{"title":"具有不同开口的扩张器和扇形扩张器产生的垂直和矢状面变化：一项随机对照试验的事后分析。","authors":"Rodrigo Teixeira, Camila Massaro, Daniela Garib","doi":"10.1177/14653125231208465","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE).</p><p><strong>Design: </strong>Two-arm parallel randomised clinical trial (RCT).</p><p><strong>Methods: </strong>This study comprised cone-beam computed tomography-derived cephalometric images from 48 participants from a RCT. The sample was randomly allocated into two groups. The study was single-blinded. In total, 24 participants were treated with rapid maxillary expansion (RME) using EDO and 24 participants underwent RME using FE. The primary outcomes were the dentoskeletal vertical changes produced by RME. The secondary outcomes were the dentoskeletal sagittal changes. A cephalometric analysis was performed before treatment and 1 or 6 months after the active phase of RME using Dolphin Imaging Software. Intergroup comparisons of interphase changes were performed using the <i>t</i>-test and Mann-Whitney U test (<i>P</i> < 0.05).</p><p><strong>Results: </strong>The final sample comprised 24 patients (11 men, 13 women; mean age = 7.6 ± 0.9 years) in the EDO group and 24 patients (10 men, 14 women; mean age = 7.8 ± 0.9 years) in the FE group. Both expanders produced a similar clockwise rotation of the mandible (FMA; mean difference [MD] = 0.09°, 95% confidence interval [CI] = -1.01 to 0.84). In the FE group, a greater increase of the SNA angle was observed after expansion compared to the EDO group (MD = 1.04°, 95% CI = -1.90 to -1.58). A greater palatal torque of maxillary incisors was observed in the FE group (MD = 1.32°, 95% CI = 0.05-2.56). Of the participants, 54% reported a little discomfort during the active phase of treatment and 46% of the participants did not report any discomfort.</p><p><strong>Conclusion: </strong>Both expanders produced similar vertical cephalometric changes. FEs caused slightly more maxillary anterior displacement after expansion with a compensatory palatal torque of the maxillary incisors compared to the EDOs. However, the amount of sagittal difference was not clinically relevant.</p><p><strong>Trial registration: </strong>The trial was registered at ClinicalTrials.gov, under the identifier NCT03705871.</p>","PeriodicalId":16677,"journal":{"name":"Journal of Orthodontics","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vertical and sagittal changes produced by an expander with differential opening and fan-type expander: A post-hoc analysis of a randomised controlled trial.\",\"authors\":\"Rodrigo Teixeira, Camila Massaro, Daniela Garib\",\"doi\":\"10.1177/14653125231208465\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE).</p><p><strong>Design: </strong>Two-arm parallel randomised clinical trial (RCT).</p><p><strong>Methods: </strong>This study comprised cone-beam computed tomography-derived cephalometric images from 48 participants from a RCT. The sample was randomly allocated into two groups. The study was single-blinded. In total, 24 participants were treated with rapid maxillary expansion (RME) using EDO and 24 participants underwent RME using FE. The primary outcomes were the dentoskeletal vertical changes produced by RME. The secondary outcomes were the dentoskeletal sagittal changes. A cephalometric analysis was performed before treatment and 1 or 6 months after the active phase of RME using Dolphin Imaging Software. Intergroup comparisons of interphase changes were performed using the <i>t</i>-test and Mann-Whitney U test (<i>P</i> < 0.05).</p><p><strong>Results: </strong>The final sample comprised 24 patients (11 men, 13 women; mean age = 7.6 ± 0.9 years) in the EDO group and 24 patients (10 men, 14 women; mean age = 7.8 ± 0.9 years) in the FE group. Both expanders produced a similar clockwise rotation of the mandible (FMA; mean difference [MD] = 0.09°, 95% confidence interval [CI] = -1.01 to 0.84). In the FE group, a greater increase of the SNA angle was observed after expansion compared to the EDO group (MD = 1.04°, 95% CI = -1.90 to -1.58). A greater palatal torque of maxillary incisors was observed in the FE group (MD = 1.32°, 95% CI = 0.05-2.56). Of the participants, 54% reported a little discomfort during the active phase of treatment and 46% of the participants did not report any discomfort.</p><p><strong>Conclusion: </strong>Both expanders produced similar vertical cephalometric changes. FEs caused slightly more maxillary anterior displacement after expansion with a compensatory palatal torque of the maxillary incisors compared to the EDOs. However, the amount of sagittal difference was not clinically relevant.</p><p><strong>Trial registration: </strong>The trial was registered at ClinicalTrials.gov, under the identifier NCT03705871.</p>\",\"PeriodicalId\":16677,\"journal\":{\"name\":\"Journal of Orthodontics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-10-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthodontics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/14653125231208465\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthodontics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/14653125231208465","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Vertical and sagittal changes produced by an expander with differential opening and fan-type expander: A post-hoc analysis of a randomised controlled trial.
Objective: To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE).
Methods: This study comprised cone-beam computed tomography-derived cephalometric images from 48 participants from a RCT. The sample was randomly allocated into two groups. The study was single-blinded. In total, 24 participants were treated with rapid maxillary expansion (RME) using EDO and 24 participants underwent RME using FE. The primary outcomes were the dentoskeletal vertical changes produced by RME. The secondary outcomes were the dentoskeletal sagittal changes. A cephalometric analysis was performed before treatment and 1 or 6 months after the active phase of RME using Dolphin Imaging Software. Intergroup comparisons of interphase changes were performed using the t-test and Mann-Whitney U test (P < 0.05).
Results: The final sample comprised 24 patients (11 men, 13 women; mean age = 7.6 ± 0.9 years) in the EDO group and 24 patients (10 men, 14 women; mean age = 7.8 ± 0.9 years) in the FE group. Both expanders produced a similar clockwise rotation of the mandible (FMA; mean difference [MD] = 0.09°, 95% confidence interval [CI] = -1.01 to 0.84). In the FE group, a greater increase of the SNA angle was observed after expansion compared to the EDO group (MD = 1.04°, 95% CI = -1.90 to -1.58). A greater palatal torque of maxillary incisors was observed in the FE group (MD = 1.32°, 95% CI = 0.05-2.56). Of the participants, 54% reported a little discomfort during the active phase of treatment and 46% of the participants did not report any discomfort.
Conclusion: Both expanders produced similar vertical cephalometric changes. FEs caused slightly more maxillary anterior displacement after expansion with a compensatory palatal torque of the maxillary incisors compared to the EDOs. However, the amount of sagittal difference was not clinically relevant.
Trial registration: The trial was registered at ClinicalTrials.gov, under the identifier NCT03705871.
期刊介绍：
The Journal of Orthodontics has an international circulation, publishing papers from throughout the world. The official journal of the British Orthodontic Society, it aims to publish high quality, evidence-based, clinically orientated or clinically relevant original research papers that will underpin evidence based orthodontic care. It particularly welcomes reports on prospective research into different treatment methods and techniques but also systematic reviews, meta-analyses and studies which will stimulate interest in new developments. Regular features include original papers on clinically relevant topics, clinical case reports, reviews of the orthodontic literature, editorials, book reviews, correspondence and other features of interest to the orthodontic community. The Journal is published in full colour throughout.
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