Govaerts Dries, Da Costa Oliver, Garip Melisa, Combes François, Jacobs Reinhilde, Politis Constantinus
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
J Orofac Orthop. 2025 Jan;86(1):38-48. doi: 10.1007/s00056-023-00487-x. Epub 2023 Jul 5.
For patients with a maxillary transversal deficiency (MTD), various treatment options are available, partly based on the practitioner's experience. This study aimed to determine a cut-off age for decision making between surgically assisted rapid palatal expansion (SARPE) over orthodontic rapid palatal expansion (ORPE) based on skeletal maturation in a female population.
A total of 100 cone beam computed tomography (CBCT) images of young females were analyzed on maturation of the pterygomaxillary (PMS), zygomaticomaxillary (ZMS), transpalatal (TPS), and midpalatal (MPS) sutures. Based on the maturation of these four junctions, four independent observers had to determine whether they would prefer ORPE or SARPE to widen the maxilla.
For the PMS, the results show a closure of 83-100% from 13 to 17 years. As for the TPS, a closure of 78-85% was observed from 15 years of age. For the 15- to 17-year-old females, a closed ZMS was present in 32-47%. Regarding MPS, closed sutures presented in 61% (stages D and E) of the 15-year-old females. The cut-off age at which SARPE was recommended was 15.1 years for the orthodontist observers and 14.8 years for the maxillofacial surgeon observers.
Significant maturation of MPS was reached at the age of 15 in a female population. The PMS, TPS, MPS, and ZMS closed sequentially. A comprehensive diagnostic approach is necessary for choosing the appropriate treatment. When in doubt, age could assist decision making in a female population, with a cut-off age of 15 years in favor of SARPE based on this study.
对于患有上颌横向发育不足(MTD)的患者,有多种治疗选择,部分基于从业者的经验。本研究旨在根据女性人群的骨骼成熟度确定在手术辅助快速腭扩展(SARPE)和正畸快速腭扩展(ORPE)之间进行决策的临界年龄。
共分析了100名年轻女性的锥形束计算机断层扫描(CBCT)图像,以观察翼上颌(PMS)、颧上颌(ZMS)、腭中缝(TPS)和腭中缝(MPS)的成熟情况。基于这四个关节的成熟度,四名独立观察者必须确定他们更倾向于选择ORPE还是SARPE来扩宽上颌。
对于PMS,结果显示从13岁到17岁闭合率为83%-100%。至于TPS,从15岁起观察到闭合率为78%-85%。对于15至17岁的女性,32%-47%存在闭合的ZMS。关于MPS,15岁女性中有61%(D和E期)出现闭合缝。正畸医生观察者建议进行SARPE的临界年龄为15.1岁,颌面外科医生观察者为14.8岁。
女性人群在15岁时MPS达到显著成熟。PMS、TPS、MPS和ZMS依次闭合。选择合适的治疗方法需要综合诊断方法。如有疑问,年龄可辅助女性人群的决策,基于本研究,临界年龄为15岁,倾向于选择SARPE。