Park Hai Ji, Yu Hyung-Seog, Kim Seong-Hun, Ahn Hyo-Won, Kang Yoon-Goo, Park Jung Jin
Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea.
Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea.
Am J Orthod Dentofacial Orthop. 2025 Sep;168(3):327-338. doi: 10.1016/j.ajodo.2025.04.005. Epub 2025 May 2.
This study aimed to compare the skeletal and dental effects of maxillary protraction using a miniscrew-assisted rapid palatal expander (MARPE) and rapid palatal expander in growing patients with skeletal Class III malocclusion undergoing maxillary protraction.
This study included 18 patients in the facemask (FM) treatment with MARPE (group 1) and 20 patients in the FM treatment with rapid palatal expander (group 2). In addition, a control group (group 3) consisting of 21 patients undergoing no treatment affecting maxillary growth was established. Radiographic measurements were taken from lateral cephalometric radiographs at the start of FM treatment and after 3 months of treatment completion.
Groups 1 and 2, receiving maxillary protraction treatment, exhibited significant increases in SNA (P <0.01) and ANB (P <0.001) values posttreatment, surpassing the control group. Group 1 showed a notably greater increase in SNA (P <0.001) and ANB (P <0.05) values than group 2. In contrast, group 2 demonstrated a significantly larger increase in FH-MP (P <0.001) and SN-U1 values (P <0.05). Both groups displayed significant advancement in the anterior border of the key ridge, the one-half point of the pterygomaxillary fissure, ANS, and point A after treatment, with group 1 showing a greater increase than group 2.
In treating severe maxillary hypoplasia or hyperdivergent skeletal patterns, MARPE appears to be more effective than tooth-borne expansion devices, offering greater skeletal effects with minimal dental and mandibular rotational effects.
本研究旨在比较使用微型螺钉辅助快速腭开展器(MARPE)和快速腭开展器对上颌前牵引的骨骼和牙齿影响,研究对象为正在接受上颌前牵引的生长发育期骨性III类错牙合患者。
本研究纳入18例接受面罩(FM)联合MARPE治疗的患者(第1组)和20例接受FM联合快速腭开展器治疗的患者(第2组)。此外,设立了一个由21例未接受影响上颌生长治疗的患者组成的对照组(第3组)。在FM治疗开始时和治疗完成3个月后,从头颅侧位片上进行影像学测量。
接受上颌前牵引治疗的第1组和第2组治疗后SNA(P<0.01)和ANB(P<0.001)值显著增加,超过了对照组。第1组的SNA(P<0.001)和ANB(P<0.05)值的增加明显大于第2组。相比之下,第2组的FH-MP(P<0.001)和SN-U1值(P<0.05)增加更为显著。两组治疗后在关键嵴前缘、翼上颌裂中点、前鼻棘和A点均有显著前移,第1组的增加幅度大于第2组。
在治疗严重上颌发育不全或高角骨骼型时,MARPE似乎比牙支持式扩弓装置更有效,能提供更大的骨骼效应,同时对牙齿和下颌的旋转效应最小。