上顎の急速な拡大は鼻腔と咽頭気道を拡大するか？検証された分析に基づく三次元的評価

Does rapid maxillary expansion enlarge the nasal cavity and pharyngeal airway? A three-dimensional assessment based on validated analyses.

抄録

目的:

成長期の患者における鼻腔（NC）および咽頭気道（PA）の急速な上顎拡大（RME）に伴う三次元的変化を、革新的で有効な評価方法を用いて評価し、骨格の拡大と気道容積の増大との間に相関関係が存在するかどうかを調査すること。

OBJECTIVES: To evaluate the three-dimensional changes following rapid maxillary expansion (RME) of the nasal cavity (NC) and pharyngeal airway (PA) in growing patients, using innovative and validated evaluation methods and to investigate whether a correlation between skeletal expansion and increase in airway volume exists.

設定とサンプル集団:

(a)RME群：39例（平均年齢10.40±1.74歳）、(b)対照群：29例（平均年齢11.07±1.45歳）。

SETTINGS AND SAMPLE POPULATION: Records of patients who had cone beam computed tomography taken before and after orthodontic treatment with or without RME were retrospectively collected and divided into two groups: (a) RME, 39 patients (mean age 10.40 ± 1.74 years); and (b) control, 29 patients, matched for age (mean age 11.07 ± 1.45 years) and follow-up period.

材料と方法:

NCとPAの総体積と部分体積を算出した。最小断面積と水圧直径を評価するためにPA中心線を決定した。時点間および群間の差を比較するために、対および非対t検定を適用した。口蓋幅と涙小管距離の変化に関するサブグループの比較には、一元配置分散分析（ANOVA）とTukeyの事後検定を用いた。

MATERIAL AND METHODS: Total and partial volumes of the NC and the PA were calculated. The PA centerline was determined to assess the minimal cross-sectional area and hydraulic diameter. Paired and unpaired t test were applied to compare the difference between time points and between groups. One-way ANOVA and post hoc Tukey's tests were used to compare subgroups with respect to changes in palatal width and lacrimal ducts distance.

結果:

すべてのNC、PAおよび骨格パラメータは、RME後に有意に拡大した。RME群のNC体積および臼歯間距離は、対照群と比較して有意に大きかった。最小断面積と水力直径の平均値は、対照群と比較してRME群では当初低かったが、RME治療後に正常化した。

RESULTS: All of the NC, PA and skeletal parameters were significantly enlarged after RME. The NC volume and inter-molar distance in the RME were significantly larger compared to the control group. The initially lower mean values of minimal cross-sectional area and hydraulic diameter in the RME group when compared to the control group normalized after RME treatment.

結論:

検証された分析によると、NC容積の増加は、成長をコントロールした後、長期的にRME後に明らかであった。

CONCLUSIONS: Based on validated analyses, the NC volume increase was evident after RME in the long term after controlling for growth.