种植钉辅助上颌快速扩弓对上颌骨三维位置的影响  

Effects of Miniscrew-assisted Rapid Palatal Expansion on Three-dimension Position of Maxilla

作　　者：刘佳君 熊晖 LIU Jiajun;XIONG Hui(Department of Orthodontics 1,Hospital of Stomatology,Wuhan University,Wuhan 430079,China.)

机构地区：[1]武汉大学口腔医院正畸一科,湖北武汉430079

出　　处：《口腔医学研究》2024年第4期330-336,共7页Journal of Oral Science Research

摘　　要：目的:研究成年患者种植钉辅助上颌快速扩弓(miniscrew-assisted rapid palatal expansion,MARPE)后上颌骨在矢状向和垂直向的变化。方法:选择种植钉辅助上颌快速扩弓的45例成年患者进行回顾性研究,其中女性38例,男性7例,平均年龄(21.7±3.4)岁。通过将患者扩弓前和扩弓后即刻的CBCT导入Dolphin 11.9软件和MIMICS 21.0软件,通过Dolphin校正头位后,在MIMICS中将患者扩弓前和扩弓后的CBCT数据生成的三维重建模型进行配准,然后对扩弓前和扩弓后的前鼻棘、鼻额缝最前下端鼻骨端、鼻骨最前下端、颧颌缝最上端颌骨端、颧额缝最内侧额骨端和颞颧缝最下端颧骨端进行定点,测量并计算扩弓前后上述点在矢状向和垂直向的变化。结果:扩弓后前鼻棘矢状向和垂直向上左侧向前(0.52±0.58)mm,向下(0.49±0.93)mm;右侧向前(0.70±0.86)mm,向下(0.41±0.97)mm,并且结果都具有统计学意义(P<0.05)。鼻额缝最前下端鼻骨端、鼻骨最前下端、颧颌缝最上端颌骨端、颧额缝最内侧额骨端和颞颧缝最下端颧骨在矢状向和垂直向上基本向后移动0.06~0.30 mm,向上移动0.10~0.55 mm,绝大部分具有统计学意义。结论:成年患者种植钉辅助上颌快速扩弓时,上颌骨向前向下移位;上颌骨上方相邻结构向上向后移位。Objective:To research the sagittal and vertical changes of the maxilla after miniscrew-assisted rapid palatal expansion(MARPE)in adult patients.Methods:A retrospective study was performed on 45 adult patients who underwent miniscrew-assisted rapid palatal expansion,including 38 females and 7 males,with an average age of(21.7±3.4)years.By importing patients’CBCT data before and immediately after the expansion into the Dolphin11.9 software and MIMICS21.0 software,after correcting the head position through Dolphin,the 3D reconstruction of the CBCT data is generated in MIMICS.The model was registered,and then the anterior nasal spines before and after the expansion of the palatal,the most anterior and inferior nasal bone end of the nasofrontal suture,the most anterior and inferior end of the nasal bone,the uppermost jaw end of the zygomaticomaxillary suture,the innermost frontal bone end of the zygomatic frontal suture,and the lowermost zygomatic bone end of the temporal zygomatic suture were fixed.The sagittal and vertical changes of above points before and after palatal expansion were measured and calculated.Results:After palatal expansion,in the sagittal and vertical direction,the anterior nasal spine was(0.52±0.58)mm forward and(0.49±0.93)mm downward on the left side,and(0.70±0.86)mm forward and(0.41±0.97)mm downward on the right side,both of which were statistically significant(P<0.05).The most anterior and inferior nasal bone end of the nasofrontal suture,the most anterior and inferior end of the nasal bone,the uppermost jaw end of the zygomaticomaxillary suture,the innermost frontal bone end of the zygomatic frontal suture,and the lowermost zygomatic bone end of the zygomatic temporal suture were generally backward 0.06 mm to 0.30 mm and upward 0.10 mm to 0.55 mm,most of which were statistically significant.Conclusion:When adult patients are treated with MARPE,the maxilla is moved forward and downward,and the adjacent structures above the maxilla are moved upward and backwards.

关 键 词：种植钉辅助上颌快速扩弓 上颌骨横向宽度不足 

分 类 号：R783.5[医药卫生—口腔医学]