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Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion

대한치과교정학회지 2020년 50권 5호 p.304 ~ 313
안윤수, 최성환, 이기준, 정영수, 백형선, 유형석,
소속 상세정보
안윤수 ( Ahn Yoon-Soo ) - Yonsei University College of Dentistry Department of Orthodontics
최성환 ( Choi Sung-Hwan ) - Yonsei University College of Dentistry Department of Orthodontics
이기준 ( Lee Kee-Joon ) - Yonsei University College of Dentistry Department of Orthodontics
정영수 ( Jung Young-Soo ) - Yonsei University College of Dentistry Department of Oral and Maxillofacial Surgery
백형선 ( Baik Hyoung-Seon ) - Yonsei University College of Dentistry Department of Orthodontics
유형석 ( Yu Hyung-Seog ) - Yonsei University College of Dentistry Department of Orthodontics

Abstract


Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion.

Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery.

Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement.

Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

키워드

Miniscrew-assisted rapid palatal expansion; Transverse maxillomandibular discrepancy; Skeletal Class III malocclusion; Stability

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