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基于微型螺钉长度的微型螺钉辅助快速腭扩张的骨骼和牙牙槽效应:一项随机临床试验。

Skeletal and dentoalveolar effects of miniscrew-assisted rapid palatal expansion based on the length of the miniscrew: a randomized clinical trial.

出版信息

Angle Orthod. 2023 Jul 1;93(4):390-397. doi: 10.2319/072322-512.1.

Abstract

OBJECTIVES

To compare skeletal and dentoalveolar changes of miniscrew-assisted rapid palatal expansion (MARPE) according to the length of the miniscrews.

MATERIALS AND METHODS

This two-arm parallel-randomized controlled trial included 32 adult patients aged 19-35 years who received orthodontic treatment with MARPE. Patients were allocated to two groups, group long (L) and short (S), through block randomization according to the length of the miniscrews installed in MARPE. Cone-beam computed tomography was performed before expansion and after removal of the MARPE; superimposition of the images was conducted. The primary outcome included the amount of bone expansion and the change in the inclination of the anchorage teeth. The secondary outcome included the success rate of midpalatal suture opening and stability of the miniscrews. Blinding was performed during outcome assessment.

RESULTS

The final sample comprised 31 patients. There was no significant difference in patient characteristics between group L (n = 16) and group S (n = 15). The change in the width of the processus zygomaticus (P = .010) and ectocanine (P = .001) was significantly higher in group L. A significantly higher success rate of the posterior miniscrews was seen in group L (P = .024). There was no statistically significant difference in the success rate of suture separation or change in tooth inclination. Notable complications were not reported.

CONCLUSIONS

MARPE with longer miniscrews can increase the amount of expansion of the maxillary basal bone and canine alveolar bone. Although it also aided in miniscrew stability, it did not guarantee successful midpalatal suture separation.

摘要

目的

根据微型种植钉的长度比较微型种植钉辅助快速腭扩展(MARPE)的骨骼和牙牙槽变化。

材料和方法

这项双臂平行随机对照试验纳入了 32 名年龄在 19-35 岁之间接受 MARPE 正畸治疗的成年患者。根据 MARPE 中安装的微型种植钉的长度,通过区组随机化将患者分为两组,即长(L)组和短(S)组。在扩展前和 MARPE 去除后进行锥形束计算机断层扫描;对图像进行叠加。主要结局包括骨扩展量和锚固牙倾斜度的变化。次要结局包括中隔骨切开术的成功率和微型种植钉的稳定性。在结果评估中进行了盲法。

结果

最终样本包括 31 名患者。L 组(n = 16)和 S 组(n = 15)之间的患者特征无统计学差异。颧突(P =.010)和外犬齿(P =.001)的宽度变化在 L 组显著更高。L 组的后微型种植钉成功率显著更高(P =.024)。中隔骨切开术的分离成功率或牙齿倾斜度的变化无统计学差异。未报告明显的并发症。

结论

使用较长微型种植钉的 MARPE 可以增加上颌基骨和犬牙槽骨的扩展量。虽然它也有助于微型种植钉的稳定性,但不能保证中隔骨切开术的成功分离。

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