Piancino Maria Grazia, Tortarolo Alessandro, Di Benedetto Laura, Moscufo Luigi, Nucci Ludovica, Bersia Michela
Department of Surgical Sciences, Dental School, University of Turin, via Nizza 230, CAP 10126, Turin, Italy.
Multidisciplinary Department of Medical-Surgical and Dental Specialties, School of Medicine and Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
J Orofac Orthop. 2024 Oct 25. doi: 10.1007/s00056-024-00556-9.
This observational study aimed to evaluate the stability of unilateral posterior crossbite (UPXB) correction with the functional appliance function generating bite (FGB appliance) during follow-up and its effects on craniofacial growth.
A total of 102 age- and gender-matched patients were included: 51 with UPXB (male [M] = 19; female [F] = 32; mean age ± standard deviation [SD] = 7.6 ± 1.4 [years.months]) and 51 controls (C; M = 19; F = 32; mean age ± SD = 7.9 ± 1.3). UPXB was corrected with the FGB appliance. Study casts were collected before treatment (T0), after correction (T1), after a follow-up of 3.7 ± 1.6 [years.months] (T2) and different transversal measurements were performed with calipers: intermolar (IMD), intermolar gingival (IMGD), intercanine (ICD), and intercanine gingival distances (ICGD). In treated patients, in addition, lateral cephalometric tracings were analyzed at T0 and T2.
At T0, all maxillary measurements were significantly smaller in the UPXB group compared to the controls (p < 0.001). Between T0 and T1, all maxillary variables increased significantly in the UPXB group (p < 0.001; IMD +4.3 ± 2.1 mm; ICD +3.1 ± 2 mm). Between T1 and T2, maxillary IMD increased further (p < 0.05; +2.2 ± 2 mm). The mean T0-T2 increases were 6.6 ± 2.6 mm (IMD) and 4.3 ± 2.6 mm (ICD). At T0, the cephalometric analysis showed significantly stronger mandibular clockwise rotation (p < 0.01) in the UPXB group compared to the control group. Between T0 and T2, the UPXB group showed a significant reduction of mandibular (p < 0.001; SpP-CoOr T0 = -3.47°± 4.38, T2 = -1.14°± 4.01) and occlusal plane (p < 0.01; SpP-Oc T0 = 11.37°± 3.91, T2 = 9.86°± 3.83) clockwise rotation, and of intermaxillary divergence (p < 0.01; SpP-GoGn T0 = 27.8°± 5.39, T2 = 26.65°± 5.49).
Treatment of UPXB with the FGB appliance effectively increased maxillary transversal width measurements, especially in the posterior region, even after follow-up, indicating stable results. Concurrently, mandibular clockwise rotation was reduced, indicating control of the vertical dimension.
本观察性研究旨在评估使用功能性矫治器功能产生咬合(FGB矫治器)矫正单侧后牙反合(UPXB)在随访期间的稳定性及其对颅面生长的影响。
共纳入102例年龄和性别匹配的患者:51例UPXB患者(男[M]=19例;女[F]=32例;平均年龄±标准差[SD]=7.6±1.4[岁.月])和51例对照者(C组;男=19例;女=32例;平均年龄±SD=7.9±1.3)。使用FGB矫治器矫正UPXB。在治疗前(T0)、矫正后(T1)、3.7±1.6[岁.月]的随访后(T2)收集研究模型,并用卡尺进行不同的横向测量:磨牙间(IMD)、磨牙间牙龈(IMGD)、尖牙间(ICD)和尖牙间牙龈距离(ICGD)。此外,对治疗患者在T0和T2时进行头颅侧位片分析。
在T0时,UPXB组所有上颌测量值均显著小于对照组(p<0.001)。在T0和T1之间,UPXB组所有上颌变量均显著增加(p<0.001;IMD增加4.3±2.1mm;ICD增加3.1±2mm)。在T1和T2之间,上颌IMD进一步增加(p<0.05;增加2.2±2mm)。T0-T2的平均增加量为6.6±2.6mm(IMD)和4.3±2.6mm(ICD)。在T0时,头颅侧位片分析显示UPXB组下颌顺时针旋转明显强于对照组(p<0.01)。在T0和T2之间,UPXB组下颌(p<0.001;SpP-CoOr T0=-3.47°±4.38,T2=-1.14°±4.01)和咬合平面(p<0.01;SpP-Oc T0=11.37°±3.91,T2=9.86°±3.83)顺时针旋转以及上下颌骨间离散度(p<0.01;SpP-GoGn T0=27.8°±5.39,T2=26.65°±5.49)均显著降低。
使用FGB矫治器治疗UPXB有效增加了上颌横向宽度测量值,尤其是在后牙区域,即使在随访后仍显示稳定结果。同时,下颌顺时针旋转减少,表明垂直维度得到控制。