上颌快速扩弓联合固定矫治器治疗的稳定性研究

Clinical stability of rapid maxillary expansion followed by fixed appliances

目的观察患者接受上颌快速扩弓联合直丝弓矫治器治疗后覆、覆盖及上牙弓宽度的变化。方法选择2003年2月—2008年1月于青岛市口腔医院进行治疗的患者37例(男19例,女18例),将患者分为4个不同的时期进行测量(N1:治疗前;N2:进行上颌快速扩弓后;N3:固定治疗后;N4:保持1年后)。分别测量每位患者的上颌尖牙间宽度、前磨牙间宽度、磨牙间宽度,并对前牙覆盖和覆进行测量。患者的平均年龄(11.3±1.4)岁(10.2～15.3岁)。结果治疗全部结束后、尖牙间宽度、前磨牙间宽度、磨牙间宽度、覆盖、覆分别增加(2.6±2.3)mm、(3.7±2.1)mm、(5.2±2.5)mm、(0.3±0.6)mm、(-0.1±1.6)mm,患者复发率在尖牙宽度为47%,前磨牙间宽度为21%,磨牙间宽度为10%,覆盖复发率为9%,覆为13%。结论患者经过上颌快速扩弓后,在固定矫治阶段复发明显,保持阶段也有一定程度的复发。上颌快速扩弓能够减小覆,增加覆盖。

Objective To study the changes in overjet,overbite and maxillary arch widths in patients who were treated with rapid maxillary expansion followed by straight wire appliances.Methods 37 patients（19 males,18 females）who were treated with rapid maxillary expansion followed by straight wire appliances in Qingdao Stomatology Hospital during February 2003 ~ January 2008 were chosen.Patients were measured at four different stages（before treatment,N1;after rapid maxillary expansion,N2;after treatment,N3;1 after retention for 1 year,N4）.The upper intercanine,interpremolar,intermolar,widths overjet,overbite were measured in each patients.Mean age of the subjects was（11.3±1.4）years（range：10.2-15.3 years） at N1,（11.5±1.4）years（range：10.5-15.6 years） at N2,（13.6±1.6） years（range：12.1-17.6 years） at N3,and（14.4±1.7）years（range：13.1-18.6 years） at N4.Results The net increase in intercanine width,interpremolar width,intermolar width,overjet,and overbite was（2.6±2.3）mm,（3.7±2.1）mm,（5.2±2.5）mm,（0.3±0.6）mm,and（-0.1±1.6）mm,respectively,and the relapse rates were 47% in intercanine width,21% in interpremolar width,and 10% in intermolar width,9% in overjet,13% in overbite at the end of the retention period.Conclusions Maxillary arch widths significantly relapse after retention,while the icrease of intercanine width is the greatest.Rapid maxillary expansion significantly decreases overbite and increases overjet,and a statistically significant decrease can be observed in both overbite and overjet after the retention period.