Machado Pasqua Bruno de Paula, Sendyk Michelle, Barros André Cristiane, Batista de Paiva João, Wilmes Benedict, Rino Neto José
School of Orthodontics, University of São Paulo, Professor Lineu Prestes Avenue 2227, 05508-000, São Paulo, Brazil.
Technology Research Center, University of Mogi das Cruzes, Reverendo Henrique de Oliveira Camargo Street 374, 18090-170, Mogi das Cruzes, Brazil.
J Orofac Orthop. 2024 Aug 5. doi: 10.1007/s00056-024-00536-z.
This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT).
Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05).
Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001).
RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.
这项双臂平行随机对照试验旨在通过临床检查和锥形束计算机断层扫描（CBCT）评估并比较在生长发育期患者中使用牙-骨支持式和牙支持式装置进行快速上颌扩弓（RME）后的牙周变化。
筛选出42例符合条件的患者（年龄11 - 14岁；上颌横向发育不足，后牙反合），并根据接受的治疗将其分为两组（使用计算机生成的数字序列进行随机分组）：混合式海拉克斯牙-骨支持组（TBB）和海拉克斯牙支持组（TB）。主要观察指标是皮质骨厚度的变化（通过CBCT测量）。此外，还评估了临床附着水平（CAL）、牙龈退缩和出血情况。两项检查均在激活期前和激活期后3个月进行。采用协方差分析（ANCOVA；P < 0.05）进行组间比较。
TBB组纳入21例患者（12名女孩和9名男孩；平均初始年龄13.3岁），TB组纳入21例患者（5名女孩和16名男孩；平均初始年龄13.2岁）。TB组在所有三个评估水平的第一前磨牙和第一磨牙处颊侧骨厚度均降低。具体而言，在距釉牙骨质界3毫米处的14号牙颊侧骨宽度显著减小（0.7毫米；p < 0.001），同时在釉牙骨质界6毫米处腭侧皮质骨厚度显著增加（1.13毫米；p < 0.001）。
使用海拉克斯矫治器进行RME会导致第一前磨牙颊侧骨厚度降低。在磨牙区域，两种装置均导致皮质骨改变，TBB组的改变不太明显。
