口腔医学 ›› 2025, Vol. 45 ›› Issue (8): 590-595.doi: 10.13591/j.cnki.kqyx.2025.08.005

• 基础与临床研究 • 上一篇    下一篇

数字化流程制作的上颌骨性扩弓器对上颌横向发育不足患者软硬组织的影响

郝舒姝, 娄姝, 杨齐飞, 蔡旻纯, 胡敏, 王震东()   

  1. 南京医科大学附属口腔医院正畸科, 江苏省口腔疾病研究重点实验室,江苏省口腔转化医学工程研究中心, 江苏南京 (210029)
  • 收稿日期:2025-02-01 出版日期:2025-08-28 发布日期:2025-08-21
  • 通讯作者: 王震东 E-mail:wangzhd74@hotmail.com
  • 基金资助:
    江苏省自然科学基金青年项目(BK20220309)

Effects of digitally processed maxillary skeletal expanders on hard and soft tissues in patients with maxillary transverse deficiency

HAO Shushu, LOU Shu, YANG Qifei, CAI Minchun, HU Min, WANG Zhendong()   

  1. Department of Orthodontics, The Affiliated Stomatology Hospital of Nanjing Medical University; Jiangsu Province Key Laboratory of Oral Diseases; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
  • Received:2025-02-01 Online:2025-08-28 Published:2025-08-21

摘要:

目的 探讨上颌横向发育不足患者经数字化流程制作的上颌骨性扩弓器治疗前后其软硬组织的三维变化。方法 选择于南京医科大学附属口腔医院正畸科就诊并经数字化流程制作上颌骨性扩弓器治疗上颌横向发育不足青春期后期或成年患者20例,拍摄治疗前后的锥形束CT,应用Dolphin 11.95软件进行三维测量分析,采用SPSS软件进行统计学分析,采用自身对照配对t检验对上颌横向发育不足患者治疗前后的软硬组织变化进行比较。结果 前部腭中缝宽度、后部腭中缝宽度、上颌根尖基骨宽度、上颌牙槽宽度均显著增大(P<0.001),牙槽嵴倾斜角度、牙槽嵴高度、∠SNA无明显变化(P>0.05);根尖距离、釉牙骨质交界处距离、窝间距离显著增加(P<0.001),第一磨牙倾斜度、∠U1-SN基本不变(P>0.05);上气道体积、鼻底基骨宽度、鼻腔宽度均显著增加(P<0.001)。结论 对于青春期后期或成年的上颌横向发育不足患者,数字化流程制作的上颌骨性扩弓器可近乎平行地扩开腭中缝,从而改善上颌骨横向宽度,改善气道通气量,且牙性副作用较小。

关键词: 上颌骨性扩弓器, 数字化流程, 上颌横向发育不足

Abstract:

Objective To investigate the three-dimensional changes in hard and soft tissues before and after treatment with digitally fabricated maxillary skeletal expanders in patients with maxillary transverse deficiency. Methods Twenty late adolescents or adults with maxillary transverse deficiency treated at the Orthodontic Department of Affiliated Stomatological Hospital of Nanjing Medical University using digitally fabricated maxillary skeletal expanders were included. Cone-beam computed tomography(CBCT) scans were obtained before and after treatment. Three-dimensional measurements were analyzed using Dolphin 3D 11.95 software, and statistical analysis was performed with SPSS software. Paired t-tests were used to compare pre-treatment and post-treatment changes in hard and soft tissues. Results Significant increases were observed in anterior midpalatal suture width, posterior midpalatal suture width, maxillary apical base width, and maxillary alveolar width(P<0.001). No significant changes were found in alveolar ridge inclination, alveolar ridge height, ∠SNA(P>0.05). Significant increases occurred in apical distance, cementoenamel junction distance, and inter-fossa distance(P<0.001), while first molar inclinationand ∠U1-SN remained stable(P>0.05). Significant improvements were noted in upper airway volume, nasal floor base width, and nasal cavity width(P<0.001). Conclusion For late adolescents or adults with maxillary transverse deficiency, digitally fabricated maxillary skeletal expanders can achieve near-parallel expansion of the midpalatal suture, effectively improving maxillary transverse dimensions and airway volume while minimizing dental side effects.

Key words: maxillary skeletal expander, digital workflow, maxillary transverse deficiency

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