Department of Orthodontics, Saarland University, Homburg, Saar, Germany.
Department of Orthodontics, Philipps-University Medical Center Marburg, Philipps-University, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
Clin Oral Investig. 2022 Jul;26(7):4715-4725. doi: 10.1007/s00784-022-04434-9. Epub 2022 Mar 10.
Rapid maxillary expansion (RME) is an established and frequently used procedure to overcome maxillary constriction. In-depth studies about morphological changes of the alveolar process and its immediate surroundings are missing. Therefore, the aim of the present study was to examine the treatment effects of a dentally anchored, rapid maxillary expander at different dentition stages upon palatal width, height and shape.
The dental casts of 114 patients-taken immediately before and after RME-were three-dimensionally analysed. Depending on the dentition stage, the patients were divided into two groups (each n = 57, group 1, early mixed dentition; group 2, late mixed or permanent dentition).
The width increases were highly significant, both in the overall and in the individual groups (p < 0.001). While the width increase was greater in the posterior area than anteriorly in the early group, the widening in the late group happened significantly greater anteriorly than posteriorly. Palatal height increased anteriorly and posteriorly in both groups to a significant extent (p < 0.001). The height increase was more pronounced in the anterior region than in the posterior region in the late group. The palatine index according to Kim revealed a change in palatal morphology both anteriorly and posteriorly in the early group but only anteriorly in the late group.
Maxillary expansion occurs more parallel in early treatment compared to V-shaped opening in the later treatment approach.
RME is more advantageous in an early dentition.
上颌快速扩弓(RME)是一种成熟且常用的方法,用于克服上颌骨狭窄。目前,关于牙槽骨及其周围组织形态变化的深入研究较少。因此,本研究旨在探讨牙支抗式快速扩弓器在不同牙列阶段对上颌宽度、高度和形状的治疗效果。
对 114 名患者的牙模进行了三维分析,这些患者在 RME 前后即刻接受了治疗。根据牙列阶段,将患者分为两组(每组 n=57,组 1,早期混合牙列;组 2,晚期混合牙列或恒牙列)。
总体而言和在各个组中,宽度增加均具有高度显著性(p<0.001)。在早期组中,后牙区的宽度增加大于前牙区,而在后组中,前牙区的增宽明显大于后牙区。两组的腭高度均在前部和后部显著增加(p<0.001)。在后组中,前区的高度增加比后区更为明显。根据 Kim 的腭指数显示,早期组的腭形态在前部和后部都发生了变化,但在后组中仅在前部发生了变化。
与后期的 V 形打开相比,早期治疗中的上颌扩张更趋于平行。
RME 在早期牙列中更具优势。