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牙列替换期前方牵引联合快速扩弓的三维影响及临床意义

The three-dimensional influence and clinical significance of anterior traction with rapid expansion during dental replacement.

作者信息

Gou Naizheng, Wang Xiaoqin, Li Haiyan, Dong Zuoying

机构信息

Department of Stomatology, Qingdao Jiaozhou Central Hospital, Jiaozhou, China.

Department of Medical Insurance, Qingdao Jiaozhou Central Hospital, Jiaozhou, China.

出版信息

Acta Odontol Scand. 2025 Aug 27;84:491-500. doi: 10.2340/aos.v84.44580.


DOI:10.2340/aos.v84.44580
PMID:40859791
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12398110/
Abstract

OBJECTIVES: This study aimed to investigate the effects of rapid maxillary expansion using a Hyrax-type appliance (RME-Hyrax) with anterior traction on the maxillary arch during mixed dentition and its clinical significance, focusing on changes in arch dimensions, occlusal stability, and masticatory function. MATERIALS AND METHODS: Forty-two patients with transverse maxillary deficiency were treated with RME-Hyrax, while an untreated control group of 40 received no treatment. Pre- and post-treatment dental casts were analyzed using a 3D scanner. Arch length, width, and occlusal stability were measured. Statistical analysis was performed using paired t-tests and linear regression. RESULTS: RME significantly increased maxillary arch widths at all measured points: 3CW: +4.06 mm, 4CW: +4.88 mm, 5CW: +4.09 mm, 6MCW: +3.00 mm (all p  <  0.001). Mandibular arch widths similarly increased (3CW: +3.18 mm, 4CW: +4.00 mm, 5CW: +4.61 mm, 6MCW: +3.07 mm; all p  <  0.001). Buccal movement of first permanent molars was significant in both arches (maxillary: 1.61-1.78 mm, mandibular: 1.52-1.68 mm; all p  <  0.001). Occlusal stability improved clinically, evidenced by increased maximum bite area (+19.66 mm², exceeding the 15% threshold for functional gain; p  <  0.001) and force (+1.06 kg, surpassing the 0.5 kg minimum meaningful change; p  <  0.001), with reduced asymmetry index (-22.03%, p  <  0.001). Masticatory efficiency improved from 54.22 to 84.61% (Δ30.39%, < 25% threshold; p  <  0.001). CONCLUSIONS: Hyrax-type RME is effective for correcting transverse maxillary deficiencies, expanding both the maxillary and mandibular arches, and improving occlusal and masticatory function. Early intervention can significantly enhance dental and functional health.

摘要

目的:本研究旨在探讨使用Hyrax型矫治器进行快速上颌扩弓(RME - Hyrax)并在前牵引的情况下,对混合牙列期上颌牙弓的影响及其临床意义,重点关注牙弓尺寸变化、咬合稳定性和咀嚼功能。 材料与方法:42例上颌横向发育不足患者接受RME - Hyrax治疗,40例未治疗的对照组未接受任何治疗。治疗前后的石膏模型使用三维扫描仪进行分析。测量牙弓长度、宽度和咬合稳定性。采用配对t检验和线性回归进行统计分析。 结果:RME显著增加了所有测量点的上颌牙弓宽度:3CW处增加4.06mm,4CW处增加4.88mm,5CW处增加4.09mm,6MCW处增加3.00mm(均p < 0.001)。下颌牙弓宽度也有类似增加(3CW处增加3.18mm,4CW处增加4.00mm,5CW处增加4.61mm,6MCW处增加3.07mm;均p < 0.001)。上下颌第一恒磨牙的颊向移动均显著(上颌:1.61 - 1.78mm,下颌:1.52 - 1.68mm;均p < 0.001)。临床上咬合稳定性得到改善,表现为最大咬合力面积增加(+19.66mm²,超过功能增益的15%阈值;p < 0.001)和咬合力增加(+1.06kg,超过最小有意义变化0.5kg;p < 0.001),不对称指数降低(-22.03%,p < 0.001)。咀嚼效率从54.22%提高到84.61%(变化30.39%,低于25%阈值;p < 0.001)。 结论:Hyrax型RME对于纠正上颌横向发育不足、扩大上颌和下颌牙弓以及改善咬合和咀嚼功能有效。早期干预可显著增强牙齿和功能健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/63bd0017c03e/AOS-84-44580-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/b370c37b850e/AOS-84-44580-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/ef0a38da0b52/AOS-84-44580-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/ff9624bc7fb7/AOS-84-44580-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/61461a7f62ea/AOS-84-44580-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/171550ceff8c/AOS-84-44580-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/63bd0017c03e/AOS-84-44580-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/b370c37b850e/AOS-84-44580-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/ef0a38da0b52/AOS-84-44580-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/ff9624bc7fb7/AOS-84-44580-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/61461a7f62ea/AOS-84-44580-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/171550ceff8c/AOS-84-44580-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/12398110/63bd0017c03e/AOS-84-44580-g006.jpg

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本文引用的文献

[1]
Impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults : A cross-sectional study.

J Orofac Orthop. 2024-10-1

[2]
Small RNAs and tooth development: The role of microRNAs in tooth agenesis and impaction.

J Dent Sci. 2024-10

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Assessment of Factors Associated with Mandibular Anterior Crowding in Mixed Dentition.

J Pharm Bioallied Sci. 2024-7

[4]
Evaluation of Cone Beam Computerized Tomography: Effects of Maxillary Bones and Their Influence on the Point of Next Teeth and Canine Development.

J Pharm Bioallied Sci. 2024-7

[5]
Human-AI collaboration improves adults' oral biomechanical functions: A multi-centre, self-controlled clinical trial.

J Dent. 2024-11

[6]
Cone-beam CT landmark detection for measuring basal bone width: a retrospective validation study.

BMC Oral Health. 2024-9-14

[7]
Mandibular response after rapid maxillary expansion in mixed dentition children with different vertical growth patterns: a retrospective study.

J Clin Pediatr Dent. 2024-9

[8]
Effect of treatment of transverse maxillary deficiency using rapid palatal expansion on oral health-related quality of life in children: complementary results for a controlled clinical trial.

Clin Oral Investig. 2024-9-13

[9]
The impact of different activation protocols of rapid maxillary expansion on external root resorption: a systematic review and meta-analysis.

Am J Transl Res. 2024-8-15

[10]
Vertical and transverse treatment effects of Invisalign First system compared to Hyrax maxillary expanders with fixed appliances in mixed dentition patients.

Angle Orthod. 2024-9-1

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