微型种植体支抗 Hyrax 上颌扩展对健康和受伤牙齿牙髓血流和敏感性的影响：一项前瞻性研究。

The impact of mini-implant hybrid hyrax maxillary expansion on pulp blood flow and sensibility in healthy and traumatized teeth: A prospective study.

机构信息

From the University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia.

出版信息

Am J Orthod Dentofacial Orthop. 2022 Aug;162(2):247-256. doi: 10.1016/j.ajodo.2021.03.028. Epub 2022 May 7.

DOI:10.1016/j.ajodo.2021.03.028

PMID:35534401

Abstract

INTRODUCTION

We aimed to assess pulp blood flow (PBF) and pulp sensibility changes in healthy and traumatized teeth undergoing maxillary expansion with a mini-implant hybrid hyrax appliance.

METHODS

Forty-five patients requiring maxillary expansion either with mini-implant supported hyrax expander (MARME) or tooth-borne hyrax expander (RME) had the pulp status of their maxillary anterior teeth assessed using laser Doppler flowmetry, electric pulp testing, and thermal testing (carbon dioxide snow). The study cohort was divided into 4 groups on the basis of expansion appliance (MARME or RME) and trauma experience (trauma or nontrauma). Each patient was tested before expansion, 2 weeks after expansion, and 3 months after expansion (T3). Relationships between PBF, time interval, and trauma were evaluated using linear mixed modeling.

RESULTS

Healthy teeth with RME or MARME expansion had reestablished pretreatment PBF at T3 (P >0.05). Traumatized teeth undergoing RME did not reach pretreatment PBF at T3 (P ≤0.05). There were no statistically significant changes in PBF in the MARME+Trauma group at all time intervals (P >0.05). A reduction in pulp blood flow occurred during rapid maxillary expansion from both expansion appliances; however, the relative reduction of PBF in MARME was less than with RME (P ≤0.05) 2 weeks after expansion. Most teeth across all groups (≥85%) maintained pulp sensibility at all time intervals regardless of whether there was a history of trauma.

CONCLUSIONS

Patients with transverse discrepancies and a history of trauma may benefit from MARME as evidenced by reduced changes in PBF compared with RME without affecting pulp sensibility.

摘要

简介

我们旨在评估上颌扩弓过程中使用微型植入物混合 Hyrax 矫治器对健康和创伤牙齿的牙髓血流（PBF）和牙髓感觉变化。

方法

45 名需要上颌扩弓的患者，分别使用微型植入物支持的 Hyrax 扩弓器（MARME）或牙支抗的 Hyrax 扩弓器（RME），使用激光多普勒血流仪、电牙髓测试和热测试（二氧化碳雪）评估其上颌前牙的牙髓状况。根据扩弓器（MARME 或 RME）和创伤经历（创伤或非创伤）将研究队列分为 4 组。每位患者在扩弓前、扩弓后 2 周（T2）和扩弓后 3 个月（T3）进行测试。使用线性混合模型评估 PBF、时间间隔和创伤之间的关系。

结果

接受 RME 或 MARME 扩弓的健康牙齿在 T3 时恢复了治疗前的 PBF（P>0.05）。接受 RME 治疗的创伤牙齿在 T3 时未达到治疗前的 PBF（P≤0.05）。MARME+Trauma 组在所有时间间隔内 PBF 均无统计学意义的变化（P>0.05）。两种扩弓器都导致快速上颌扩弓期间牙髓血流减少；然而，MARME 引起的 PBF 相对减少少于 RME（P≤0.05），扩弓后 2 周。大多数牙齿（≥85%）在所有时间间隔内都保持牙髓敏感性，无论是否有创伤史。