手术辅助快速扩弓矫治上颌横向发育不足的临床疗效分析

目的:评价手术辅助快速扩弓矫治成人上颌横向发育不足病例牙齿和基骨的变化。方法:上颌发育不足患者20例(男13例,女7例)按年龄分为扩弓组和手术组,扩弓组(平均年龄12.51±0.82岁)行矫形快速扩弓治疗;手术组(平均年龄19.07±2.54岁)行手术协助快速扩弓治疗。所有患者治疗前后摄头颅定位正侧位片和咬合片,头影测量分析、比较。结果:两组病例均有明显的扩弓效果,手术组牙弓宽度增加更为显著,扩弓组牙弓长度增加明显,但组间均无显著性差异;治疗前后,手术组B点显著后移,而扩弓组B点前移,组间有显著性差异(P<0.05);治疗前后,手术组腭平面后旋,扩弓组腭平面前旋,组间有显著性差异(P<0.01);治疗前后,两组病例上颌切牙均内倾,组间无显著性差异。结论:手术协助快速扩弓治疗成人上颌横向发育不足,可取得良好的扩弓效果;对上下颌骨、上颌切牙在矢状面的改变更有利于III类错畸形的矫正;在病例的选择上,更适用于低角病例。

Effects of surgically assisted rapid maxillary expansion in correction of maxillary transverse deficiency

Objective：To evaluate and compare the dental and skeletal changes of orthopedic rapid maxillary expansion （RME） and surgically assisted RME （SARME） of Maxillary Transverse Deficiency. Method： The patients were divided into two groups： the expansion group consisted of 10 patients （six males, four females; mean age, （12.51 ±0.82）years who were treated with orthopedic RME and the surgery group consisted of 10 patients （seven males,three females; average age： （19.07±2.54）years who were treated by surgically assisted RME （SARME）. Cephalograms were taken before and after treatment. Result： There was no significant difference between SARME and RME groups in the effects of arch expansion. But significant differences between the SARME and RME groups were found in the SN/PP（P 〈0.01） and SNA,SNB （P 〈0.05）. Conclusion： SARME works well in arch expansion for maxillary transverse deficiency of adult patient; and at the same time, it is more effective in the correction of Class Ⅲ malloclusion.