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DOI: 10.1055/s-2003-40420
© Georg Thieme Verlag Stuttgart · New York
Forcierte Gaumennahterweiterung im Wechselgebiss: Auswirkungen auf die bleibenden Schneidezähne
Rapid maxillary expansion in the mixed dentition: Permanent maxillary incisor behaviorPublication History
Publication Date:
08 July 2003 (online)
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Zusammenfassung
Ziel der vorliegenden Studie war die Untersuchung der Auswirkungen einer im Wechselgebiss durchgeführten forcierten Gaumennahterweiterung auf die bleibenden Schneidezähne, bei Nutzung der oberen Milchzähne zur Verankerung. Die Untersuchungsgruppe (Gruppe A) bestand aus 42 Patienten (21 w, 21 m) mit einem Durchschnittsalter von 8,8 Jahren am Ende der Retentionsphase. Die Kontrollgruppe setzte sich aus 38 Patienten zusammen (23 w, 15 m), war durchschnittlich 9,2 Jahre alt und nicht kieferorthopädisch therapiert worden. Beide Gruppen waren in Hinblick auf Fehlstellungen und Lebensalter gleich. Bei der verwendeten Apparatur handelte es sich um ein von Haas beschriebenes Expansionsgerät, das für die Befestigung an Milchzähnen modifiziert wurde. Nach einer aktiven Phase von durchschnittlich 18 Tagen und einer Aktivierung der Apparatur um 5-8 mm wurden die Schrauben blockiert und die Geräte verblieben weiterhin für mindestens 10 Monate zur Retention im Mund. Die bleibenden Zähne wurden keiner aktiven Kraft oder passiven Retention ausgesetzt. Schließlich wurden Abdrücke genommen und an den Studienmodellen die folgenden Messwerte erhoben: Abstand der seitlichen bleibenden Schneidezähne, Abstand der Eckzähne und Irregularitätsindex. In Gruppe A betrug der durchschnittliche Abstand zwischen den seitlichen bleibenden Schneidezähnen 29,5 ± 2,6 mm und in Gruppe B 26,3 ± 3,1 mm (p < 0,01). Der Abstand der Eckzähne belief sich in Gruppe A auf 36,7 ± 2,3 mm und in Gruppe B 30,1 ± 3,0 mm (p < 0,01). Der durchschnittliche Irregularitätsindex betrug in Gruppe A -1,6 ± 2,8 mm und +3,4 ± 3,1 mm in Gruppe B. Die forcierte Gaumennahterweiterung führte zu einem erhöhten Platzangebot in der Front und erlaubte die spontane Einreihung der bleibenden Schneidezähne. Am Ende der Retentionsphase hatten die Patienten der Untersuchungsgruppe daher besser ausgerichtete Schneidezähne als die der Kontrollgruppe.
Abstract
The purpose of this study was to evaluate the effect on the permanent incisors after a rapid maxillary expansion performed in the mixed dentition using maxillary deciduous teeth as anchorage. The experimental group (Group A) was composed of 42 patients (21 f and 21 m), mean age 8.8 years at the end of retention. The control group (Group B) was composed of 38 patients (23 f and 15 m), mean age 9.2 years who had no previous orthodontic treatment; groups were matched by malocclusion and age. The appliance used in the experimental group was a RPE as described by Haas modified to be anchored on the maxillary deciduous dentition. After a mean appliance activation period of 18 days for 5-8 mm expansion, the appliance was stabilized and kept in place as retention for at least 10 months. No active force nor passive retention was applied on the permanent dentition. Impressions of the dental arches were taken, models were developed, and the following measurements were performed: permanent maxillary interlateral incisor width, maxillary intercuspid width and irregularity index. The mean permanent maxillary interlateral width was 29.5 mm ± 2.6 mm in Group A and 26.3 mm ± 3.1 in Group B (p < 0.01); the mean intercuspid width was 36.7 ± 2.3 mm in Group A and 30.1 ± 3.0 mm in Group B (p < 0.01); the mean irregularity index was -1.6 mm ± 2.8 mm in Group A and + 3.4 mm ± 3.1 mm in Group B (p < 0.01). Rapid maxillary expansion produced more space to allow the spontaneous alignment of the permanent maxillary incisors. Therefore the permanent maxillary incisors of Group A demonstrated, at the end of retention phase, a better alignment compared to the untreated group.
Schlüsselwörter
Forcierte Gaumennahterweiterung - Milchzähne als Verankerung
Key words
Rapid maxillary expansion - deciduous teeth as anchorage
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Dr. Mauro Cozzani
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