Karabiber Gülden, Yılmaz Hanife Nuray
Faculty of Dentistry, Department of Orthodontics, İstanbul Medeniyet University, Fatih Mah., Eski Ankara Asfaltı Cad., No:28 Tuzla/Orhanlı, 34956, Istanbul, Turkey.
Faculty of Dentistry, Department of Orthodontics, Marmara University, Istanbul, Turkey.
J Orofac Orthop. 2023 Jan;84(1):1-9. doi: 10.1007/s00056-021-00333-y. Epub 2021 Aug 6.
True unilateral posterior crossbite (TUPC) requires unilateral expansion to prevent nonocclusion at the noncrossbite (NC) side. The recommended osteotomies for TUPC after sutural closure are anterior, lateral, and posterior osteotomies only on the crossbite (C) side and median osteotomy of the midpalatal suture, i.e., unilateral surgically assisted rapid maxillary expansion (SARME). The goal was to assess airway and perinasal soft tissue outcomes after SARME.
Data from 16 patients (8 males, 8 females; mean age 18.38 ± 1.45 years) were retrospectively assessed after unilateral SARME. The expansion (twice daily: 0.5 mm/day) and retention periods comprised 3 weeks and 6 months, respectively. Stereophotogrammetric images were used for soft tissue assessment; cone beam computed tomography (CBCT) was used to evaluate the anterior nasal airway. Statistical analyses were performed.
Using linear measurements, soft tissue distances of the alar base and alare to midsagittal plane (MSP) were significantly increased on the C side. A significant decrease was observed for the distance from the lower nostril point to the MSP on the NC side compared to a significant increase on the C side. Comparing the C and NC sides, the changes were significantly higher on the C side for all parameters except the upper nostril point to the MSP distance. Cheek volume was significantly higher on the C side. Volume changes of the anterior nasal airway (ANA) were significantly increased on the C side, but volume changes between NC and C were not significantly different.
Unilateral SARME led to significant expansion of ANA on the C side, but did not lead to asymmetry in the nasal region or have adverse effects on the airway or perinasal soft tissues. Thus, this novel treatment method may be useful in the treatment of patients with TUPC.
真性单侧后牙反合（TUPC）需要进行单侧扩弓，以防止非反合（NC）侧出现咬合不正。在缝合关闭后，推荐用于TUPC的截骨术仅在反合（C）侧进行前部、外侧和后部截骨，以及腭中缝的正中截骨，即单侧手术辅助快速上颌扩弓（SARME）。本研究旨在评估SARME术后气道和鼻周软组织的结果。
对16例患者（8例男性，8例女性；平均年龄18.38±1.45岁）进行单侧SARME术后的数据进行回顾性评估。扩弓（每天两次，每次0.5毫米/天）和保持期分别为3周和6个月。采用立体摄影测量图像进行软组织评估；使用锥形束计算机断层扫描（CBCT）评估前鼻气道。进行了统计分析。
通过线性测量，C侧鼻翼基部和鼻翼到正中矢状面（MSP）的软组织距离显著增加。与C侧显著增加相比，NC侧下鼻孔点到MSP的距离显著减小。比较C侧和NC侧，除了上鼻孔点到MSP的距离外，所有参数在C侧的变化均显著更高。C侧的颊部体积显著更大。C侧前鼻气道（ANA）的体积变化显著增加，但NC侧和C侧之间的体积变化无显著差异。
单侧SARME导致C侧ANA显著扩张，但未导致鼻区不对称，也未对气道或鼻周软组织产生不利影响。因此，这种新的治疗方法可能对TUPC患者的治疗有用。
