使用弹性牙合垫治疗功能性后牙反牙合后腭部的变化：使用偏距分析和面面匹配技术的三维成像研究。
Palatal changes after treatment of functional posterior cross-bite using elastodontic appliances: a 3D imaging study using deviation analysis and surface-to-surface matching technique.
机构信息
Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy.
Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
出版信息
BMC Oral Health. 2023 Feb 2;23(1):68. doi: 10.1186/s12903-023-02731-7.
BACKGROUND
The present study aimed to evaluate the changes in palate dimension and morphology after treatment of functional posterior crossbite (FPXB) with elastodontic devices (EAs).
METHODS
The treatment group (TG) consisted of 25 subjects (mean age 7.3 ± 0.9 years) who received treatment with EA for one year. The control group (CG) comprised 14 untreated subjects (mean age 6.8 ± 0.7 years).
INCLUSION CRITERIA
intra-oral scan registered before (T0) and after treatment (T1), FPXB with a mandibular shift towards the crossbite site of ≥ 2 mm, class I molar relationship.
EXCLUSION CRITERIA
missing teeth, anterior crossbite, temporomandibular disorders, previous orthodontic treatment, carious lesions, mobility of deciduous posterior teeth, craniofacial deformities. Digital models were analyzed to assess the inter-canine (ICW) and inter-molar widths (IMW) and the corresponding emi-lateral measurements (eICW and eIMW) using the median palatine plane as reference. According to a specific 3D imaging technology, the morphology and symmetry of the palate was investigated by analysing the 3D deviation between the two specular models of the palate.
RESULTS
At T0, both groups showed a significantly narrower dimension of eICW and eIMW at the crossbite side compared to the non-crossbite side (p < 0.05). Also, the 3D deviation analysis demonstrates a limited matching percentage of the original/mirrored models in both TG (81.12%) and CG (79.36%), confirming the asymmetry of the palate. The area of mis-matching was located at the alveolar bone level. At T1, subjects in the TG showed a significant increment of ICW and IMW (p < 0.05), a reduction of the differences of eICW and eIMW between both sides (p < 0.05) and an increment of the percentage matching (TG = 92.32%) (p < 0.05), suggesting a significant recovery of the palatal asymmetry. No significant changes were found between T0 and T1 in the CG (p > 0.05).
CONCLUSIONS
EAs could be successfully used to correct FPXB in mixed dentition and could restore the harmonious development of the palate in children.
背景
本研究旨在评估功能性后牙反（FPXB）矫治中使用弹性矫治器（EAs）后腭部尺寸和形态的变化。
方法
治疗组（TG）由 25 名接受 EA 治疗 1 年的受试者（平均年龄 7.3±0.9 岁）组成。对照组（CG）由 14 名未经治疗的受试者（平均年龄 6.8±0.7 岁）组成。
纳入标准
治疗前（T0）和治疗后（T1）的口腔内扫描、下颌向反牙合侧移位≥2mm 的 FPXB、I 类磨牙关系。
排除标准
缺牙、前牙反牙合、颞下颌关节紊乱、既往正畸治疗、龋齿、乳牙松动、颅面畸形。使用中矢状平面作为参考，对数字模型进行分析，以评估尖牙间宽度（ICW）和磨牙间宽度（IMW）以及相应的外侧宽度（eICW 和 eIMW）。根据一种特定的 3D 成像技术，通过分析腭部两个镜像模型之间的 3D 偏差，研究腭部的形态和对称性。
结果
T0 时，两组反牙合侧的 eICW 和 eIMW 均明显小于非反牙合侧（p<0.05）。此外，3D 偏差分析表明 TG（81.12%）和 CG（79.36%）中原始/镜像模型的匹配百分比均有限，证实了腭部的不对称性。不匹配区域位于牙槽骨水平。T1 时，TG 组的 ICW 和 IMW 显著增加（p<0.05），eICW 和 eIMW 两侧的差异减小（p<0.05），匹配百分比增加（TG=92.32%）（p<0.05），提示腭部不对称性得到显著改善。CG 组在 T0 与 T1 之间无显著变化（p>0.05）。
结论
EAs 可成功用于混合牙列中 FPXB 的矫治，并可恢复儿童腭部的协调发育。
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