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微螺钉辅助快速腭扩张（MARPE）：影响规划的因素。

Miniscrew-assisted rapid palatal expansion (MARPE): Factors influencing planning.

机构信息

University of Mogi das Cruzes, Technology Research Center (Mogi das Cruzes/SP, Brazil).

University of São Paulo, School of Orthodontics (São Paulo/SP, Brazil).

出版信息

Dental Press J Orthod. 2024 Aug 12;29(3):e242439. doi: 10.1590/2177-6709.29.3.e242439.oar. eCollection 2024.

DOI:10.1590/2177-6709.29.3.e242439.oar
PMID:39140568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11321490/
Abstract

OBJECTIVE

This cross-sectional study evaluated the bone thickness on mini-implants insertion site, the factors that influence the digital planning of MARPE appliance (miniscrew-assisted rapid palatal expansion), and its different designs.

METHODS

A total of 135 plannings were assessed regarding the size of the expander screw used, the positioning and the type of the mini-implant rings, and their location in relation to the teeth. Bone thickness measurements were assessed in the region of the mini-implants' trajectory. Differences between the sexes was verified using the ANOVA test (5% significance).

RESULTS

73 cases were planned with 4 mini-implants and 62 cases, with 6 mini-implants. In 90% of cases, teeth #16 and #26 were used as supports, and the most used expander screw was 13mm (64.1% of cases). The anterior mini-implants of conventional MARPE showed more pronounced insertion in bone in males (5.9 ± 2mm; p= 0.025). The extra mini-implants (anterior region) were inserted with greater bone thickness in males (11.1 ± 2.3mm) compared to females (9.9 ± 1.8mm; p=0.041). A greater bone thickness was observed in males (10.1 ± 2.1 mm) when using mini-implants in the paramedian region.

CONCLUSION

Additional rings allow more pronounced bone insertion. Male patients had greater bone thickness, which may be related to greater difficulty in opening the sutures. The alveolar process region seems to be a satisfactory site for mini-implants to those patients with reduced bone thickness in the paramedian posterior region. MARPE appliance must be customized for each patient, due to bone thickness and anatomical variations.

摘要

目的

本横断面研究评估了微型种植体植入部位的骨厚度、影响 MARPE 矫治器（微型种植体辅助快速腭扩张）数字化规划的因素及其不同设计。

方法

共评估了 135 个规划，涉及扩张器螺钉的大小、微型种植体环的定位和类型及其与牙齿的相对位置。在微型种植体轨迹区域评估骨厚度测量值。使用方差分析检验（5%显著性）比较男女之间的差异。

结果

73 例计划使用 4 个微型种植体，62 例计划使用 6 个微型种植体。90%的病例中使用 #16 和 #26 牙作为支抗，最常用的扩张器螺钉为 13mm（64.1%的病例）。传统 MARPE 的前牙微型种植体在男性中表现出更明显的骨内插入（5.9±2mm；p=0.025）。额外的微型种植体（前牙区）在男性中的骨插入厚度较大（11.1±2.3mm），而女性较小（9.9±1.8mm；p=0.041）。男性在前牙区使用微型种植体时，骨厚度更大（10.1±2.1mm）。

结论

附加环允许更明显的骨插入。男性患者的骨厚度更大，这可能与骨缝张开难度较大有关。对于后正中区骨厚度较小的患者，牙槽突区似乎是微型种植体的理想部位。由于骨厚度和解剖变异，MARPE 矫治器必须针对每位患者进行定制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/7d0c420ca076/2177-6709-dpjo-29-03-e242439-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/2a2073ffe37d/2177-6709-dpjo-29-03-e242439-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/6983ffdf0cb6/2177-6709-dpjo-29-03-e242439-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/c93ce33058ac/2177-6709-dpjo-29-03-e242439-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/95bfccca24f2/2177-6709-dpjo-29-03-e242439-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/211b51b1cdc9/2177-6709-dpjo-29-03-e242439-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/f73ac013cb9c/2177-6709-dpjo-29-03-e242439-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/7d0c420ca076/2177-6709-dpjo-29-03-e242439-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/2a2073ffe37d/2177-6709-dpjo-29-03-e242439-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/6983ffdf0cb6/2177-6709-dpjo-29-03-e242439-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/c93ce33058ac/2177-6709-dpjo-29-03-e242439-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/95bfccca24f2/2177-6709-dpjo-29-03-e242439-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/211b51b1cdc9/2177-6709-dpjo-29-03-e242439-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/f73ac013cb9c/2177-6709-dpjo-29-03-e242439-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca23/11321490/7d0c420ca076/2177-6709-dpjo-29-03-e242439-gf7.jpg

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Analysis of factors associated with the success of microimplant-assisted rapid palatal expansion.分析与微植体辅助快速腭扩张成功相关的因素。
Am J Orthod Dentofacial Orthop. 2023 Jul;164(1):67-77. doi: 10.1016/j.ajodo.2022.10.029. Epub 2023 Mar 1.
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Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth-borne and tooth-bone-borne expanders: A randomized clinical trial.
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Orthod Craniofac Res. 2022 Nov;25(4):476-484. doi: 10.1111/ocr.12559. Epub 2022 Jan 6.
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