传统与改良Hyrax扩弓器对牙弓、牙槽骨、基骨影响的CBCT对比研究

摘要/Abstract

摘要： 目的应用CBCT比较传统Hyrax扩弓器与改良Hyrax扩弓器对牙弓、牙槽骨及基骨的影响。方法将30例上颌牙弓狭窄的患者随机分为2组，传统Hyrax扩弓器组15例患者，8男7女，平均年龄（14.1±2.5）岁，改良Hyrax扩弓器组15例患者，9男6女，平均年龄（13.9±2.6）岁。收集2组患者扩弓前及扩弓3个月后的CBCT扫描数据，重建三维影像并测量牙弓、牙槽骨及基骨的相应指标，应用配对样本的t检验分析2组扩弓后测量指标的变化，应用独立样本的t检验分析2组测量指标之间的差异。结果 2组都存在基骨的改变及牙弓宽度的增加，2组之间的比较显示传统Hyrax组的第一、二前磨牙牙弓宽度大于改良Hyrax组，第一磨牙颊侧及腭侧牙槽骨厚度的变化2组并无统计学的差异，而第一前磨牙颊侧及腭侧牙槽骨的厚度变化2组有统计学差异，此外，2组之间绝对牙倾斜度比较也并无统计学差异。结论两种快速扩弓方法对于纠正上颌牙弓狭窄都有较为明显的效果，传统Hyrax扩弓器对第一前磨牙牙弓宽度及颊腭侧牙槽骨厚度的影响更大。

关键词: Hyrax扩弓器, 改良Hyrax扩弓器, 牙弓宽度, 牙槽骨厚度, 基骨宽度

Abstract: Objective To compare the effects of conventional and hybrid Hyrax appliances on arch widths, dentoalveolar and basal bone. Methods 30 patients requiring maxillary expansion were randomly divided into two groups. A conventional hyrax appliance was applied in one group, consisting of 15 patients (8 boys, 7 girls; mean age (14.1±2.5) years), and a hybrid hyrax appliance was used in the other group of 15 patients (9 boys, 6 girls; mean age (13.9±2.6) years). Conebeam computed tomography records were taken before and 3 months after expansion, and dental arch width, dentoalveolar, and basal bone variables were measured on the rebuild 3D images. The pairedsamples test was used to evaluate treatment changes for both groups. The independentsamples test and the t test were used to compare the variables between the two groups. Results Significant basal bone changes and increases in dental arch width were observed in both groups. However, the widths between the first and second premolars were significantly greater in conventional Hyrax appliance than those in hybrid Hyrax appliance. There were no significantly differences in buccal and palatal alveolar bone thickness changes of the first molar between the two groups, whereas changes of the first premolars significantly differed between the two groups. No significant intergroup difference was found in the absolute dental tipping. Conclusions The two rapid expansions are both effective methods for a narrow maxilla treatment. However, the conventional hyrax appliance can result in greater expansion in the premolar dental arch width and the buccal and palatal alveolar bone thickness.

Key words: conventional Hyrax appliances, hybrid Hyrax appliances, dental arch widths, alveolar bone thickness, basal bone width

中图分类号:

R783.5

王小旻陈付蓉李琥. 传统与改良Hyrax扩弓器对牙弓、牙槽骨、基骨影响的CBCT对比研究[J]. , 2016, 36(7): 615-620.

参考文献

[1]Wertz R,Dreskin M.Midpalatal suture opening: a normative study[J].Am J of Orthod,1977,71(4):367-381
[2]Da SFO,Lara TS,de Almeida AM,et al.Evaluation of the midpalatal suture during rapid palatal expansion in children: a CT study[J].J Clin Pediatr Dent,2005,29(3):231-238
[3]Takenouchi H,Mayahara K,Arai Y,et al.Longitudinal quantitative evaluation of the midpalatal suture after rapid expansion using in vivo microCT[J].Arch Oral Biol,2014,59(4):414-423
[4]Schuster G,BorelScherf I,Schopf PM.Frequency of and complications in the use of RPE appliancesresults of a survey in the Federal State of Hesse,Germany[J].J Orofac Orthop,2005,66(2):148-161
[5]Baysal A,Karadede I,Hekimoglu S,et al.Evaluation of root resorption following rapid maxillary expansion using conebeam computed tomography[J].Angle Orthod,2012,82(3):488-494
[6]Garib DG,Menezes MH,Silva Filho OG,et al.Immediate periodontal bone plate changes induced by rapid maxillary expansion in the early mixed dentition: CT findings[J].Dental Press J Orthod,2014,19(3):36-43
[7]Ludwig B,Baumgaertel S,Zorkun B,et al.Application of a new viscoelastic finite element method model and analysis of miniscrewsupported hybrid hyrax treatment[J].Am J Orthod Dentofacial Orthop,2013,143(3):426-435
[8]El H,Palomo JM.Threedimensional evaluation of upper airway following rapid maxillary expansion: a CBCT study[J].Angle Orthod,2014,84(2):265-273
[9]Jingjing Z,Xuemei G.A prospective CBCT study of upper airway changes after rapid maxillary expansion[J].Int J Pediatr Otorhinolaryngol,2013,77(11):1805-1810
[10]Christie KF,Boucher N,Chung CH.Effects of bonded rapid palatal expansion on the transverse dimensions of the maxilla: A conebeam computed tomography study[J].Am J Orthod Dentofacial Orthop,2010,137(4):S79-S85
[11]Rungcharassaeng K,Caruso JM,Kan JY,et al.Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion[J].Am J Orthod Dentofacial Orthop,2007,132(4):428-
[12]Lamparski DG Jr,Rinchuse DJ,Close JM,et al.Comparison of skeletal and dental changes between 2point and 4point rapid palatal expanders[J].Am J Orthod Dentofacial Orthop,2003,123(3):321-328
[13]Farronato G,Giannini L,Galbiati G,et al.Comparison of the dental and skeletal effects of two different rapid palatal expansion appliances for the correction of the maxillary asymmetric transverse discrepancies[J].Minerva Stomatol,2012,61(3):45-55
[14]Chung CH,Font B.Skeletal and dental changes in the sagittal,vertical,and transverse dimensions afterrapid palatal expansion[J].Am J Orthod Dentofacial Orthop,2004,126:569-575
[15]Timock AM,Valane C,Terry N,et al.Accuracy and reliability of buccal bone height and thickness measurements from conebeam computed tomography imaging[J].Am J Orthod Dentofacial Orthop,2011,140(5):734-744
[16]Wood R,Sun Z,Chaudhry J,et al.Factors affecting the accuracy of buccal alveolar bone height measurements from conebeam computed tomography images[J].Am J Orthod Dentofacial Orthop,2013,143(3):353-363
[17]Ballanti F,Lione R,Fanucci E,et al.Immediate and postretention effects of rapid maxillary expansion investigated by computed tomography in growing patients[J].Angle Orthod,2009,79(1):24-29
[18]Sercan A,Schaefer JS,English JD,et al.A conebeam computed tomography evaluation of buccal bone thickness following maxillary expansion[J].. Imaging Sci Dent,2013,43(2):85-90
[19]Garib DG,Janson G,Freitas MRD,et al.Periodontal effects of rapid maxillary expansion with tootht6borne and toothborneexpanders: a computed tomography evaluation[J].Am J Orthod Dentofacial Orthop,2006,129(6):749-758
[20]Wilmes B,Ludwig B,Katyal V,et al.The Hybrid Hyrax Distalizer,a new allinone appliance for rapid palatal expansion,early class III treatment and upper molar distalization[J].J Orthod,2014,41(s1):S47-S53
[21]ChaneFane C,Darqué F.Rapid maxillary expansion assisted by palatal miniimplants in adolescentsPreliminary study[J].Int Orthod,2015,13(1):96-111
[22]Wilmes B,Nienkemper M,Drescher D.Application and effectiveness of a miniimplantand toothborne rapid palatal expansion device: the hybrid hyrax[J].World J Orthod,2010,11(4):323-330
[23]Ludwig B,Baumgaertel S,Zorkun B,et al.Application of a new viscoelastic finite element method model and analysis of miniscrewsupported hybrid hyrax treatment[J].Am J Orthod Dentofacial Orthop,2013,143(3):426-435
[24]Baccetti T,Franchi L,Cameron CG,et al.Treatment timing for rapid maxillary expansion[J].Angle Orthod,2001,71(5):343-350
[25]Franchi L,Baccetti T,McNamara JA.Postpubertal assessment of treatment timing for maxillary expansion and protraction therapy followed by fixed appliances[J].Am J Orthod Dentofacial Orthop,2004,126(5):555-568