Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul and São Lucas Hospital of PUCRS, Porto Alegre, Brazil; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès and Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain.
Department of Orthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
J Craniomaxillofac Surg. 2022 Mar;50(3):211-217. doi: 10.1016/j.jcms.2021.12.011. Epub 2021 Dec 27.
The purpose of this study was to evaluate maxillary expansion, operative time and pain associated with a new minimally invasive surgical technique to treat maxillary hypoplasia in adult patients. Consecutive patients were included and prospectively analyzed. The technique consists in miniscrew-assisted rapid palatal expansion (MARPE), minimally invasive approach to maxillary osteotomies, latency period and activation period until the desired expansion. The parameters evaluated included operative time, treatment-related pain by the visual analog scale (VAS), and transverse maxillary expansion. The Shapiro-Wilk test was used to assess the normality of data distribution. A paired t-test was used to compare the data between T0 (preoperative) and T1 (postoperative - end of activation). The significance level was set at 5%. Eleven patients were included. Mean operative time was 24.11 min (14.4-32 min) and overall postoperative VAS score was 2.81 (0-9). A comparative analysis showed significant increases in maxillary width at the skeletal, alveolar, and dental levels (p < 0.0001 for all), with a mean range of 1.8 (SD 0.3) mm to 4.7 (SD 0.5) mm. The present minimally invasive surgical MARPE (MISMARPE) technique appears to yield good skeletal outcomes with minimal trauma. It might have potential for clinical use, but larger comparative studies are needed to confirm the clinical relevance of the approach.
本研究旨在评估一种新的微创外科技术治疗成人上颌发育不全的上颌扩张、手术时间和相关疼痛。连续纳入患者并进行前瞻性分析。该技术包括微螺钉辅助快速腭扩张(MARPE)、微创上颌骨切开术、潜伏期和激活期,直到达到所需的扩张。评估的参数包括手术时间、视觉模拟评分(VAS)评估的治疗相关疼痛以及横向上颌扩张。Shapiro-Wilk 检验用于评估数据分布的正态性。配对 t 检验用于比较 T0(术前)和 T1(术后-激活结束)之间的数据。显著性水平设为 5%。共纳入 11 例患者。平均手术时间为 24.11 分钟(14.4-32 分钟),总术后 VAS 评分为 2.81(0-9)。对比分析显示,上颌在骨骼、牙槽和牙齿水平的宽度均有显著增加(所有 P < 0.0001),平均范围为 1.8(SD 0.3)mm 至 4.7(SD 0.5)mm。本研究微创 MARPE(MISMARPE)技术似乎具有良好的骨骼效果,创伤最小。它可能具有临床应用的潜力,但需要更大的对比研究来证实该方法的临床相关性。