Evaluation of Hard Tissue Changes in Skeletally Matured Patients with Maxillary Transverse Discrepancy Treated by Rotterdam Palatal Distractor

对采用鹿特丹腭牵引器治疗上颌横向错颌畸形骨骼成熟患者的硬组织变化进行评估

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Abstract

OBJECTIVE: The aim of this clinical study was to evaluate the hard tissue changes in skeletally mature adult patients with maxillary transverse deficiency (MTD) managed using Rotterdam Palatal Distractor and to access bony and dental changes that occur in transverse plane during transpalatal distraction using radiographs and dental study models, respectively. METHODS: Ten adult patients with MTD were treated with a Rotterdam Palatal Distractor (RPD). Dental study models, postero-anterior (PA) and lateral cephalograms were obtained pre-operatively (T0), at the end of consolidation period of 3 months (T1) and after six months into retentive phase (T2). The statistical analysis of the obtained data was analyzed using paired 'T' test. Two-'tailed' tests were applied for getting significance of changes observed on dental study models and radiographs. RESULTS: The study model measurements illustrated statistically significant increase in inter-central incisor width (+ 4.12 mm), inter-canine width (+ 5.23 mm), inter-first premolar width (+ 5.62 mm) and inter-first molar width (+ 5.11 mm). The PA cephalogram measurements demonstrated statistically significant increase in effective nasal cavity width (+ 3.89 mm), skeletal maxillary width (+ 4.51 mm) and inter-last molar width (+ 5.15 mm). The lateral cephalogram measurements demonstrated statistically significant increase in SNA (+ 0.90), decrease in SNB (- 0.70), increase in ANB (+ 1.60) and increase in SN-Go-Gn (+ 2.80). CONCLUSIONS: Surgically assisted rapid maxillary expansion is an established procedure for the management of MTD in skeletally mature individuals. The efficacy of bone-borne distractors in achieving maxillary expansion has been confirmed clinically and radiologically in our study.

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