腭中缝融合程度对种植体支抗辅助上颌快速扩弓效果的影响

Effect of micro-implant assisted rapid palatal expansion in patients with different radiographic stages of mid-palatal suture maturation

目的通过分析种植体支抗辅助上颌快速扩弓(micro-implant assisted rapid palatal expansion,MARPE)前后患者上颌锥形束CT图像,探讨腭中缝融合程度对MARPE疗效的影响。方法回顾性分析2017年2月至2019年10月于吉林大学口腔医院正畸科就诊的10~34岁上颌横向发育不足患者28例[男性7例,女性21例,年龄(15.5±5.5)岁],分为未融合组[腭中缝未融合,男性4例,女性14例,年龄(13.0±2.4)岁]和融合组[腭中缝开始融合,男性3例,女性7例,年龄(19.9±6.9)岁]。分别于扩弓器植入当天和扩弓治疗结束当天拍摄锥形束CT,将两时间点锥形束CT数据导入Dolphin Imaging软件,测量并比较两组腭中缝打开量、骨性扩弓百分比等测量项目。结果扩弓后未融合组腭中缝平均打开量和骨性扩弓百分比[分别为(4.97±1.47)mm和(71±20)%]均显著大于融合组[分别为(3.23±1.45)mm和(46±18)%](P<0.05)。结论腭中缝融合程度不同的患者MARPE效果差异显著,扩弓前评估腭中缝融合程度对MARPE疗效预估有参考意义。

Objective To evaluate the effect of micro-implant assisted rapid palatal expansion(MARPE)in patients with different radiographic stages of midpalatal suture maturation.Methods Twenty-eight patients[7 males and 21 females;age(15.5±5.5)years]with maxillary transverse deficiency were selected in the Department of Orthodontics,Hospital of Stomatology,Jilin University from February 2017 to October 2019.According to the fusion of the midpalatal suture,the patients were divided into two groups:10 patients[3 males and 7 females;age(19.9±6.9)years]were in fusion group and 18 patients[4 males and 14 females;age(13.0±2.4)years]were in non-fusion group.Each patient had cone-beam CT(CBCT)images taken immediately after the placement of micro-implants(T1)and the completion of maxillary expansion(T2).The CBCT images were analyzed using the Dolphin Imaging software to evaluate the amount of midpalatal expansion and the percentages of bony expansion,etc.Statistical analysis was carried out to compare the two groups.Results After MARPE treatment,the amount of sutural expansion in fusion group was(3.23±1.45)mm while that in non-fusion group was(4.97±1.47)mm(P<0.05).There was a statistically significant difference in the percentages of bony expansion efficiency between the non-fusion group(71±20)%and the fusion group(46±18)%(P<0.05).Conclusions Bony expansion efficiency was affacted by the radiographic stages of midpalatal suture maturation.