螺旋快速扩弓器对牙弓变化后咬颌诱导顺应性的影响

Articulation-induced compliance following dental arch change with rapid maxillary expansion

为观察螺旋快速扩弓器对牙弓变化后咬颌诱导顺应性的影响,选择2003/2006郑州市中心医院收治的替牙期或恒牙早期上颌狭窄患者17例,应用螺旋快速扩弓器进行扩弓治疗,用电子游标卡尺测量并比较扩弓前、扩弓后及保持半年后的上、下颌的尖牙间、双尖牙间、第一磨牙间牙弓宽度及上颌第一磨牙颌平面夹角。结果表明:①扩弓后上颌尖牙间牙弓宽度平均增加3.9mm,双尖牙间牙弓宽度平均增加4.2mm,第一磨牙间牙弓宽度平均增加5.0mm,上颌第一磨牙颌平面夹角平均减小1.1°。②保持半年后,上颌牙弓宽度增加有回复,但较扩弓前仍有显著改变(P<0.01)。上颌第一磨牙颌平面夹角与矫治前比较差异不显著(P>0.05)。③下颌牙弓宽度在扩弓结束时与扩弓前比较差异不显著(P>0.05),保持半年后下颌牙弓扩大有统计学意义(P<0.01),其中尖牙间牙弓宽度平均增加2.4mm,双尖牙间牙弓宽度平均增加2.6mm,第一磨牙间牙弓宽度平均增加3.2mm。可见螺旋快速扩弓器可以有效扩大上颌牙弓,下颌牙弓在上颌牙弓扩大后由于咬颌的诱导也顺应性增宽。

In order to explore the effect of rapid maxillary expansion on the compliance induced by articulation after dental arch change, this experiment adopted 17 cases of upper mandible stenosis at mixed dentition period to permanent dentition period, who were admitted in the Central Hospital of Zhengzhou from 2003 to 2006. All the patients were subjected to rapid maxillary expansion, and electronic vernier caliper was used to measure and compare the arch widths of canine teeth, premolar, first molar, as well as the included angle between maxillary first molar and plane before expansion, after expansion, and half a year of retention. The result indicated that： ①After the expansion, the average arch widths of maxillary canine teeth, premolar, first molar were increased 3.9 mm, 4.2 mm and 5.0 mm, respectively. The angle of maxillary first molar was decreased 1.1° on average.②After half a year of retention, the increase of maxillary dental arch width recovered, and still significantly different from that before expansion （P 〈 0.01）. There were no significant difference in the angle of maxillary first molar before and after expansion （P 〉 0.05）.③The mandibular arch width after expansion was identical with that before expansion （P 〉 0.05）, and presented significant increase after half a year of retention （P 〈 0.01）. The average arch widths of canine teeth, premolar, first molar were increased 2.4 mm, 2.6 mm and 3.2 mm, respectively. In conclusion, rapid maxillary expansion can enlarge the maxillary dental arch, which will widen the mandibular arch due to the articulation.