Angle Orthod. 2024 Jul 1;94(4):414-420. doi: 10.2319/092623-650.1.
To compare the buccal and palatal bone changes of maxillary posterior teeth produced by hybrid hyrax (HH) and conventional hyrax (CH) expanders in growing patients.
A sample of 32 patients with posterior crossbites in the late mixed dentition was recruited and randomly allocated into two groups. Group HH was composed of 18 individuals with a mean age of 10.7 years (six female, 12 male) treated with a hybrid expander with two anterior parasagittal miniscrews. Group CH was composed of 14 individuals with a mean age of 11.4 years (six female, eight male) treated with a conventional Hyrax expander. Cone-beam computed tomography (CBCT) exams were obtained before expansion (T1) and after 11 months when the expander was removed (T2). Buccal and palatal bone plate thickness and height of maxillary posterior teeth were measured. Intergroup comparisons were performed using t or Mann-Whitney tests (P < .05).
The CH group showed greater decreases of the buccal bone plate height (mean change: 1.27 mm) at the maxillary first premolars compared to the HH group (mean change: 0.11 mm, P = .001). No intergroup difference was found for changes in the buccal and palatal bone thickness.
Hybrid expanders showed a tendency to cause less negative impact on the buccal bone plate height of first premolars compared to conventional Hyrax expanders. However, the difference was not clinically significant. Both hybrid and conventional Hyrax expanders are safe for the alveolar bone morphology in the late mixed dentition.
比较混合头帽(HH)和传统头帽(CH)扩弓器对上颌后牙颊腭向骨变化的影响。
选取 32 例替牙晚期后牙反牙合患者,随机分为两组。HH 组 18 例,平均年龄 10.7 岁(女 6 例,男 12 例),使用带有 2 个前矢状位微螺钉的混合扩弓器治疗。CH 组 14 例,平均年龄 11.4 岁(女 6 例,男 8 例),使用传统 Hyrax 扩弓器治疗。在扩弓前(T1)和 11 个月扩弓器拆除时(T2)分别进行锥形束 CT 检查。测量上颌后牙颊腭侧骨皮质厚度和牙冠高度。采用 t 检验或曼-惠特尼检验进行组间比较(P <.05)。
CH 组上颌第一前磨牙颊侧骨皮质高度的降低更为明显(平均变化:1.27mm),而 HH 组为 0.11mm(P =.001)。两组间颊腭侧骨皮质厚度的变化无统计学差异。
与传统 Hyrax 扩弓器相比,混合扩弓器对上颌第一前磨牙颊侧骨皮质高度的负面影响较小,但差异无临床意义。混合头帽和传统 Hyrax 扩弓器对上颌后牙萌出间隙的改建均是安全的。