The effects of pterygomaxillary disjunction in surgically assisted rapid maxillary expansion: A systematic review and meta-analysis

IF 2.4 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Orthodontics & Craniofacial Research Pub Date : 2024-04-25 DOI:10.1111/ocr.12797

Kuei-Yuan Chen, Cheng-Yu Yang, Chia-Ning Fan, Chin-Shan Kuo, Shou-Zen Fan, Yuan-Wu Chen

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引用次数: 0

Abstract

Objective

This study aims to assess the expansive effects of pterygomaxillary disjunction (PMD) in surgically assisted rapid maxillary expansion (SARME) surgery using a meta-analysis approach.

Materials and Methods

The study conducted a comprehensive literature search across five databases: PubMed, Scopus, Medline, Embase, and Cochrane, adhering to the PRISMA 2020 guidelines. Dental alterations were assessed using either cone-beam computed tomography (CBCT) or dental casts, while skeletal changes were exclusively measured from CBCT scans. We analysed the dentoskeletal changes between PMD +/− groups and conducted a within-group comparison. The primary focus of the results was on the mean differences observed in pre- and post-operative measurements.

Results

Dental expansion was larger in the PMD+ group but not statistically significant. Skeletal expansion showed a significantly larger expansion in the posterior region in the PMD+ group (P = .033). Without PMD, anterior palatal expansion was significantly larger (P = .03), and the buccal tipping of posterior teeth was also significantly larger (P = .011) to achieve acceptable dental expansion outcomes.

Conclusions

Both PMD +/− groups of SARME surgery can achieve satisfactory dental expansion outcomes. However, bone expansion and tooth inclination are also important factors that influence orthodontic treatment and post-expansion stability. By reducing the bony resistance with PMD, larger posterior palatal expansion and more parallel bony expansion are observed. In contrast, without PMD, there is smaller palatal expansion and greater tooth inclination in the posterior region. This could potentially lead to compromised periodontal conditions following expansion.

Abstract Image

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翼颌脱节对手术辅助快速上颌骨扩张的影响：系统回顾和荟萃分析。

材料与方法本研究在五个数据库中进行了全面的文献检索，包括PubMed、Scopus、Medline、Embase和Cochrane：该研究遵循 PRISMA 2020 指南，在 PubMed、Scopus、Medline、Embase 和 Cochrane 五个数据库中进行了全面的文献检索。牙齿的改变通过锥束计算机断层扫描（CBCT）或牙齿模型进行评估，而骨骼的改变则完全通过CBCT扫描进行测量。我们分析了 PMD +/- 组之间的牙齿骨骼变化，并进行了组内比较。结果牙槽骨扩张在 PMD+ 组较大，但无统计学意义。PMD+组后牙区的骨骼扩张明显更大（P = .033）。结论SARME手术的PMD+/-组均可获得令人满意的牙齿扩张效果。然而，骨膨胀和牙齿倾斜也是影响正畸治疗和膨胀后稳定性的重要因素。通过 PMD 减少骨阻力，可以观察到更大的腭后扩张和更平行的骨扩张。相反，如果没有 PMD，后牙区的腭扩展较小，牙齿倾斜度较大。这有可能导致扩张后的牙周状况受到影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthodontics & Craniofacial Research 医学-牙科与口腔外科

CiteScore

5.30

自引率

3.20%

发文量

审稿时长

>12 weeks

期刊介绍： Orthodontics & Craniofacial Research - Genes, Growth and Development is published to serve its readers as an international forum for the presentation and critical discussion of issues pertinent to the advancement of the specialty of orthodontics and the evidence-based knowledge of craniofacial growth and development. This forum is based on scientifically supported information, but also includes minority and conflicting opinions. The objective of the journal is to facilitate effective communication between the research community and practicing clinicians. Original papers of high scientific quality that report the findings of clinical trials, clinical epidemiology, and novel therapeutic or diagnostic approaches are appropriate submissions. Similarly, we welcome papers in genetics, developmental biology, syndromology, surgery, speech and hearing, and other biomedical disciplines related to clinical orthodontics and normal and abnormal craniofacial growth and development. In addition to original and basic research, the journal publishes concise reviews, case reports of substantial value, invited essays, letters, and announcements. The journal is published quarterly. The review of submitted papers will be coordinated by the editor and members of the editorial board. It is policy to review manuscripts within 3 to 4 weeks of receipt and to publish within 3 to 6 months of acceptance.