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微种植体支抗辅助快速腭扩展与牙支抗扩展治疗青春期后生长突增期上颌横向骨发育不足的比较。

Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage.

出版信息

Angle Orthod. 2021 Jan 1;91(1):36-45. doi: 10.2319/041920-332.1.

Abstract

OBJECTIVE

To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage.

MATERIALS AND METHODS

Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 ± 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 ± 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests.

RESULTS

The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P < .01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P < .01).

CONCLUSIONS

MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage.

摘要

目的

研究微种植体辅助快速腭扩张(MARPE)在青春期后生长突增阶段治疗骨骼上颌骨发育不良的疗效。

材料和方法

60 例青春期后生长突增阶段骨骼上颌骨横向发育不足的患者被随机分为 MARPE 和 Hyrax 组。30 例患者(平均年龄:15.1 ± 1.6 岁)采用四点 MARPE 矫治器治疗;30 例患者(平均年龄 14.8 ± 1.5 岁)采用 Hyrax 扩弓器治疗。在扩张前后获得锥形束 CT 扫描和牙模。使用配对 t 检验和独立 t 检验对数据进行分析。

结果

MARPE 和 Hyrax 组中,中隔骨切开术分离的成功率分别为 100%和 86.7%。MARPE 组的腭扩张和第一磨牙水平的骨骼与牙齿比率更大(分别为 3.82mm 和 61.4%),而 Hyrax 组的腭扩张和骨骼与牙齿比率更小(分别为 2.20mm 和 32.3%)(P <.01)。MARPE 组颊侧牙槽骨高度和第一磨牙颊倾减少小于 Hyrax 组(P <.01)。

结论

MARPE 可实现更可预测和更大的骨骼扩张,以及更少的颊侧倾斜和支抗牙牙槽骨高度损失。因此,MARPE 是青春期后生长突增阶段骨骼上颌骨发育不良患者的更好选择。

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