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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。
OBJECTIVE: To evaluate the changes of teeth and basement bone in patients with lateral maxillary hypoplasia in adults undergoing surgery assisted rapid expansion. Methods: Twenty patients (13 males and 7 females) with maxillary hypoplasia were divided into two groups according to their age, which were expanded arch group and operation group. The patients in the expanded arch group (average age 12.51 ± 0.82 years) underwent orthopedic rapid expansion. Age 19.07 ± 2.54 years old) surgery to facilitate rapid expansion of the bowel. All patients were taken before and after treatment of cranial positioning posterior films and occlusal films, cephalometric analysis, comparison. Results: Significant arch expansion was observed in both groups. The increase of dental arch width was more significant in the operation group. The length of dental arch increased significantly in the arch group, but there was no significant difference between the two groups. Before and after treatment, (P <0.05). Before and after treatment, there was a significant difference between the two groups in the rotation of the palatal plane and the pronation of the palatal plane in the expansion group (P < 0.01). Before and after treatment, the incisors of both maxillary incisors were both inwardly inclined, with no significant difference between the two groups. CONCLUSIONS: Surgery to assist rapid expansion of the transverse process of maxillofacial hypoplasia can achieve good expansion of the maxillary; maxillary and maxillary, maxillary incisors in the sagittal plane is more conducive to the correction of class III malformations; in the case of Choice, more suitable for low-angle cases.