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功能性治疗单侧后牙反牙合可改善混合牙列患者的髁突不对称。

Functional treatment of unilateral posterior crossbite improves condylar asymmetry in mixed dentition patients.

作者信息

Tortarolo Alessandro, Olivero Virginia, Tomatis Elisabetta, Crincoli Vito, Di Benedetto Laura, Vallelonga Teresa, Piancino Maria Grazia

机构信息

Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy.

Department of Basic Medical Sciences, Neuroscience and Sense Organs, Piazza G. Cesare 11, 70124, University of Bari, Bari, Italy.

出版信息

Eur J Orthod. 2025 Apr 8;47(3). doi: 10.1093/ejo/cjaf029.

Abstract

BACKGROUND/OBJECTIVES: This study's aim was to evaluate the effects of unilateral posterior crossbite (UPXB) treatment with the appliance Function Generating Bite (FGB) on the asymmetry of mandibular condyles and rami.

MATERIALS/METHODS: This retrospective study included 156 patients: 52 with UPXB (F = 30, M = 22, mean age ± SD = 7.9 ± 1.5 [yr.mo]) treated with FGB, 104 age and gender-matched control subjects without the malocclusion (control-T0: N = 52, F = 30, M = 22, mean age ± SD = 8.2 ± 1.3; control-T1, n = 52, F = 30, M = 22, mean age ± SD 9.7 ± 1.2). Pre- (T0) and post-treatment (T1) orthopantomographies were analyzed by finding the intersection between a line tangent to the lateral profile of the condyle and ramus and a perpendicular line tangent to the condylar head; the intersection and tangent points were used to measure condylar and ramal heights and to calculate the percentage difference between the sides (asymmetry index). Cephalometric analysis was performed on lateral skull X-rays taken at T0 and T1.

RESULTS

Condylar asymmetry was significantly increased in UPXB at T0 (P < 0.00001) but not at T1. Between T0/T1 the asymmetry was significantly reduced (P < 0.01). Cephalometric analysis showed that mandibular clockwise rotation was significantly increased in UPXB at T0 (P < 0,01) but not at T1, when the clockwise rotation was significantly reduced (P < 0.05).

LIMITATIONS

This study did not include an untreated UPXB group and did not evaluate condylar morphology, Conclusions/implications: Functional treatment of UPXB with FGB was associated with a significant reduction in condylar asymmetry and significant mandibular repositioning, highlighting that FGB could rebalance condylar growth in developing patients.

摘要

背景/目的:本研究旨在评估使用功能发生咬合器(FGB)治疗单侧后牙反合(UPXB)对下颌髁突和下颌升支不对称性的影响。

材料/方法:这项回顾性研究纳入了156例患者:52例UPXB患者(女性30例,男性22例,平均年龄±标准差=7.9±1.5[岁.月])接受FGB治疗,104例年龄和性别匹配的无错合畸形对照受试者(对照-T0:N=52例,女性30例,男性22例,平均年龄±标准差=8.2±1.3;对照-T1,n=52例,女性30例,男性22例,平均年龄±标准差9.7±1.2)。通过找到与髁突和下颌升支外侧轮廓相切的直线与与髁突头部相切的垂直线的交点,对治疗前(T0)和治疗后(T1)的曲面断层片进行分析;交点和切点用于测量髁突和下颌升支的高度,并计算两侧之间的百分比差异(不对称指数)。对在T0和T1拍摄的头颅侧位X线片进行头影测量分析。

结果

UPXB患者在T0时髁突不对称性显著增加(P<0.00001),但在T1时未增加。在T0/T1之间,不对称性显著降低(P<0.01)。头影测量分析显示,UPXB患者在T0时下颌顺时针旋转显著增加(P<0.01),但在T1时未增加,此时顺时针旋转显著降低(P<0.05)。

局限性

本研究未纳入未经治疗的UPXB组,也未评估髁突形态。结论/意义:使用FGB对UPXB进行功能治疗与髁突不对称性显著降低和下颌显著复位相关,突出表明FGB可以使发育中患者的髁突生长重新平衡。

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