基于隐形矫治器的扩弓螺丝和镍钛腭板扩弓器对单侧唇腭裂患者气道尺寸及睡眠参数的影响：一项随机临床试验。
完整摘要 · 中文译文
目的：本研究比较了在睡眠问卷评分升高的混合牙列患者中，基于透明矫治器的扩弓螺钉（CAE）与镍钛腭部扩弓器的疗效。 方法：对24名存在上颌横向发育不足且睡眠问卷评分升高的UCLP患者进行了一项随机临床试验。参与者被分配接受CAE或NiTi腭部扩弓器治疗。在扩弓前后进行锥形束计算机断层扫描（CBCT）和多导睡眠监测（PSG）。评估气道容积和睡眠参数的变化。进行相关性分析以确定扩弓特征与气道或PSG结果之间的关联。 结果：扩弓前后的锥形束计算机断层扫描（CBCT）和多导睡眠监测（PSG）显示，两种方式均显著改善了咽部气道容积和睡眠参数。两组均表现出咽部气道容积和PSG参数的显著改善。基于CBCT的横向测量确认两组尖牙间宽度、磨牙间宽度、基骨宽度和磨牙颊侧倾斜均显著增加，其中第1组在尖牙间宽度和磨牙间宽度上的增加显著大于第2组。相关性分析显示，尖牙间宽度的变化与鼻咽、口咽及总咽部气道容积的增加之间存在统计学显著正相关，磨牙间宽度的变化与口咽部气道容积之间也存在显著正相关；未观察到其他显著相关性。 未观察到J-J'宽度、基骨宽度或磨牙颊向倾斜与气道或PSG参数之间存在相关性。在NiTi组中，骨骼扩张与Δ最低SpO₂之间观察到统计学上显著负相关。 结论：CAE和NiTi腭扩张器均显著改善UCLP患者的气道尺寸和睡眠参数。前部横向扩展（尖牙间和磨牙间宽度）与气道容积增加呈正相关，而基骨横向扩展（J-J'宽度、基骨宽度）和磨牙倾斜度则无此相关性，提示整体扩张效应而非其机制亚型可能是功能获益的主要驱动因素。两种装置显示出相当的临床有效性。
完整摘要 · 英文原文
PURPOSE: This study compared the outcomes of clear aligner-based expansion screw (CAE) and nickel-titanium palatal expanders in mixed dentition patients with elevated sleep questionnaire scores. METHODS: A randomized clinical trial was conducted on 24 UCLP patients presenting with transverse maxillary deficiency and elevated sleep questionnaire scores. Participants were allocated to treatment with either CAE or NiTi palatal expander. Cone-beam computed tomography (CBCT) and polysomnography (PSG) were performed before and after expansion. Changes in airway volume and sleep parameters were assessed. Correlation analyses were conducted to determine associations between expansion characteristics and airway or PSG outcomes. RESULTS: Pre- and post-expansion Cone-Beam Computed Tomography (CBCT) and polysomnography (PSG) showed that both modalities significantly improved pharyngeal airway volume and sleep parameters. Both groups demonstrated significant improvements in pharyngeal airway volume and PSG parameters. CBCT-based transverse measurements confirmed significant increases in intercanine width, intermolar width, basal bone width, and buccal tipping of molar in both groups, with group1 showing significantly greater gains in intercanine and intermolar width than group 2. Correlation analysis revealed statistically significant positive correlations between the change in intercanine width and increases in nasopharyngeal, oropharyngeal, and total pharyngeal airway volume, and between the change in intermolar width and oropharyngeal airway volume; no significant correlations were observed for J-J' width, basal bone width, or buccal tipping of molar with airway or PSG parameters. A statistically significant negative correlation was observed between skeletal expansion and Δ minimum SpO₂ in the NiTi group. CONCLUSION: Both CAE and NiTi palatal expanders significantly improved airway dimensions and sleep parameters in UCLP patients. Anterior transverse widening (intercanine and intermolar width) correlated positively with airway volume gains, whereas basal skeletal widening (J-J' width, basal bone width) and molar inclination did not, suggesting that the overall expansion effect rather than its mechanistic subtype may be the primary driver of functional benefit. Both appliances demonstrated comparable clinical effectiveness.