度。骨切开术辅助快速上颌弓扩张并进行牙槽骨增量具有增加牙槽骨容纳空间以促进牙齿移动的优势。这种方法用于矫正一位 46 岁男性的严重上颌狭窄、双侧后牙反颌和前牙拥挤。治疗时间为 14 个月。快速上颌弓扩张在 7 个月内克服了反颌,增加了犬齿间距离 5.2mm 和磨牙间距离 9.8mm。随后的种植体修复能够恢复正常功能的咬合关系。7 年的随访显示了满意和稳定的临床效果。骨切开术辅助快速上颌弓扩张并进行牙槽骨增量是一种新颖有效的跨学科方法,可用于矫正成人上颌横向不足。需要进行良好控制的前瞻性临床试验以进一步研究。

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