Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Philips van Leydenlaan 25, 6525 EX, Nijmegen, The Netherlands.
Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands.
J Orofac Orthop. 2021 Nov;82(6):372-381. doi: 10.1007/s00056-020-00274-y. Epub 2021 Jan 28.
To evaluate the influence of orthodontic treatment with surgically assisted rapid maxillary expansion (SARME) on the interdental papilla height of maxillary central incisors.
In this retrospective study, patients who completed orthodontic treatment including SARME at the Radboud University Medical Center Orthodontic Department before December 2019 were included. Frontal intraoral photographs taken before (T1) and after completion of treatment (T2) were examined to determine the papilla height between the maxillary central incisors using the Jemt classification. The difference between the Jemt classification at T1 and T2 (∆Jemt) was defined as the primary outcome variable. Secondary outcome variables were gender, age, treatment duration, type of expansion appliance, maximal central diastema during expansion, pretreatment overlapping between the central incisors, gingival biotype, crown morphology and the distance between the bone crest and incisal contact point. Kappa statistics and paired t‑tests were used to determine reliability of the measurements. Pearson's Χ test and independent t‑tests were used to compare the variables between the groups of patients with and without papillary recession. Finally, multiple logistic regression analysis was performed.
In all, 93 patients fulfilled the inclusion criteria and were included in the study. The Jemt score worsened for 30 patients (32%) between T1 and T2, indicating the occurrence of papillary recession. Incisal overlapping, crown morphology, small width to length ratio, increasing age and an increasing distance between crestal bone and the incisal contact point were factors associated with papillary recession.
After orthodontic treatment including SARME, one third of patients exhibited recession of papilla height of the maxillary central incisors.
评估外科辅助上颌快速扩弓（SARME）正畸治疗对上颌中切牙牙周乳头高度的影响。
本回顾性研究纳入了 2019 年 12 月前在 Radboud 大学医学中心正畸科完成包括 SARME 在内的正畸治疗的患者。拍摄治疗前（T1）和治疗完成后（T2）的正面口内照片，使用 Jemt 分类法确定上颌中切牙之间的乳头高度。T1 和 T2 之间的 Jemt 分类差值（∆Jemt）定义为主要结局变量。次要结局变量为性别、年龄、治疗持续时间、扩弓器类型、扩弓过程中的最大中切牙间隙、治疗前中切牙重叠、牙龈生物型、冠形态以及牙槽嵴顶和切缘接触点之间的距离。使用 Kappa 统计和配对 t 检验确定测量的可靠性。使用 Pearson's Χ 检验和独立 t 检验比较有和无乳头退缩的患者组之间的变量。最后进行了多因素逻辑回归分析。
共有 93 名患者符合纳入标准并被纳入研究。30 名患者（32%）在 T1 和 T2 之间 Jemt 评分恶化，表明出现了乳头退缩。切缘重叠、冠形态、长宽比小、年龄增加和牙槽嵴顶与切缘接触点之间的距离增加是与乳头退缩相关的因素。
在上颌中切牙的 SARME 正畸治疗后，三分之一的患者出现了牙周乳头高度的退缩。
