个性化微支抗钉辅助快速扩弓器扩展成人腭中缝的疗效

Effect of personalized miniscrew-assisted rapid palatal expander on expansion of the median palatal suture in adults

目的探讨运用数字化技术制作个性化微支抗钉辅助快速扩弓器的过程,并评估用此扩弓器扩展成人腭中缝的疗效。方法使用数字化技术制作个性化微支抗钉辅助快速扩弓器,并运用此扩弓器对1例21岁伴有上颌横向发育不足的成年女性进行扩弓治疗并结合相关文献进行回顾性分析。结果个性化微支抗钉辅助快速扩弓器可采用口内扫描、计算机辅助设计和计算机辅助制造(computer-aided design and computeraided manufacturing,CAD/CAM)和3D打印等数字化技术制作完成,扩弓治疗后,此患者前部腭中缝宽度打开量为3.9 mm,后部腭中缝宽度打开量为3.2 mm,上颌基骨宽度增宽了4.7 mm;上颌双侧第一磨牙倾斜度变化不明显,牙槽嵴高度少量降低。文献复习结果表明运用数字化技术制作个性化扩弓器是扩弓器发展的主流方向,并且支抗钉的初期稳定性对于扩弓治疗能否成功有决定性作用。磨牙倾斜度的增加由多部分组成;牙槽嵴高度的减少会因测量方法而可能被高估。结论个性化微支抗钉辅助快速扩弓器可有效扩展伴有上颌横向发育不足的成年患者的腭中缝,但是扩弓治疗对上颌双侧第一磨牙倾斜度和牙槽嵴高度的影响还需增大样本量进一步探讨。

Objective To investigate the manufacturing procedures of personalized miniscrew-assisted rapid palatal expanders(p MARPE)using digital technologies and to evaluate the effect of the expanders when expanding the midpalatal suture of an adult.Methods Digital technologies were used to make p MARPE,which was used to treat a 21-yearold woman with maxillary transverse deficiency(MTD).The relevant literature on MARPE was reviewed.Results PMARPE could be manufactured using intraoral digital scanning,computer-aided design and computer-aided manufacturing(CAD/CAM),and 3 D printing technologies.After expansion,the width of the anterior midpalatal suture,posterior midpalatal suture and maxillary skeletal width increased by 3.9 mm,3.2 mm and 4.7 mm,respectively.There was nosignificant change in the inclination of maxillary first molars,and the height of alveolar ridge decreased slightly.It could be seen that using digital technologies to manufacture personalized expanders was possible for MARPE,and the initial stability of miniscrews played an important role in the expansion success rate,the increase of molar inclination is composed of many parts,and the decrease of alveolar ridge height may be overestimated due to the measurement method,as shown by a literature review.Conclusion The midpalatal suture of an adult patient with MTD could be expanded by p MARPE.However,the effect of this expander on the inclination of the first molar and alveolar bone height needs to be further studied with a larger sample size.