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自锁托槽矫治器和微螺钉辅助上颌快速扩弓治疗后的上颌牙和骨骼变化。

Maxillary dental and skeletal effects after treatment with self-ligating appliance and miniscrew-assisted rapid maxillary expansion.

机构信息

Department of Orthodontics, Ingá University Center Uningá, Maringá, Paraná, Brazil.

Department of Orthodontics, Advanced Dentistry Institute IOA, Asunción, Paraguay.

出版信息

Am J Orthod Dentofacial Orthop. 2021 Feb;159(2):e93-e101. doi: 10.1016/j.ajodo.2020.09.011. Epub 2020 Dec 4.

Abstract

INTRODUCTION

The objective of the present study was to compare the maxillary dental and skeletal effects after treatment with self-ligating appliance and miniscrew-assisted rapid maxillary expansion (MARPE).

METHODS

The sample comprised 37 patients with Class I malocclusion treated without tooth extraction, divided into 2 groups: group 1 comprises 21 patients with a mean age of 19.55 years (standard deviation = 1.31), submitted to orthodontic treatment with Damon self-ligating appliance, and evaluated until the end of the alignment and leveling stage. Group 2 comprises 16 patients with a mean age of 24.92 years (standard deviation = 7.60), with maxillary atresia, who underwent MARPE, and were evaluated after the removal of the expander. Buccal bone thickness; dental inclinations; and transverse distances of the maxillary arch, nasal base, and jugula widths were measured on cone-beam computed tomography scans before and after treatment. The intergroup comparison was performed with the independent t test.

RESULTS

With treatment, there was a significantly greater decrease in buccal bone thickness of canines and premolars in the self-ligating group, the premolars presented a greater buccal inclination in the self-ligating group, and the intercanine and intermolar distances and nasal base and jugula widths showed significantly greater increases in the MARPE group than in the self-ligating group.

CONCLUSIONS

MARPE treated more severe skeletal transverse maxillary discrepancies and obtained better results than self-ligating appliances in terms of buccal bone loss, tooth inclination, and transverse skeletal increase of the maxilla. MARPE presented more skeletal effects and self-ligating appliances, more dental effects.

摘要

简介

本研究的目的是比较自锁托槽和微螺钉辅助快速上颌扩张(MARPE)治疗后上颌牙齿和骨骼的效果。

方法

本样本包括 37 名未经拔牙治疗的 I 类错牙合患者,分为 2 组:第 1 组包括 21 名平均年龄为 19.55 岁(标准差=1.31)的患者,接受 Damon 自锁托槽正畸治疗,并在矫正和排齐阶段结束时进行评估。第 2 组包括 16 名平均年龄为 24.92 岁(标准差=7.60)、上颌狭窄的患者,他们接受了 MARPE 治疗,并在扩张器拆除后进行评估。在治疗前后的锥形束 CT 扫描上测量颊侧骨厚度、牙齿倾斜度以及上颌弓、鼻基底和颈宽度的横向距离。使用独立 t 检验进行组间比较。

结果

治疗后,自锁组的犬齿和前磨牙颊侧骨厚度明显减少,自锁组的前磨牙颊倾度较大,MARPE 组的牙间距离和牙间距离以及鼻基底和颈宽度的增加明显大于自锁组。

结论

MARPE 治疗更为严重的上颌骨骼横向差异,与自锁托槽相比,在颊侧骨丢失、牙齿倾斜和上颌骨骼横向增加方面取得了更好的效果。MARPE 表现出更多的骨骼效应,自锁托槽则表现出更多的牙齿效应。

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