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成人非手术和手术上颌扩弓后的三维腭部形态及上颌牙弓变化

Three-dimensional palatal morphology and upper arch changes following nonsurgical and surgical maxillary expansion in adults.

作者信息

Türker Gökhan, Çoban Gökhan, Bayraktar Alara Ünal, Kurt Gökmen, Kılıç Erdem, Alkan Alper

机构信息

Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin, Turkey.

Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Oct;134(4):425-431. doi: 10.1016/j.oooo.2022.02.013. Epub 2022 Mar 3.

Abstract

OBJECTIVE

The objective of this study was to evaluate the effects of nonsurgical rapid maxillary expansion (RME) and surgically assisted RME (SARME) on palatal morphology and upper arch dimensions using three-dimensional (3D) models in skeletally mature patients.

STUDY DESIGN

Thirty-eight skeletally mature patients with a maxillary transverse deficiency were divided into RME and SARME groups. Nineteen patients in the RME group (mean age, 19.16 ± 2.25 years) were treated using a full-coverage bonded acrylic splint expander; 19 patients in the SARME group (mean age, 20.38 ± 3.36) were treated using the banded palatal expansion appliance with hyrax screws. The 3D models were obtained before and after expansion. The maxillary dental arch widths, maxillary first molar angulation, palatal area, and palatal volume were calculated on the 3D models.

RESULTS

All variables showed statistically significant changes after the retention period (P < .001). The maxillary arch width between first premolars (P < .05), the palatal area (P < .01), and the palatal volume (P < .05) significantly increased in the SARME group compared to the RME group. The maxillary first molar tipping in the RME group was significantly higher than that in the SARME group (P < .01).

CONCLUSIONS

Although SARME has more positive effects in skeletally mature patients, nonsurgical RME can be considered as an alternative by evaluating surgical risks, periodontal status, and the need for skeletal expansion.

摘要

目的

本研究的目的是使用三维(3D)模型评估非手术快速上颌扩弓(RME)和外科辅助快速上颌扩弓(SARME)对骨骼成熟患者腭部形态和上颌弓尺寸的影响。

研究设计

38例骨骼成熟且存在上颌横向发育不足的患者被分为RME组和SARME组。RME组的19例患者(平均年龄19.16±2.25岁)使用全覆盖粘结式丙烯酸夹板扩弓器进行治疗;SARME组的19例患者(平均年龄20.38±3.36岁)使用带环腭部扩弓矫治器及Hyrax螺钉进行治疗。在扩弓前后获取3D模型。在3D模型上计算上颌牙弓宽度、上颌第一磨牙倾斜度、腭部面积和腭部容积。

结果

在保持期后,所有变量均显示出具有统计学意义的变化(P <.001)。与RME组相比,SARME组第一前磨牙之间的上颌弓宽度(P <.05)、腭部面积(P <.01)和腭部容积(P <.05)显著增加。RME组上颌第一磨牙的倾斜度显著高于SARME组(P <.01)。

结论

尽管SARME对骨骼成熟患者有更积极的影响,但通过评估手术风险、牙周状况和骨骼扩展的需求,非手术RME可被视为一种替代方法。

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