| Objective:In this study,CBCT images of patients with different degrees of palatal suture fusion after implant anchorage assisted arch expansion were observed to compare the differences in the efficiency of arch expansion,so as to explore the influence of the degree of palatal suture fusion on the efficiency of maxillary arch expansion,providing reference for clinicians to choose the method of arch expansion,and also providing important reference for the subsequent development of reasonable and feasible correction plans for arch expansion.Methods:Patients with maxillary transverse deficiency treated with MSE were recruited from the Department of Orthodontics,General Hospital of Northern Theater Command,Thirty-five patients were selected according to the inclusion criteria,including 25 females and 20 males.The stages of the medial palatal suture observed by CBCT were classified into stages C,D and E.CBCT images were taken on the day of MSE dental expansion and the day of the end of expansion,all the photographs were performed by the same senior dental outpatient radiographer,The patient was in a sitting position with the plane of the orbitoear parallel to the ground,and the scan was performed while the teeth were interlacing.All scanned data were saved in DICOM format and imported into Invivo Dental 5.0 software for measurement.The width of the medial palatal suture,the width of the maxillary base bone,the tilt Angle of the first molar,the tilt Angle of the implant nail,the bone expansion rate,the width of the outermost sphenoid plate,the width of the nasofrontal suture and the width of the outermost zygomatic bone before and after treatment were measured.All measurements were taken by the same experimenter and repeated for 3 times with an interval of 7 days to ensure the accuracy of the measured data.The measured data were imported into SPSS26.0 software for statistical analysis.Paired sample t test was performed on the data of all patients before and after MSE augmentation.ANOVE variance analysis was used for patients with different degrees of fusion at stage C,D and E.The correlation between the expansion of palatal sutures and the change of surrounding tissues was analyzed and compared by Pearson correlation analysis.Results:After MSE arch expansion,the bone expansion rate of patients with palatal suture fusion degree at stage C was(65.54±11.32)%,the incline Angle of implant nail was increased by(10.42±3.92)°,the width of sphenoid wing plate was increased by(4.44±1.22)mm,and the width of nasofrontal suture was increased by(1.52±0.55)mm.The distance between cheekbones increased(2.33±0.93)mm,and the width of nasal cavity increased(3.70±1.06)mm.The bone expansion rate of stage D patients was(45.67±10.86)%,the tilt Angle of implant nail increased(15.97±8.84),the width of sphenoid wing plate increased(3.06±1.51)mm,the width of nasofrontal suture increased(1.18±0.60)mm,and the spacing between cheekbones increased(1.79±1.06)mm.The width of nasal cavity increased(2.77±1.19)mm,the bone expansion rate of stage E patients was(29.51±6.50)%,the tilt Angle of implant nail increased(22.41±3.10),the width of sphenoid wing plate increased(1.07±0.41)mm,and the width of nasofrontal suture increased(0.48±0.13)mm.Zygomatic spacing increases(0.57 + 0.14)mm,nasal cavity width increase(1.05 + 0.40)mm,after statistical analysis found that the three statistical differences between(P ＜ 0.05).Integration degree is higher,the tilt of the first molars,the greater the gap between statistical differences(P ＜ 0.05).Conclusion:The degree of fusion of palatine suture will affect the efficiency of arch expansion.The lower the degree of fusion,the better the effect of arch expansion.The implant-assisted maxillary arch expansion will affect the surrounding structure while opening the palatal suture,and the closer the arch expansion device is,the more obvious the change is.Ultrasonic bone knife assisted MSE maxillary expansion can effectively open the palate suture with high degree of fusion. |
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