摘要
目的研究上颌快速扩弓(rapid maxillary expansion,RME)对生长发育期儿童颌面部矢状向软硬组织的影响。方法回顾性分析2018年1月至2020年12月在上海市口腔医院门诊就诊的6~12岁儿童,其中上牙弓狭窄并接受了RME治疗的40例错畸形患儿为试验组,上颌牙弓宽度正常、因个别牙错而就诊的27例患儿作为对照组。所有患者于治疗前(T0)和治疗结束2年后(T1)均拍摄头颅侧位片。图像导入Dolphin Imaging头影测量软件,结果用SPSS 22.0软件进行统计分析。结果试验组和对照组治疗前后软硬组织相关各测量指标差异均有统计学意义。对比两组患儿的治疗效果发现,试验组治疗后SNB值增加、ANB值缩小,而对照组的变化值均明显小于试验组(P<0.05),表明上颌快速扩弓有利于下颌骨矢状向的生长发育。在牙性测量指标中,U1-SN、U1-NA、U1-APog(上中切牙突距)、Overjet(前牙覆盖)在两组间差异均有统计学意义(P<0.01),表明RME对上中切牙的凸度有明显的改善,而对下中切牙却无明显影响。在软组织指标中,RME明显减小了上唇突度、唇间隙和上中切牙暴露程度(P<0.05),但是对鼻部、颏部及其相互关系并无影响。结论RME不仅改善了上牙及上唇突度,还有利于生长发育期儿童下颌矢状向生长发育。
Objective To investigate the effect of rapid maxillary expansion(RME)on sagittal soft and hard maxillofacial tissue in growing children.Methods In this retrospective study,children aged 6-12 years treated in Shanghai Stomatology Hospital from Jan 2018 to Dec 2020 were employed as subjects.Of the subjects,40 patients treated with RME were as the experimental group,27 patients presenting individualized malocclusion were as the control group.Lateral cephalogram was taken before(T0)and 2 years after treatment(T1).The images were imported into Dolphin Imaging’s cephalometric measurement software,and the results were statistically analyzed using SPSS 22.0 software.Results Statistically significant differences were observed in all measurements before and after treatment in both two groups.A comparative analysis revealed that SNB value increased and ANB value decreased in the experimental group after treatment,while the changes in the control group were significantly smaller than those in the experimental group(P<0.05),indicating that RME is beneficial to the growth and development of mandibular in sagittal direction.Among the dentoalveolar measurements,statistically significant differences(P<0.01)were observed in U1-SN(upper incisor to sella-nasion angle),U1-NA(upper incisor to nasion-A point angle),U1-APog(upper incisor to A point-pogonion line distance),and overjet between the two groups.These findings indicate that RME significantly reduces the inclination of the maxillary central incisors,while having no significant effect on the mandibular central incisors.Compared with the control group,RME significantly reduced upper lip prominence,lip space and upper central incisor exposure(P<0.05),but had no effect on nose,chin and their correlation.Conclusion RME not only improved the prominence of the upper teeth and upper lip,but also facilitate the sagittal growth of mandibular in growing children.
作者
向鲜花
杨刚
刘月华
李远远
XIANG Xian-hua;YANG Gang;LIU Yue-hua;LI Yuan-yuan(Department of Pediatric Dentistry,Shanghai Stomatological Hospital,Fudan University,Shanghai 201102,China;Department of Stomatology,SunTo(Jiaxing)Women and Children’s Hospital,Jiaxing 314000,Zhejiang Province,China;Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases,Shanghai 201102,China;Department of Orthodontics,Shanghai Stomatological Hospital,Fudan University,Shanghai 201102,China)
出处
《复旦学报(医学版)》
北大核心
2025年第3期343-348,357,共7页
Fudan University Journal of Medical Sciences
基金
上海市卫健委面上项目(202340147)
国家自然科学基金(82401047)
上海市口腔医院医匠培养计划项目(SHH-2022-YJ-A05)。
关键词
错畸形
上颌快速扩弓(RME)
生长发育
软硬组织
儿童
malocclusion
rapid maxillary expansion(RME)
growth and development
soft and hard tissue
child
