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推磨牙向后矫治器与快速扩弓和前方牵引治疗生长发育期安氏 III 类错牙合患者气道间隙的变化:一项随机临床试验。

Cephalometric changes of pushing splints 3 compared to rapid maxillary expansion and facemask therapy on the airway space in class III growing patients: A randomized clinical trial.

机构信息

Dentistry Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Department of Experimental and Clinical Medicine, School of Dentistry, University of Florence, Florence, Italy.

出版信息

Orthod Craniofac Res. 2024 Aug;27(4):552-559. doi: 10.1111/ocr.12767. Epub 2024 Feb 17.

Abstract

BACKGROUND

Early orthopaedic treatment with rapid maxillary expansion (RME) associated with facemask (FM) has been shown to be effective in correcting Class III malocclusions in children. Treatment with pushing splints 3 (PS3) has shown to correct skeletal discrepancies in Class III growing patients. However, the effects of orthopaedic treatment on the upper airways in children with Class III malocclusion is controversial.

OBJECTIVES

The aim of this study was to evaluate the cephalometric changes in the airways of PS3 compared to the RME/FM protocol.

MATERIALS AND METHODS

In this study, 48 patients with Class III malocclusion (age range 5.5-8.5 years old) were selected for this study, and 24 were treated with PS3 appliance and 24 with RME/FM therapy. Lateral cephalograms before (T0) and at the end of the treatment (T1) were analysed to compare pharyngeal spaces. Paired and unpaired t tests were used for data analysis (P < .05).

RESULTS

A total of 41 patients (21 patients for the PS3 group, 11 males and 10 females, mean age 7.0 ± 1.2 years; 20 patients for the RME/FM group, 10 males and 10 females, mean age 7.2 ± 1.3 years) were included. The results showed a statistically significant (P < .05) increase in the nasopharyngeal space after both therapies. However, the effects were similar considering that there were no differences between groups for the assessed variables at T0-T1.

CONCLUSIONS

Early treatment of Class III malocclusion with PS3 does not induce a statistically significant increase in the sagittal airway space compared to RME/FM. The absence of untreated group could not define the role of growth in the increase of space.

摘要

背景

早期正畸治疗联合快速扩弓(RME)和功能矫治器(FM)已被证明能有效矫正儿童的 III 类错颌。推磨牙向后(PS3)治疗已被证明能矫正生长发育期 III 类错颌患者的骨骼差异。然而,正畸治疗对 III 类错颌儿童上气道的影响仍存在争议。

目的

本研究旨在比较 PS3 和 RME/FM 治疗方案对上气道的头影测量变化。

材料和方法

本研究共纳入 48 例 III 类错颌患者(年龄 5.5-8.5 岁),其中 24 例采用 PS3 矫治器治疗,24 例采用 RME/FM 治疗。分析治疗前后(T0、T1)的侧位头颅侧位片,比较咽腔间隙。采用配对和独立样本 t 检验进行数据分析(P<0.05)。

结果

共纳入 41 例患者(PS3 组 21 例,男 11 例,女 10 例,平均年龄 7.0±1.2 岁;RME/FM 组 20 例,男 10 例,女 10 例,平均年龄 7.2±1.3 岁)。结果显示,两种治疗方法均能显著增加鼻咽腔空间(P<0.05)。但考虑到 T0-T1 时两组各变量差异无统计学意义,两种治疗方法的效果相似。

结论

与 RME/FM 相比,PS3 早期治疗 III 类错颌并不能显著增加矢状位气道空间。未设置未治疗组无法确定生长在增加气道空间中的作用。

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