Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.
Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, P.R. China.
Orthod Craniofac Res. 2024 Oct;27(5):681-689. doi: 10.1111/ocr.12786. Epub 2024 Apr 2.
To investigate the changes in condyle-glenoid fossa relationship after maxillary skeletal expansion (MSE) and to verify the correlation between the condyle positional changes and expansion effect.
In this study, 20 patients (mean age 21.1 ± 5.7 years, 8 male, 12 female) with maxillary transverse deficiency (MTD) were treated with the MSE appliance, which contained molar bands and a expander with four micro-implants. The CBCT images were taken before expansion (T0), after expansion (T1) and after 6 months of maintenance (T2). The posterior TMJ space (PS), superior TMJ space (SS), anterior TMJ space, coronal lateral TMJ space (CLS), coronal medial TMJ space (CMS), condyle axis angle, maxillary basal bone width (BWM), inter-molars width, nasal bone width, molar inclination and molar palatal cusp height (U6H) were measured using Dolphin Imaging.
At T1, compared with T0, the PS and SS significantly increased by 0.41 mm (P = .008) and 0.3 mm (P = .007). But only the SS significantly increased by 0.21 mm (P = .025) at T2. There was a significant difference of 0.37 mm (left-right, P = .014) between the left and right SS at T0, but no significant difference at T1 and T2. The increased BMW showed weak positive correlations with the change of PS (P = .015) and CMS (P = .031), and the decreased U6H showed weak negative correlations with the change of PS (P = .015) and CLS (P = .031) at T1.
The use of MSE led to an increase in the SS and PS, which were weakly correlated with BWM and U6H. But this effect in the TMJ space gradually diminished after 6 months of maintenance, and the symmetry of the condyle-fossa relationship was preserved.
研究上颌骨扩弓（MSE）后髁突-关节窝关系的变化，并验证髁突位置变化与扩弓效果的相关性。
本研究纳入 20 名（平均年龄 21.1±5.7 岁，男 8 例，女 12 例）上颌骨横向发育不足（MTD）患者，均采用包含带环和四颗微种植体的扩弓器进行治疗。在扩弓前（T0）、扩弓后（T1）和扩弓后 6 个月（T2）时拍摄 CBCT 图像。采用 Dolphin Imaging 软件测量髁突后间隙（PS）、髁突上间隙（SS）、前间隙、冠状外侧间隙（CLS）、冠状内侧间隙（CMS）、髁突轴角、上颌基骨宽度（BWM）、磨牙间宽度、鼻骨宽度、磨牙倾斜度和磨牙腭尖高度（U6H）。
T1 时，与 T0 相比，PS 和 SS 分别显著增加了 0.41mm（P=.008）和 0.3mm（P=.007）。但 T2 时仅 SS 显著增加了 0.21mm（P=.025）。T0 时左右 SS 之间存在 0.37mm 的显著差异（左右，P=.014），但 T1 和 T2 时无显著差异。增加的 BWM 与 PS （P=.015）和 CMS （P=.031）的变化呈弱正相关，而 U6H 的减少与 PS （P=.015）和 CLS （P=.031）的变化呈弱负相关。
MSE 的应用导致 SS 和 PS 增加，与 BWM 和 U6H 呈弱相关。但在 6 个月的维持治疗后，TMJ 空间的这种效应逐渐减弱，髁突-关节窝关系的对称性得以保持。
