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探索微创外科辅助快速上颌扩弓改善患者治疗效果的潜力。

Exploring the potential of minimally invasive surgically assisted rapid maxillary expansion to transform patient outcomes.

作者信息

Gayıbov Nizami, Demirbas Ahmet Emin, Kaba Yusuf Nuri, Eren Cemil, Çoban Gökhan

机构信息

Institute of Health Science, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Türkiye.

Department Head, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Türkiye.

出版信息

J Craniomaxillofac Surg. 2025 Aug;53(8):1141-1148. doi: 10.1016/j.jcms.2025.04.004. Epub 2025 May 5.

Abstract

Maxillary transverse deficiency (MTD) can be treated with Minimally Invasive Surgically Assisted Rapid Maxillary Expansion (MISARME) to improve surgical outcomes in non-growing patients and increase patient satisfaction. The purpose of this study was to compare Surgically Assisted Rapid Maxillary Expansion (SARME) and MISARME in terms of patient outcomes, including blood loss, operation time, edema, pain, and nasal soft tissue changes. This randomized, double-blind clinical trial was conducted on patients who underwent SARME to treat MTD. The primary predictor variable was the type of the SARME technique: SARME or MISARME. The primary outcome was bleeding and operation time. Secondary outcomes were postoperative pain, edema, and nasal soft tissue changes. The study was completed with 35 patients. Blood loss and operation time were significantly higher in the SARME (68.61 ± 28.68 ml-45.27 ± 2.08 min) compared to the MISARME (52.05 ± 14.03 ml-23.82 ± 9.39 min) (P < .05). No statistically significant difference was observed in the mean alar base and nasal widths at any time point within the MISARME(P < .05), while a significant difference was found in the SARME(p > .05). The edema measured between the T1-T0 time points was significantly lower in the MISARME compared to the SARME(P = .002). According to these results, MISARME may improve patient outcomes and reduce undesirable changes in nasolabial soft tissues.

摘要

上颌横向发育不足(MTD)可通过微创外科辅助快速上颌扩弓术(MISARME)进行治疗,以改善非生长发育期患者的手术效果并提高患者满意度。本研究的目的是比较外科辅助快速上颌扩弓术(SARME)和微创外科辅助快速上颌扩弓术(MISARME)在患者手术结果方面的差异,包括失血量、手术时间、水肿、疼痛和鼻软组织变化。本随机双盲临床试验针对接受SARME治疗MTD的患者开展。主要预测变量是SARME技术的类型:SARME或MISARME。主要结果是出血情况和手术时间。次要结果是术后疼痛、水肿和鼻软组织变化。该研究共纳入35例患者。与MISARME组(52.05±14.03ml - 23.82±9.39分钟)相比,SARME组(68.61±28.68ml - 45.27±2.08分钟)的失血量和手术时间显著更高(P <.05)。在MISARME组内的任何时间点,鼻翼基底宽度和鼻宽度的均值均未观察到统计学上的显著差异(P <.05),而在SARME组中则发现有显著差异(P>.05)。与SARME组相比,MISARME组在T1 - T0时间点之间测得的水肿程度显著更低(P = 0.002)。根据这些结果,MISARME可能会改善患者手术结果并减少鼻唇软组织的不良变化。

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