Andre Walter, Heinz Winsauer, Eduardo Crespo, David Walter, Clemens Winsauer, Alexander Schwärzler, Sergi Mojal, Ignacio Arcos, Andreu Puigdollers
{"title":"成人上颌扩张：CBCT评估骨骼变化，并确定微型螺钉辅助腭扩张力控制多循环缓慢激活和连续快速激活之间的效率因子- MASPE与MARPE。","authors":"Andre Walter, Heinz Winsauer, Eduardo Crespo, David Walter, Clemens Winsauer, Alexander Schwärzler, Sergi Mojal, Ignacio Arcos, Andreu Puigdollers","doi":"10.1186/s13005-024-00474-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before (T1) and after expansion (T2).</p><p><strong>Materials and methods: </strong>The Force Controlled PolyCyclic (FCPC) SLOW palatal expansion group (FCPC-MASPE-G) comprised 35 adults aged 18-54 years and received a skeletal expander limiting expansive force only allowing 500 cN at the activation wrench (force control). Discontinuous, polycyclic activations according to the FCPC-protocol were applied. The MARPE-group (n = 6) underwent continuous RAPID activation without FCPC until the desired width was reached. CBCT scans were taken pre and post-expansion. Inclusion criteria for both groups were successful outcomes without surgical assistance.</p><p><strong>Results: </strong>The maxilla opened transversally in both groups mildly V-shaped, with a pyramidal shape in the coronal plane, impacting the zygomatic bone. Width measurements at T2 indicated superior mechanical response in FCPC-MASPE-G. Response of zygomaticomaxillary sutures was similar in both groups (p < 0.001 to 0.025). Pterygoid process deformations were notably less in FCPC-MASPE-G (0.87-1.35 mm, p < 0.001) compared to MARPE-G (2.70-3.04 mm, p < 0.001 to 0.009). Dental measurements were similar (p < 0.001 to 0.023), but the ratio \"Mid-palatal suture Opening Related to Expander opening\" (M.O.R.E.-factor) was better with 84% in FCPC-MASPE-G than with 50% in MARPE-G.</p><p><strong>Conclusion: </strong>Slow expansion with FCPC protocol effectively widens the maxilla in adults, with significant impact on bones and sutures and less pterygoid process deformation compared to rapid expansion. Cranial complications were absent in both groups.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"20 1","pages":"70"},"PeriodicalIF":2.4000,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610166/pdf/","citationCount":"0","resultStr":"{\"title\":\"Adult maxillary expansion: CBCT evaluation of skeletal changes and determining an efficiency factor between force-controlled polycyclic slow activation and continuous rapid activation for mini-screw-assisted palatal expansion - MASPE vs. MARPE.\",\"authors\":\"Andre Walter, Heinz Winsauer, Eduardo Crespo, David Walter, Clemens Winsauer, Alexander Schwärzler, Sergi Mojal, Ignacio Arcos, Andreu Puigdollers\",\"doi\":\"10.1186/s13005-024-00474-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before (T1) and after expansion (T2).</p><p><strong>Materials and methods: </strong>The Force Controlled PolyCyclic (FCPC) SLOW palatal expansion group (FCPC-MASPE-G) comprised 35 adults aged 18-54 years and received a skeletal expander limiting expansive force only allowing 500 cN at the activation wrench (force control). Discontinuous, polycyclic activations according to the FCPC-protocol were applied. The MARPE-group (n = 6) underwent continuous RAPID activation without FCPC until the desired width was reached. CBCT scans were taken pre and post-expansion. Inclusion criteria for both groups were successful outcomes without surgical assistance.</p><p><strong>Results: </strong>The maxilla opened transversally in both groups mildly V-shaped, with a pyramidal shape in the coronal plane, impacting the zygomatic bone. Width measurements at T2 indicated superior mechanical response in FCPC-MASPE-G. Response of zygomaticomaxillary sutures was similar in both groups (p < 0.001 to 0.025). Pterygoid process deformations were notably less in FCPC-MASPE-G (0.87-1.35 mm, p < 0.001) compared to MARPE-G (2.70-3.04 mm, p < 0.001 to 0.009). Dental measurements were similar (p < 0.001 to 0.023), but the ratio \\\"Mid-palatal suture Opening Related to Expander opening\\\" (M.O.R.E.-factor) was better with 84% in FCPC-MASPE-G than with 50% in MARPE-G.</p><p><strong>Conclusion: </strong>Slow expansion with FCPC protocol effectively widens the maxilla in adults, with significant impact on bones and sutures and less pterygoid process deformation compared to rapid expansion. Cranial complications were absent in both groups.</p>\",\"PeriodicalId\":12994,\"journal\":{\"name\":\"Head & Face Medicine\",\"volume\":\"20 1\",\"pages\":\"70\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-12-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610166/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Head & Face Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13005-024-00474-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Head & Face Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13005-024-00474-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Adult maxillary expansion: CBCT evaluation of skeletal changes and determining an efficiency factor between force-controlled polycyclic slow activation and continuous rapid activation for mini-screw-assisted palatal expansion - MASPE vs. MARPE.
Aim: This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before (T1) and after expansion (T2).
Materials and methods: The Force Controlled PolyCyclic (FCPC) SLOW palatal expansion group (FCPC-MASPE-G) comprised 35 adults aged 18-54 years and received a skeletal expander limiting expansive force only allowing 500 cN at the activation wrench (force control). Discontinuous, polycyclic activations according to the FCPC-protocol were applied. The MARPE-group (n = 6) underwent continuous RAPID activation without FCPC until the desired width was reached. CBCT scans were taken pre and post-expansion. Inclusion criteria for both groups were successful outcomes without surgical assistance.
Results: The maxilla opened transversally in both groups mildly V-shaped, with a pyramidal shape in the coronal plane, impacting the zygomatic bone. Width measurements at T2 indicated superior mechanical response in FCPC-MASPE-G. Response of zygomaticomaxillary sutures was similar in both groups (p < 0.001 to 0.025). Pterygoid process deformations were notably less in FCPC-MASPE-G (0.87-1.35 mm, p < 0.001) compared to MARPE-G (2.70-3.04 mm, p < 0.001 to 0.009). Dental measurements were similar (p < 0.001 to 0.023), but the ratio "Mid-palatal suture Opening Related to Expander opening" (M.O.R.E.-factor) was better with 84% in FCPC-MASPE-G than with 50% in MARPE-G.
Conclusion: Slow expansion with FCPC protocol effectively widens the maxilla in adults, with significant impact on bones and sutures and less pterygoid process deformation compared to rapid expansion. Cranial complications were absent in both groups.
期刊介绍：
Head & Face Medicine is a multidisciplinary open access journal that publishes basic and clinical research concerning all aspects of cranial, facial and oral conditions.
The journal covers all aspects of cranial, facial and oral diseases and their management. It has been designed as a multidisciplinary journal for clinicians and researchers involved in the diagnostic and therapeutic aspects of diseases which affect the human head and face. The journal is wide-ranging, covering the development, aetiology, epidemiology and therapy of head and face diseases to the basic science that underlies these diseases. Management of head and face diseases includes all aspects of surgical and non-surgical treatments including psychopharmacological therapies.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
