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年轻成年患者中商用和定制微型螺钉辅助快速腭扩展系统的扩展程度和模式:一项回顾性比较分析。

Degree and pattern of expansion of commercially available and custom-fabricated miniscrew-assisted rapid palatal expansion systems in young adult patients: A retrospective comparative analysis.

作者信息

Almaqrami Bushra Sufyan, Al-Somairi Majedh Abdo Ali, Al-Gumaei Waseem Saleh, Al-Tayar Barakat, Abdulghani Ehab A, Alhammadi Maged S, Liu Zhijian, Xiong Hui, He Hong

机构信息

Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Ningbo Dental Hospital, Ningbo 315032, Zhejiang, China; Orthodontics Division, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Republic of Yemen.

Department of Orthodontics, School of Stomatology, China Medical University, Shenyang 110000, China.

出版信息

Int Orthod. 2025 Mar;23(1):100931. doi: 10.1016/j.ortho.2024.100931. Epub 2024 Oct 24.

Abstract

BACKGROUND

Miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a noteworthy non-surgical method for treating maxillary transverse deficiency, especially in young adult patients. Studies have shown that MARPE can achieve significant dentoalveolar and skeletal expansion with long-term stability. The primary objective of this study was to assess the skeletal changes in the maxillary transverse dimension, and the secondary objective was to evaluate the dentoalveolar changes, following the use of a commercially available maxillary skeletal expander (MSE) in comparison to a custom-fabricated MARPE.

METHODS

This retrospective study involved 50 young adult patients diagnosed with skeletal transverse maxillary deficiency, divided into two groups (MSE and custom MARPE), with 25 patients in each group. Pre- and post-expansion cone-beam computed tomography (CBCT) images were used to analyse skeletal, alveolar, and dental changes.

RESULTS

Both MSE and custom MARPE groups achieved significant skeletal and dentoalveolar expansion. However, the custom MARPE group exhibited notably greater expansion in several metrics; in the axial plane, the average expansion was 4.68±1.35mm and 3.37±1.53mm at the anterolateral maxillary walls and 3.99±1.35mm and 3.28±1.19mm at the greater palatine foramen region for custom MARPE and MSE groups, respectively (P<0.01). In coronal plane, the custom MARPE showed significantly greater transverse expansion at the mid-nasal, basal, alveolar, and dental levels.

CONCLUSION

Both MARPE systems are effective for maxillary expansion. However, the custom-fabricated MARPE may offer more favourable results, with broader and more uniform skeletal expansion. This can be especially beneficial for patients with specific anatomical requirements.

摘要

背景

微型螺钉辅助快速腭扩展术(MARPE)已成为一种值得关注的治疗上颌横向发育不足的非手术方法,尤其适用于年轻成年患者。研究表明,MARPE可实现显著的牙牙槽和骨骼扩展,并具有长期稳定性。本研究的主要目的是评估使用市售上颌骨扩弓器(MSE)与定制MARPE后上颌横向尺寸的骨骼变化,次要目的是评估牙牙槽变化。

方法

这项回顾性研究纳入了50例被诊断为上颌骨横向发育不足的年轻成年患者,分为两组(MSE组和定制MARPE组),每组25例。使用扩弓前后的锥形束计算机断层扫描(CBCT)图像分析骨骼、牙槽和牙齿的变化。

结果

MSE组和定制MARPE组均实现了显著的骨骼和牙牙槽扩展。然而,定制MARPE组在几个指标上的扩展明显更大;在轴向平面上,定制MARPE组和MSE组在上颌前外侧壁的平均扩展分别为4.68±1.35mm和3.37±1.53mm,在腭大孔区域分别为3.99±1.35mm和3.28±1.19mm(P<0.01)。在冠状平面上,定制MARPE在鼻中部、基部、牙槽和牙齿水平显示出明显更大的横向扩展。

结论

两种MARPE系统对上颌扩展均有效。然而,定制的MARPE可能会提供更有利的结果,骨骼扩展更广泛且更均匀。这对有特定解剖学需求的患者可能特别有益。

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