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应用锥形束 CT 评价生长发育期单侧后牙反[牙合]患者快速扩弓联合固定正畸治疗后面部侧貌及髁突位置的变化

Cone beam computed tomographic evaluation of the changes in condylar position in growing patients with unilateral posterior crossbite undergoing rapid maxillary expansion followed by fixed orthodontic therapy.

机构信息

Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA.

Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.

出版信息

Eur Arch Paediatr Dent. 2021 Oct;22(5):959-967. doi: 10.1007/s40368-021-00628-z. Epub 2021 May 5.

Abstract

PURPOSE

This study aimed at assessing changes in condylar position (CP) in growing patients with unilateral posterior crossbite (UPC) undergoing rapid maxillary expansion (RME) followed by fixed orthodontic treatment (FOT) (experimental-group); and growing patients without posterior crossbite (PC) treated with FOT alone (control-group).

METHODS

Cone beam computed tomography (CBCT) images were obtained before treatment (T0), 6 months after RME (T1) and after FOT (T2) for the experimental-group (n = 19); and at T0 and T2 for the control-group (n = 22). Condylar position-related measurements including the anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), lateral position of condyle (LC) and condylar angle (CA) were measured. Non-parametric tests were used.

RESULTS

On the crossbite side, significant increases were found in LC (P = 0.039) and CA (P = 0.007), and on the non-crossbite side significant increases were observed in SJS (P = 0.027) and LC (P = 0.001) between T0, T1 and T2 in patients with UPC. On the right and left sides in the control-group, significant increases were identified in LC (P < 0.001 and P = 0.012, respectively) between T0 and T2.

CONCLUSIONS

In growing patients with UPC, RME followed by FOT is associated with significant changes in CP-related measurements.

摘要

目的

本研究旨在评估单侧后牙反(UPC)患者在接受快速上颌扩张(RME)后再行固定正畸治疗(FOT)(实验组)以及无后牙反(PC)患者仅行 FOT 治疗(对照组)后髁突位置(CP)的变化。

方法

实验组(n=19)在治疗前(T0)、RME 后 6 个月(T1)和 FOT 后(T2)时以及对照组(n=22)在 T0 和 T2 时分别获得锥形束 CT(CBCT)图像。测量与髁突位置相关的测量值,包括前关节间隙(AJS)、上关节间隙(SJS)、后关节间隙(PJS)、髁突外侧位置(LC)和髁突角(CA)。采用非参数检验。

结果

在反侧,LC(P=0.039)和 CA(P=0.007)显著增加,在非反侧,SJS(P=0.027)和 LC(P=0.001)在 UPC 患者 T0、T1 和 T2 之间显著增加。在对照组的右侧和左侧,LC (P<0.001 和 P=0.012)在 T0 与 T2 之间显著增加。

结论

在 UPC 生长患者中,RME 后行 FOT 治疗与 CP 相关测量值的显著变化有关。

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