School of Dentistry, Federal University of Goiás, Goiânia, Brazil.
Medical School, Federal University of Goiás, Goiânia, Brazil.
Orthod Craniofac Res. 2020 Aug;23(3):300-312. doi: 10.1111/ocr.12370. Epub 2020 Feb 26.
The aim of this study was to evaluate craniofacial asymmetry in children with transverse maxillary deficiency, with or without functional unilateral posterior crossbite (UPC), before and after rapid maxillary expansion (RME).
A sample of 51 children with cone beam computed tomography scans obtained before RME (T1) and a year after RME (T2).
This prospective study consisted of 2 groups: 25 children with functional UPC (6.77 ± 1.5 years) and 26 children without UPC (7.41 ± 1.31 years). Linear and angular measurements were obtained from zygomatic, maxilla, glenoid fossa and mandible, using original and mirrored 3D overlapped models. All right and left side comparisons in both groups and intergroups asymmetries were compared using MANOVA and t test for independent samples, respectively, statistically significant at P < .05.
The UPC group showed no side differences, but mandibular horizontal rotation at T1, and this asymmetry was improved in T2. The non-UPC group showed at baseline significant lateral asymmetry in orbitale, position of palatine foramen, respectively, in average 2.95 mm and 1.16 mm, and 0.49 mm of average asymmetry in condylar height. The glenoid fossa was symmetric in both groups at T1 and T2.
Children with transverse maxillary deficiency showed slight morphological asymmetry, located in the mandible position in cases of UPC, and in the orbital and maxillary regions in cases without UPC. One year after RME, patients improved their craniofacial asymmetry, with significant changes in the mandible and correction of the mandibular rotation in patients who presented UPC.
本研究旨在评估伴有或不伴有功能性单侧后牙反(UPC)的横向上颌发育不全儿童在快速上颌扩张(RME)前后的颅面不对称情况。
本研究为前瞻性研究,共纳入 51 例接受锥形束 CT 扫描的儿童,分别在 RME 前(T1)和 RME 后 1 年(T2)进行检查。
本研究包括 2 组:25 例伴有功能性 UPC(6.77±1.5 岁)和 26 例无 UPC(7.41±1.31 岁)的儿童。使用原始和镜像 3D 重叠模型获得颧骨、上颌、关节窝和下颌的线性和角度测量值。使用 MANOVA 对两组和组间的所有左右侧比较以及不对称性进行比较,采用独立样本 t 检验,P<.05 为差异有统计学意义。
UPC 组无侧别差异,但 T1 时下颌发生水平旋转,T2 时这种不对称性得到改善。非 UPC 组在基线时存在眶点、腭孔位置的明显侧别不对称,分别为 2.95mm 和 1.16mm,以及髁突高度的平均 0.49mm 不对称性。在 T1 和 T2 时,两组的关节窝均对称。
横向上颌发育不全的儿童存在轻微的形态不对称性,UPC 病例中位于下颌位置,无 UPC 病例中位于眶部和上颌区域。RME 后 1 年,患者的颅面不对称性得到改善,伴有 UPC 患者的下颌明显变化和下颌旋转的矫正。