Department of Orthodontics, Faculty of Dentistry, Antalya Bilim University, Antalya, Turkey.
Department of Orthodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey.
Orthod Craniofac Res. 2021 Nov;24(4):543-552. doi: 10.1111/ocr.12471. Epub 2021 Feb 8.
This study sought to evaluate the effects of different maxillary protraction methods on the pharyngeal airway in Class III patients with maxillary retrognathia.
A total of 59 individuals (31 females and 28 males) with a mean age of 11.38 ± 1.24 years were included in this study.
Fifty-nine treated maxillary retrognathic patients who underwent different protraction methods were evaluated. Twenty patients treated with RME (Rapid Maxillary Expansion) made up the first group, and 20 patients treated with 5-week Alt-RAMEC (Alternate Rapid Maxillary Expansion and Constriction) protocol comprised the second group. Lastly, 19 patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Sixteen linear and four areal pharyngeal airway measurements were made on lateral cephalograms before and after treatment. Differences between the groups were assessed using analysis of variance (ANOVA) tests.
The mean maxillary protraction levels were determined as 2.7, 3.69 and 4.01 mm in the RME, Alt-RAMEC and SA groups, respectively. In the nasopharynx, AD1-PNS, AD2-PNS, PNS-Ba and PNS-Ho measurements revealed a significant increase in the SA group compared to the other groups (P < .05). In the oropharynx, PNS-Ep measurement increased significantly in the RME group (P < .05). In the total pharyngeal airway area, an increase was detected in the SA, Alt-RAMEC, and RME groups.
The most effective protraction method in terms of pharyngeal airway dimensions, especially in the nasopharynx, is the application of the face mask with skeletal anchorage. A greater increase in vertical airway length (PNS-Ep) was observed with RME.
本研究旨在评估不同上颌骨前牵引方法对上颌后缩型 III 类错颌患者咽腔气道的影响。
本研究共纳入 59 名（31 名女性和 28 名男性）年龄 11.38±1.24 岁的患者。
评估了 59 例接受不同前牵引方法治疗的上颌后缩患者。第一组为 20 例接受快速上颌扩展（RME）治疗的患者，第二组为 20 例接受 5 周交替快速上颌扩展和收缩（Alt-RAMEC）方案治疗的患者，第三组为 19 例接受面弓和微种植体支抗治疗的患者。在治疗前后的侧位头颅侧位片上测量了 16 个线性和 4 个面积咽腔气道测量值。使用方差分析（ANOVA）检验评估组间差异。
RME、Alt-RAMEC 和 SA 组的平均上颌前牵引水平分别为 2.7、3.69 和 4.01mm。在鼻咽部，SA 组的 AD1-PNS、AD2-PNS、PNS-Ba 和 PNS-Ho 测量值与其他组相比有显著增加（P<.05）。在口咽部，RME 组的 PNS-Ep 测量值显著增加（P<.05）。在总咽腔气道面积方面，SA、Alt-RAMEC 和 RME 组均有增加。
就咽腔气道尺寸而言，最有效的前牵引方法是使用面弓和微种植体支抗，尤其是在鼻咽部。RME 可使垂直气道长度（PNS-Ep）显著增加。
