加力时间对快速扩弓效果的影响初探

Correlation between circadian rhythm and rapid palatal expansion

目的 采用不同加力时间进行正畸快速扩弓治疗，探讨不同加力时间对快速扩弓治疗的影响和作用，为正畸临床治疗提供依据。方法纳入111例行快速扩弓治疗的连续病例，根据性别分组，男性组55例，女性组56例；平均年龄：男性（11．2±2．1）岁、女性（11．4±2．7）岁，均采用相同固定快速扩弓装置。每组分为0、3、6、9、12、15、18、21点8个时间点亚组加力，每组加力方式相同，每日加力9．8N。通过模型分析测量扩弓量，并进行余弦拟合及方差分析。结果每组8个时间点亚组正畸扩弓量符合余弦函数拟合昼夜节律规律。快速扩弓治疗的扩弓量峰值出现在21点，男性第一磨牙区扩弓量为（6．85±0．10）mm，女性为（6．81±0．15）mm；男性尖牙区扩弓量为（5．75±0．12）mm，女性为（5．54±0．14）mm。而扩弓量谷值出现在9点，男性第一磨牙区扩弓量为（5．88±0．15）mm，女性为（5．76±0．10）mm；男性尖牙区扩弓量为（4．26±0．19）mm，女性为（4．17±0．10）mm。每组8个时间点亚组扩弓量差异均有统计学意义（P〈0．05）。结论不同加力时间可以影响正畸扩弓治疗的效果。快速扩弓治疗较适合在21点前后加力。

Objective To investigate the correlation between circadian rhythm and rapid palatal expansion （RPE）. Methods One hundred and eleven consecutive patients （55 males and 56 females） using the same rapid palatal expansion devices were included in the study. The mean age of males was （ 11.2 ± 2. 1 ） years and the mean age of the females was （ 11.4 ± 2. 7 ） years, According to the activation time （0, 3, 6, 9, 12, 15, 18 and 21 o＇clock） , the patients were divided into eight groups. The data were analyzed using Halberg methods for cosinor-rhythmometry and t test. Results The results of the tooth movement in eight different groups fitted to a cosine curve. The acrophase and bathyphase appeared at 21 and 9 o＇clock, respectively. Conclusions The human circadian rhythm could affect the rapid palatal expansion. This study demonstrated that the best activation time for patients with RPE was around 21 o＇clock.