Stability of transverse maxillary dental arch dimensions following orthodontic-surgical correction of anterior open bites.
Stability of transverse maxillary dental arch dimensions following orthodontic-surgical correction of anterior open bites.
复制标题
前牙开牙合正畸手术矫正后上颌横向牙弓尺寸的稳定性。
DOI：
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发表时间：
1998
期刊：
影响因子：
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通讯作者：
M. A. van 't Hof
中科院分区：
文献类型：
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作者：
T. Hoppenreijs;F. P. van der Linden;H. Freihofer;P. Stoelinga;D. Tuinzing;B. Jacobs;M. A. van 't Hof
从三个不同的机构收集了130例垂直上颌骨增生、下颌骨发育不全伴高下颌平面角、狭窄锥形上颌牙弓形式和前垂直开牙合患者的样本，以评估开牙合矫正后上颌横向牙弓尺寸的稳定性。手术治疗包括Le Fort I或双颌截骨术。使用Reflex显微镜在牙模型上三维测量磨牙间、磨牙间和前牙弓宽度，并分析正畸或手术上颌扩大后的横向稳定性。在77例患者中进行了正畸扩展，随后进行了单件Le Fort I侵入式截骨术，在53例患者中进行了多节段Le Fort I侵入式截骨术的外科上颌骨扩展。正畸与手术扩弓后牙弓宽度的增加及复发率无显著性差异。平均随访69个月后，这两组中20%的患者的横弓宽度没有复发。额外的双侧矢状劈开截骨术对稳定性没有可检测到的影响。采用多节段Le Fort I截骨术并辅以坚固内固定的患者，其横向稳定性优于骨内钢丝固定和上下颌固定。上颌磨牙间和磨牙间牙弓宽度复发与舌间置或牙列交错缺失无关。这些牙弓宽度的复发与下颌骨顺时针旋转有显着相关性，但与覆牙合或覆盖的变化无关。
A sample of 130 patients with vertical maxillary hyperplasia; mandibular hypoplasia with a high mandibular plane angle; narrow, tapered maxillary dental arch form; and anterior vertical open bite were collected from three different institutions to evaluate the stability of transverse maxillary arch dimensions after correction of the open bite. Surgical treatment consisted of Le Fort I or bimaxillary osteotomies. Intermolar, interpremolar, and anterior arch widths were measured three-dimensionally on dental casts using a Reflex microscope, and transverse stability after orthodontic or surgical maxillary expansion was analyzed. Orthodontic expansion followed by a one-piece Le Fort I intrusion osteotomy was performed in 77 patients, and surgical maxillary expansion by a multisegment Le Fort I intrusion osteotomy was performed in 53 patients. The increase of transverse arch width and the relapse after orthodontic or surgical expansion were not significantly different. The transverse arch width in these two groups did not relapse in 20% of the patients after a mean follow-up of 69 months. An additional bilateral sagittal split osteotomy had no detectable effect on stability. Patients who underwent a multisegment Le Fort I osteotomy stabilized with rigid internal fixation showed better transverse stability than those with intraosseous wire fixation and maxillomandibular fixation. Maxillary intermolar and interpremolar arch width relapses were not correlated with tongue interposition or loss of interdigitation. The relapse of these arch widths showed significant correlations with clockwise rotation of the mandible but not with changes of overbite or overjet.