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上颌骨扩张后使用牙支抗与组织支抗微螺钉辅助快速腭扩张器的治疗效果。

Treatment effects after maxillary expansion using tooth-borne vs tissue-borne miniscrew-assisted rapid palatal expansion appliance.

机构信息

Department of Orthodontics, Xiangya Stomatological Hospital and Xiangya School of Stomatology, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Central South University, Changsha, Hunan, China; Third Xiangya Hospital and Xiangya School of Medicine, Central South University, Changsha, Hunan, China.

Department of Orthodontics, Xiangya Stomatological Hospital and Xiangya School of Stomatology, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Central South University, Changsha, Hunan, China.

出版信息

Am J Orthod Dentofacial Orthop. 2023 Oct;164(4):545-553. doi: 10.1016/j.ajodo.2023.02.022. Epub 2023 May 13.

Abstract

INTRODUCTION

The study investigated the skeletal effects and root resorption in young adults with maxillary transverse deficiency after tissue-borne or tooth-borne mini-implant anchorage maxillary expansion.

METHODS

Ninety-one young adults with maxillary transverse deficiency, aged 16-25 years, were divided into 3 groups according to the treatment method: group A (n = 29) comprising patients treated with tissue-borne miniscrew-assisted rapid palatal expansion (MARPE), the group B (n = 32) comprising patients treated with tooth-borne MARPE, and the control group (n = 30) comprising patients only treated with fixed orthodontic therapies. Pretreatment and posttreatment cone-beam computed tomography images were used to assess the change of maxillary width, nasal width, first molar torque and root volume by paired t test in the 3 groups, respectively. Analysis of variance and Tukey least significant difference analysis were used to detect the changes of all descriptions among the 3 groups P <0.05.

RESULTS

In the 2 experimental groups, we observed significant increases in the width of the maxilla, nasal, and arch width, as well as the molar torque. In addition, the height of the alveolar bone and the root volume decreased significantly. There were no significant differences in the maxilla, nasal, and arch width change between the 2 groups. Group B displayed more increases in buccal tipping, alveolar bone loss, and root volume loss than group A (P <0.05). Compared with groups A and B, the control group showed negligible tooth volume loss, with no expansion effect in both skeletal and dental descriptions.

CONCLUSIONS

Tissue-borne MARPE produced the same expansion efficiency as tooth-borne MARPE. However, tooth-borne MARPE causes more dentoalveolar side effects in buccal tipping, root resorption and alveolar bone loss.

摘要

简介

本研究探讨了组织支抗和牙支抗微型种植体支抗上颌扩弓对伴有上颌横向发育不足的年轻成年人的骨骼影响和牙根吸收。

方法

91 例上颌横向发育不足的年轻成年人,年龄 16-25 岁,根据治疗方法分为 3 组:A 组(n=29),患者采用组织支抗微螺钉辅助快速腭扩张(MARPE)治疗;B 组(n=32),患者采用牙支抗 MARPE 治疗;对照组(n=30),患者仅采用固定正畸治疗。分别采用配对 t 检验比较 3 组治疗前后锥形束 CT 图像上上颌宽度、鼻宽度、第一磨牙转矩和根体积的变化。采用方差分析和 Tukey 最小显著差异分析检测 3 组间所有描述的变化,P<0.05。

结果

在 2 个实验组中,我们观察到上颌、鼻和牙弓宽度以及磨牙转矩显著增加。此外,牙槽骨高度和根体积显著下降。2 组间上颌、鼻和牙弓宽度的变化无显著差异。B 组较 A 组颊倾、牙槽骨丧失和根体积丧失增加更多(P<0.05)。与 A 组和 B 组相比,对照组的牙体积损失较小,在骨骼和牙齿描述方面均无扩张效果。

结论

组织支抗 MARPE 产生的扩张效率与牙支抗 MARPE 相同。然而,牙支抗 MARPE 导致更多的颊倾、牙根吸收和牙槽骨丧失的牙牙槽副作用。

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