Angle Orthod. 2020 Jan;90(1):13-22. doi: 10.2319/050619-316.1. Epub 2019 Aug 28.
To evaluate the molar inclination and skeletal and alveolar bone changes when comparing tooth bone-borne (MSE) and tissue bone-borne type maxillary expanders (C-expander) using cone-beam computed tomography (CBCT) in late adolescence.
A sample of 48 late-adolescent patients were divided into two groups according to the type of expander: MSE group (n = 24, age = 19.2 ± 5.9 years) and C-expander group (n = 24, age = 18.1 ± 4.5 years). CBCT scans were taken before treatment and 3 months after expansion. Transverse skeletal and dental expansion, alveolar inclination, tooth axis, buccal alveolar bone height, thickness, dehiscence, and fenestration were evaluated on the maxillary first molar. Paired -test, independent -test, Pearson's chi-square test, and Spearman correlation analysis were performed.
The MSE group produced greater dental expansion ( < .05), whereas skeletal expansion was similar in both groups ( = .859). The C expander group had more alveolar bone inclination change ( < .01), and the MSE group had more buccal tipping of the anchorage teeth ( < .01 or .001). Buccal alveolar bone height loss and thickness changes were greater in the MSE group ( < .01 or <.001). Formation of dehiscences was more frequent in the MSE group ( < .001), whereas for fenestrations, there were no significant differences between the two groups. Buccal bone height loss in the MSE group had a negative correlation with initial buccal bone thickness.
The incorporation of teeth into bone-borne expanders resulted in an increase in the severity of side effects. For patients in late adolescence, tissue bone-borne expanders offer comparable skeletal effects to tooth bone-borne expanders, with fewer dentoalveolar side effects.
通过锥形束 CT(CBCT)评估青少年后期使用牙骨支抗(MSE)和组织骨支抗型上颌扩弓器(C 扩弓器)时的磨牙倾斜度和骨骼及牙槽骨变化。
根据扩弓器类型将 48 例青少年后期患者分为两组:MSE 组(n=24,年龄 19.2±5.9 岁)和 C 扩弓器组(n=24,年龄 18.1±4.5 岁)。治疗前和扩弓后 3 个月拍摄 CBCT 扫描。评估上颌第一磨牙的横向骨骼和牙齿扩张、牙槽骨倾斜、牙齿轴、颊侧牙槽骨高度、厚度、缺损、开窗。采用配对 t 检验、独立 t 检验、Pearson 卡方检验和 Spearman 相关分析。
MSE 组的牙齿扩张更大(<0.05),而两组的骨骼扩张相似(=0.859)。C 扩弓器组的牙槽骨倾斜变化更大(<0.01),MSE 组的支抗牙颊向倾斜更大(<0.01 或 0.001)。MSE 组的颊侧牙槽骨高度丧失和厚度变化更大(<0.01 或<0.001)。MSE 组的缺损发生率更高(<0.001),而对于开窗,两组之间无显著差异。MSE 组的颊侧骨高度丢失与初始颊侧骨厚度呈负相关。
将牙齿纳入骨支抗扩弓器会增加副作用的严重程度。对于青少年后期患者,组织骨支抗扩弓器具有与牙骨支抗扩弓器相当的骨骼效果,且牙骨支抗扩弓器的牙牙槽副作用较少。