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微螺钉辅助快速腭中缝扩展(MARPE)对上颌中切牙间乳头高度的影响。

Influence of miniscrew-assisted rapid palatal expansion (MARPE) on the interdental papilla height of maxillary central incisors.

作者信息

Chen Hao, Kapetanović Aldin, Piao Zhengguo, Xi Tong, Schols Jan G J H

机构信息

Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

Department of Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Clin Oral Investig. 2023 Oct;27(10):6007-6014. doi: 10.1007/s00784-023-05214-9. Epub 2023 Aug 19.

Abstract

OBJECTIVES

To evaluate the influence of miniscrew-assisted rapid palatal expansion (MARPE) on the interdental papilla height of maxillary central incisors.

MATERIALS AND METHODS

Patients who completed MARPE treatment at the Radboud University Medical Center between 2018 and 2021 were included in this retrospective study. The papilla height between the maxillary central incisors was evaluated on frontal intraoral photographs taken before expansion (T0) and 1.5 years after MARPE treatment (T1) using the Jemt classification. The difference in Jemt score at T0 and T1 was the primary outcome variable. In addition, gender, age, Angle classification, MARPE duration, midpalatal suture maturation stage, maximal central diastema (MCD) immediately after expansion, crown width to length ratio (W/L), pretreatment overlap of maxillary central incisors, and the distance between the approximal contact point of the central incisors and the bone crest (CP-B) were also record.

RESULTS

Twenty-two patients were included (2 men, 20 women, mean age 27.3 ± 8.8 years) and 4 patients (18%) showed a significant reduction in the Jemt score following MARPE (p = 0.04), indicating papilla recession. Interdental papilla recession was significantly associated with the increase of CP-B (p = 0.02), smaller W/L (p < 0.01), overlapping of maxillary central incisors (p < 0.01), and smaller MCD immediately after expansion (p = 0.02).

CONCLUSIONS

One and a half years after MARPE, 18% of patients exhibited mild recession of papilla height of the maxillary central incisors. Overlapping and smaller W/L of maxillary central incisors were prognostic factors for interdental papilla recession.

CLINICAL RELEVANCE

Clinicians have to be aware of and inform the patients about the occurrence of papilla recession following MARPE.

摘要

目的

评估微螺钉辅助快速上颌扩弓(MARPE)对上颌中切牙间乳头高度的影响。

材料与方法

本回顾性研究纳入了2018年至2021年在拉德堡德大学医学中心完成MARPE治疗的患者。使用Jemt分类法,在扩弓前(T0)和MARPE治疗后1.5年(T1)拍摄的正面口腔内照片上评估上颌中切牙间的乳头高度。T0和T1时Jemt评分的差异是主要结局变量。此外,还记录了性别、年龄、安氏分类、MARPE持续时间、腭中缝成熟阶段、扩弓后即刻的最大中切牙间隙(MCD)、冠宽与长度比(W/L)、上颌中切牙的治疗前覆合情况以及中切牙邻接点与牙槽嵴之间的距离(CP-B)。

结果

纳入22例患者(2例男性,20例女性,平均年龄27.3±8.8岁),4例患者(18%)在MARPE治疗后Jemt评分显著降低(p = 0.04),表明乳头退缩。牙间乳头退缩与CP-B增加(p = 0.02)、W/L较小(p < 0.01)上颌中切牙覆合(p < 0.01)以及扩弓后即刻MCD较小(p = 0.02)显著相关。

结论

MARPE治疗后一年半,18%的患者出现上颌中切牙乳头高度轻度退缩。上颌中切牙的覆合和较小的W/L是牙间乳头退缩的预后因素。

临床意义

临床医生必须意识到MARPE治疗后乳头退缩的发生并告知患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7524/10560192/c2e70624caac/784_2023_5214_Fig1_HTML.jpg

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