Department of Pediatric Dentistry, Orthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
Clin Oral Investig. 2022 May;26(5):3885-3897. doi: 10.1007/s00784-021-04355-z. Epub 2022 Jan 10.
To evaluate dental and skeletal changes caused by surgically assisted rapid palatal expansion (SARPE) using the superimposition of three-dimensional cone-beam computed tomography (CBCT) images on the cranial base.
This is a retrospective quasi-experiment before-and-after study using a convenience sample. Twenty-four adult patients (13 male and 11 female) were evaluated before SARPE (T0), immediately after expansion (T1), and after 6 months of retention (T2). CBCT scans were superimposed on the anterior cranial base using voxel-based registration. Measurements from different reference points were used for comparisons between times.
At T1, all teeth had significant buccal tipping. At T2, most teeth remained in the same position as at T1, except the first premolar and the first molar, whose buccal roots moved slightly. The amount of bony expansion was 65 to 70% of the amount of tooth movement. The A point and maxillary incisors moved anteriorly from T0 to T1 and T2 (p < 0.0001). Inter-nasal distance had increased significantly at T1 (p < 0.0001) and remained stable at T2 (p = 0.478). No expansion was achieved at the zygomatic arch (p = 0.114).
SARPE promoted substantial buccal tipping of posterior teeth and some bone displacement; it also moved the maxilla and teeth forward and increased nasal width.
No other clinical studies have evaluated dental and skeletal changes caused by SARPE using superimposition of 3D CBCT images on the cranial base. This study findings may help clinical dentists plan treatments using safe and reliable information.
通过颅底三维锥形束 CT（CBCT）图像叠加来评估手术辅助快速腭扩张（SARPE）引起的牙齿和骨骼变化。
这是一项回顾性准实验性前后研究，采用方便样本。共评估了 24 名成年患者（13 名男性和 11 名女性），分别在 SARPE 前（T0）、扩张后即刻（T1）和保持 6 个月后（T2）进行评估。使用体素基配准将 CBCT 扫描叠加到前颅底。使用不同参考点的测量值进行时间比较。
在 T1 时，所有牙齿均有明显颊向倾斜。在 T2 时，除第一前磨牙和第一磨牙颊根稍有移动外，大多数牙齿仍保持与 T1 相同的位置。骨扩张量为牙齿移动量的 65%至 70%。A 点和上颌切牙从 T0 到 T1 和 T2 均向前移动（p<0.0001）。鼻间距离在 T1 时显著增加（p<0.0001），在 T2 时保持稳定（p=0.478）。颧弓无明显扩张（p=0.114）。
SARPE 促进了后牙的颊向倾斜和一些骨移位，同时也使上颌和牙齿向前移动，并增加了鼻宽。
没有其他临床研究通过颅底三维 CBCT 图像叠加来评估 SARPE 引起的牙齿和骨骼变化。本研究结果可能有助于临床牙医使用安全可靠的信息来计划治疗。
