成人手术辅助快速扩弓与种植钉辅助快速扩弓效率的对比
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摘要
目的评估并比较成年人手术辅助快速扩弓(SARPE)和种植钉辅助快速扩弓(MARPE)的效率。方法选取上颌宽度不足成年人16例,按照扩弓方式分为SARPE组(n=9)和MARPE组(n=7)。扩弓前及扩弓结束保持3个月后拍摄锥形束CT,数据导入Dolphin软件中行三维重建,并对扩弓前后骨性宽度、支抗牙倾斜度、牙槽高度及厚度进行评价。结果 SARPE组和MARPE组扩弓后骨性宽度明显增加,表现为腭中缝、鼻腔、鼻底、颧上颌缝处宽度增加(P<0.05)。与SARPE组相比,MARPE组上颌第一磨牙处鼻腔宽度变化量较大(P<0.05),其他差异无统计学意义(P>0.05)。SARPE组和MARPE组中支抗牙均发生颊倾(P<0.05)。SARPE组和MARPE组颊侧牙槽高度及厚度扩弓前后差异无统计学意义(P>0.05)。结论 SARPE和MARPE均有明显的骨性扩宽效应,M ARPE较前者有一定优势。
Objective To evaluate and compare the expansion effectiveness between surgically assisted rapid palatal expansion( SARPE) and miniscrew-assisted rapid palatal expansion( MARPE) in adults. Methods A total of 16 adult patients with transverse maxillary deficiency were selected and divided into 2 groups according to the expansion design:SARPE group( n = 9) and MARPE group( n = 7). CBCT scans were performed before treatment and 3 months after retention. The data obtained were analyzed with Dolphin 11.8. Skeletal expansion,tipping of the anchored teeth,and buccal alveolar thickness and height were measured before and after treatment. Results The skeletal expansion increased significantly after treatment in both groups. There were significant increases in the width of midpalatal suture,nasal cavity,nasal floor,and zygomaticomaxillary suture( P<0.05). Change of nasal cavity width in maxillary first molar area in MARPE group was more significant than that in SARPE group( P<0.05),but there were no significant differences in other changes between the two groups( P>0.05). Both SARPE and MARPE resulted in tipping of the anchored teeth( P<0.05). The differences of the buccal alveolar height and thickness were not statistically significant between the twogroups( P>0.05). Conclusion Both SARPE and MARPE are effective treatment modalities for the correction of maxillary transverse deficiency in adults through separation of the midpalatal suture while MARPE shows certain superiority.
Objective To evaluate and compare the expansion effectiveness between surgically assisted rapid palatal expansion( SARPE) and miniscrew-assisted rapid palatal expansion( MARPE) in adults. Methods A total of 16 adult patients with transverse maxillary deficiency were selected and divided into 2 groups according to the expansion design:SARPE group( n = 9) and MARPE group( n = 7). CBCT scans were performed before treatment and 3 months after retention. The data obtained were analyzed with Dolphin 11.8. Skeletal expansion,tipping of the anchored teeth,and buccal alveolar thickness and height were measured before and after treatment. Results The skeletal expansion increased significantly after treatment in both groups. There were significant increases in the width of midpalatal suture,nasal cavity,nasal floor,and zygomaticomaxillary suture( P<0.05). Change of nasal cavity width in maxillary first molar area in MARPE group was more significant than that in SARPE group( P<0.05),but there were no significant differences in other changes between the two groups( P>0.05). Both SARPE and MARPE resulted in tipping of the anchored teeth( P<0.05). The differences of the buccal alveolar height and thickness were not statistically significant between the twogroups( P>0.05). Conclusion Both SARPE and MARPE are effective treatment modalities for the correction of maxillary transverse deficiency in adults through separation of the midpalatal suture while MARPE shows certain superiority.
引文
[1]da Silva Filho OG,Montes LA,Torelly LF,et al. Rapid maxillary expansion in the deciduous and mixed dentition evaluated through posteroanterior cephalometric analysis[J]. Am J Orthod Dentofacial Orthop,1995,107(3):268-275.
[2]Bj9rk A,Skieller V. Growth in width of the maxilla studied by the implant method[J]. Scand J Plast Reconstr Surg,1974,8(1-2):26-33.
[3]Bishara SE,Staley RN. Maxillary expansion:Clinical implications[J]. Am J Orthod Dentofacial Orthop,1987,91(1):3-14.
[4]寇波,王春玲,刘东旭,等.年轻成人上颌快速扩弓(YA-RME)对牙颌结构的影响[J].现代口腔医学杂志,2006,20(5):464-467.KOU Bo,WANG Chunling,LIU Dongxu,et al. Dental and skeletal changes of young adults w ith posterior crossbite after rapid maxillary expansion[J]. J M odern Stomatol,2016,20(5):464-467.
[5]Handelman CS,Wang L,BeGole EA,et al. Nonsurgical rapid maxillary expansion in adults:report on 47 cases using the Haas expander[J]. Angle Orthod,2000,70(2):129-144.
[6]Koudstaal MJ,Poort LJ,van der Wal KG,et al. Surgically assisted rapid maxillary expansion(SARM E):a review of the literature[J]. Int J Oral M axillofac Surg,2005,34(7):709-714.
[7] Lee KJ,Park YC,Park JY,et al. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient w ith severe mandibular prognathism[J]. Am J Orthod Dentofacial Orthop,2010,137(6):830-839.
[8] Persson M,Thilander B. Palatal suture closure in man from 15 to 35 years of age[J]. Am J Orthod,1977,72(1):42-52.
[9] Lehman JA Jr,Haas AJ. Surgical-orthodontic correction of transverse maxillary deficiency[J]. Clin Plast Surg,1989,16(4):749-755.
[10]Melsen B. Palatal growth studied on human autopsy material. A histologic microradiographic study[J]. Am J Orthod,1975,68(1):42-54.
[11]Woods M,Wiesenfeld D,Probert T. Surgically-assisted maxillary expansion[J]. Aust Dent J,1997,42(1):38-42.
[12]Seeberger R,Kater W,Davids R. Long term effects of surgically assisted rapid maxillary expansion w ithout performing osteotomy of the pterygoid plates[J]. J Craniomaxillofac Surg,2010,38(3):175-178.
[13]Gallagher V,Gallagher C,Sleeman D. Surgically assisted rapid palatal expansion for management of transverse maxillary deficiency[J]. J Ir Dent Assoc,2002,48(1):18-21.
[14] Northway WM,Meade JB Jr. Surgically assisted rapid maxillary expansion:a comparison of technique, response,and stability[J]. Angle Orthod,1997,67(4):309-320.
[15] Suzuki H,Moon W,Previdente LH,et al. Miniscrewassisted rapid palatal expander(M ARPE):the quest for pure orthopedic movement[J]. Dental Press J Orthod,2016,21(4):17-23.
[16]Pogrel MA,Kaban LB,Vargervik K,et al. Surgically assisted rapid maxillary expansion in adults[J]. Int J Adult Orthodon Orthognath Surg,1992,7(1):37-41.
[17]翁露茜,宋晓佳,李娟,等.腭中缝骨皮质切开辅助快速扩弓矫治15~25岁上颌横向宽度不足患者临床研究[J].浙江大学学报(医学版),2017,46(2):198-205.WENG Luxi,SONG Xiaojia,LI Juan,et al. M idpalatal cortex osteotomy assisted rapid maxillary expansion for correction of maxillary transverse deficiency in young adults[J]. Journal of Zhejiang University(M edical Sciences),2017,46(2):198-205.
[18]贾海潮,厉松,刘松林,等.种植钉辅助上颌快速扩弓治疗年轻成人上颌牙弓狭窄的CBCT分析[J].中华口腔正畸学杂志,2016,23(3):126-131.JIA Haichao,LI Song,LIU Songlin,et al. Effects of microimplant-assisted rapid palatal expansion on maxillary transverse discrepancy in young adult patients:a CBCT analysis[J]. Chin J Orthod,2016,23(3):126-131.
[19]Byloff FK,Mossaz CF. Skeletal and dental changes follow ing surgically assisted rapid palatal expansion[J].Eur J Orthod,2004,26(4):403-489.
[20]Angelieri F,Cevidanes LH,Franchi L,et al. Midpalatal suture maturation:classification method for individual assessment before rapid maxillary expansion[J]. Am J Orthod Dentofacial Orthop,2013,144(5):759-769.
[21] Betts NJ. Surgically assisted maxillary expansion[J].Atlas Oral M axillofac Surg Clin North Am,2016,24(1):67-77.
[22]Pogrel MA,Kaban LB,Vargervik K,et al. Surgically assisted rapid maxillary expansion in adults[J]. Int J Adult Orthodon Orthognath Surg,1992,7(1):37-41.
[23]Moura LB,Spin-Neto R,Sverzut CE,et al. Evaluation of the palatal split pattern in surgically rapid maxillary expansion-comparison of tw o techniques[J]. Oral M axillofac Surg,2016,20(3):255-258.
[24]Carlson C,Sung J,Mccomb RW,et al. Microimplantassisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult[J].Am J Orthod Dentofacial Orthop,2016,149(5):716-728.
[25] Cantarella D,Dominguez-Mompell R,Mallya SM,et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander,analyzed w ith a novel 3D method based on CBCT imaging[J]. Prog Orthod,2017,18(1):34.
[26]Thilander B,Nyman S,Karring T,et al. Bone regeneration in alveolar bone dehiscences related to orthodontic tooth movements[J]. Eur J Orthod,1983,5(2):105-114.
[27]Park JJ,Park YC,Lee KJ,et al. Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults:A cone-beam computed tomography study[J]. Korean J Orthod,2017,47(2):77-86.
[2]Bj9rk A,Skieller V. Growth in width of the maxilla studied by the implant method[J]. Scand J Plast Reconstr Surg,1974,8(1-2):26-33.
[3]Bishara SE,Staley RN. Maxillary expansion:Clinical implications[J]. Am J Orthod Dentofacial Orthop,1987,91(1):3-14.
[4]寇波,王春玲,刘东旭,等.年轻成人上颌快速扩弓(YA-RME)对牙颌结构的影响[J].现代口腔医学杂志,2006,20(5):464-467.KOU Bo,WANG Chunling,LIU Dongxu,et al. Dental and skeletal changes of young adults w ith posterior crossbite after rapid maxillary expansion[J]. J M odern Stomatol,2016,20(5):464-467.
[5]Handelman CS,Wang L,BeGole EA,et al. Nonsurgical rapid maxillary expansion in adults:report on 47 cases using the Haas expander[J]. Angle Orthod,2000,70(2):129-144.
[6]Koudstaal MJ,Poort LJ,van der Wal KG,et al. Surgically assisted rapid maxillary expansion(SARM E):a review of the literature[J]. Int J Oral M axillofac Surg,2005,34(7):709-714.
[7] Lee KJ,Park YC,Park JY,et al. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient w ith severe mandibular prognathism[J]. Am J Orthod Dentofacial Orthop,2010,137(6):830-839.
[8] Persson M,Thilander B. Palatal suture closure in man from 15 to 35 years of age[J]. Am J Orthod,1977,72(1):42-52.
[9] Lehman JA Jr,Haas AJ. Surgical-orthodontic correction of transverse maxillary deficiency[J]. Clin Plast Surg,1989,16(4):749-755.
[10]Melsen B. Palatal growth studied on human autopsy material. A histologic microradiographic study[J]. Am J Orthod,1975,68(1):42-54.
[11]Woods M,Wiesenfeld D,Probert T. Surgically-assisted maxillary expansion[J]. Aust Dent J,1997,42(1):38-42.
[12]Seeberger R,Kater W,Davids R. Long term effects of surgically assisted rapid maxillary expansion w ithout performing osteotomy of the pterygoid plates[J]. J Craniomaxillofac Surg,2010,38(3):175-178.
[13]Gallagher V,Gallagher C,Sleeman D. Surgically assisted rapid palatal expansion for management of transverse maxillary deficiency[J]. J Ir Dent Assoc,2002,48(1):18-21.
[14] Northway WM,Meade JB Jr. Surgically assisted rapid maxillary expansion:a comparison of technique, response,and stability[J]. Angle Orthod,1997,67(4):309-320.
[15] Suzuki H,Moon W,Previdente LH,et al. Miniscrewassisted rapid palatal expander(M ARPE):the quest for pure orthopedic movement[J]. Dental Press J Orthod,2016,21(4):17-23.
[16]Pogrel MA,Kaban LB,Vargervik K,et al. Surgically assisted rapid maxillary expansion in adults[J]. Int J Adult Orthodon Orthognath Surg,1992,7(1):37-41.
[17]翁露茜,宋晓佳,李娟,等.腭中缝骨皮质切开辅助快速扩弓矫治15~25岁上颌横向宽度不足患者临床研究[J].浙江大学学报(医学版),2017,46(2):198-205.WENG Luxi,SONG Xiaojia,LI Juan,et al. M idpalatal cortex osteotomy assisted rapid maxillary expansion for correction of maxillary transverse deficiency in young adults[J]. Journal of Zhejiang University(M edical Sciences),2017,46(2):198-205.
[18]贾海潮,厉松,刘松林,等.种植钉辅助上颌快速扩弓治疗年轻成人上颌牙弓狭窄的CBCT分析[J].中华口腔正畸学杂志,2016,23(3):126-131.JIA Haichao,LI Song,LIU Songlin,et al. Effects of microimplant-assisted rapid palatal expansion on maxillary transverse discrepancy in young adult patients:a CBCT analysis[J]. Chin J Orthod,2016,23(3):126-131.
[19]Byloff FK,Mossaz CF. Skeletal and dental changes follow ing surgically assisted rapid palatal expansion[J].Eur J Orthod,2004,26(4):403-489.
[20]Angelieri F,Cevidanes LH,Franchi L,et al. Midpalatal suture maturation:classification method for individual assessment before rapid maxillary expansion[J]. Am J Orthod Dentofacial Orthop,2013,144(5):759-769.
[21] Betts NJ. Surgically assisted maxillary expansion[J].Atlas Oral M axillofac Surg Clin North Am,2016,24(1):67-77.
[22]Pogrel MA,Kaban LB,Vargervik K,et al. Surgically assisted rapid maxillary expansion in adults[J]. Int J Adult Orthodon Orthognath Surg,1992,7(1):37-41.
[23]Moura LB,Spin-Neto R,Sverzut CE,et al. Evaluation of the palatal split pattern in surgically rapid maxillary expansion-comparison of tw o techniques[J]. Oral M axillofac Surg,2016,20(3):255-258.
[24]Carlson C,Sung J,Mccomb RW,et al. Microimplantassisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult[J].Am J Orthod Dentofacial Orthop,2016,149(5):716-728.
[25] Cantarella D,Dominguez-Mompell R,Mallya SM,et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander,analyzed w ith a novel 3D method based on CBCT imaging[J]. Prog Orthod,2017,18(1):34.
[26]Thilander B,Nyman S,Karring T,et al. Bone regeneration in alveolar bone dehiscences related to orthodontic tooth movements[J]. Eur J Orthod,1983,5(2):105-114.
[27]Park JJ,Park YC,Lee KJ,et al. Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults:A cone-beam computed tomography study[J]. Korean J Orthod,2017,47(2):77-86.