Oral and Maxillofacial Surgery Department, Soke Oral and Dental Health Centre, Aydin, Turkey.
Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Necmettin Erbakan University, Konya, Turkey.
J Stomatol Oral Maxillofac Surg. 2021 Jun;122(3):263-266. doi: 10.1016/j.jormas.2020.06.014. Epub 2020 Jul 1.
Maxillary transverse deficiency is a common skeletal problem. When the patient is younger, it is treated by rapid palatal expansion by using orthodontic appliances. If this fails or the patient is older, which means skeletal growth is completed, surgically aided rapid palatal expansion (SARPE) becomes necessary. In this technique, after the osteotomies have been made, the two maxillary bones are distracted by tooth-borne device. Since a tooth-borne device will apply the distraction forces on the teeth, the pulp volumes may change. Our aim was to investigate the volume changes of the tooth pulps after SARPE in which a tooth-borne device was used. We scanned our database and included 20 patients (7 males and 13 females) aging between 16 and 30 (mean 19.5±3.97) to this retrospective study. All the patients had undergone SARPE surgeries and they had pre-surgery and postconsolidation cone beam computerized tomography (CBCT) images. All the surgeries had been done in similar ways; all the patients had used similar tooth-borne modified acrylic bonded expansion device. We divided the maxillary teeth into three groups: the incisors, the premolars and the molars. We imported the CBCT images of each patient into 3D Slicer software. We calculated volumes of pulps for all maxillary teeth. We compared volumes with paired t test. Statistical significance level was accepted as P< .05. The devices had been left in place between 83 and 179 days including distraction and consolidation periods (mean 121.35±27.83 days). Amount of the expansions varied between 6.03mm and 11.16mm (mean 7.19±1.18mm). We found a statistically significant decrease of the pulp volumes in incisor, premolar and molar teeth (P<.001) between pre-surgery and postconsolidation periods. When using tooth-borne devices in SARPE, their impacts on teeth pulps should also be considered.
上颌横向发育不足是一种常见的骨骼问题。当患者年龄较小时，通过正畸矫治器进行快速腭扩张治疗。如果这种方法失败或患者年龄较大，即骨骼生长完成，则需要进行手术辅助快速腭扩张（SARPE）。在这种技术中，完成截骨术后，通过牙支抗装置分散上颌骨。由于牙支抗装置会将分散力施加在牙齿上，牙髓体积可能会发生变化。我们的目的是研究使用牙支抗装置的 SARPE 后牙髓体积的变化。我们扫描了数据库，纳入了 20 名年龄在 16 至 30 岁之间（平均 19.5±3.97 岁）的患者（7 名男性和 13 名女性）进行回顾性研究。所有患者均接受 SARPE 手术，并在术前和巩固期进行锥形束计算机断层扫描（CBCT）检查。所有手术均以类似的方式进行；所有患者均使用类似的牙支抗改良丙烯酸粘接扩弓装置。我们将上颌牙齿分为三组：切牙、前磨牙和磨牙。我们将每位患者的 CBCT 图像导入 3D Slicer 软件。我们计算了所有上颌牙齿的牙髓体积。我们使用配对 t 检验比较了体积。统计学显著性水平为 P<.05。支抗装置的放置时间为 83 至 179 天，包括扩弓和巩固期（平均 121.35±27.83 天）。扩展量为 6.03mm 至 11.16mm 之间（平均 7.19±1.18mm）。我们发现，在术前和巩固期之间，切牙、前磨牙和磨牙的牙髓体积有统计学显著减少（P<.001）。在 SARPE 中使用牙支抗装置时，还应考虑其对牙齿牙髓的影响。
