种植支抗扩弓矫治上颌横向发育不足的CBCT研究

A CBCT study of maxillary transverse deficiency in the treatment of implant-supported rapid maxillary expansion

目的:借助锥形束CT(cone-beam computed tomography,CBCT)评价种植支抗扩弓矫治上颌横向发育不足的临床疗效。方法:选取符合纳入标准的对象19例,根据扩弓方式分为种植支抗扩弓组和普通扩弓组,初诊时和扩弓结束即刻拍摄CBCT,记录上颌中切牙间出现间隙的情况及腭中缝影像变化。结果:种植支抗扩弓组腭中骨性扩展占总扩展量的42.39%,牙槽骨扩展占38.34%,牙性扩展占19.27%;普通扩弓组骨性扩展量占总扩展量的24.70%,牙槽骨扩展占55.57%,牙性扩展占19.73%;种植支抗扩弓组和普通扩弓组之间骨性扩弓差异具有统计学意义(P<0.05),牙槽扩展和牙性扩展两组之间差异则无统计学意义(P>0.05)。结论::种植支抗扩弓和普通扩弓均能产生明显的骨性扩弓效果;种植支抗扩弓较普通扩弓能产生更大的骨性效应。

Objective： Two different expansion devices were used to evaluate the clinical effectiveness of rapid maxillary expansion（ RME） in the transverse plane that conventional Haas Expander（ HASS） stents and implanted-supported RME instruments. Methods： A sample of 10 patients who have been treated with an implant-supported RME and 9 patients who have been treated with a HASS RME were utilized for this study. Cone-beam computed tomography（ CBCT） scans were taken before treatment and immediately following full activation of the expansion appliances. Defined landmarks were located on the pre-and post-treatment orientated images. Changes in pre-and post-treatment measurements were noted and differences between the two treatment groups were evaluated using the independent samples t-test. Results： At the level of first molar,for implant-supported treatment groups the expansion at the skeletal level was 42. 39% of the total expansion,alveolar level was 38. 34% of the total expansion and the dental level was 19. 27% of the total expansion. For HASS treatment groups the expansion at the skeletal level was 34. 70% of the total expansion,alveolar level was 55. 57% of the total expansion and dental level was 19. 73% of the total expansion. Conclusion： Both groups showed similar results with greater skeletal expansion. Implant-supported RME may produced more expansion at the skeletal level than the HASS RME group.