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Informationen aus Orthodontie & Kieferorthopädie 2016; 48(04): 214-220
DOI: 10.1055/s-0042-121090
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Kurzzeiteffekte eines modifizierten Alt-RAMEC-Protokolls zur frühzeitigen Behandlung der Klasse-III-Malokklusion: eine kontrollierte Studie[*]

Short-Term Effects of a Modified Alt-RAMEC Protocol for Early Treatment of Class III Malocclusion: A Controlled Study
C. Masucci
1   Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy
,
L. Franchi
2   Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
,
V. Giuntini
1   Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy
,
E. Defraia
1   Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
04. Januar 2017 (online)

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Zusammenfassung

Zielsetzung: Untersuchung der Auswirkungen eines modifizierten Verfahrens zur forcierten alternierenden Expansion und Konstriktion der Gaumennaht (Alt-RAMEC) in Verbindung mit einer Gesichtsmaske (FM) bei heranwachsenden Patienten mit Klasse-III-Dysgnathie.

Ausführung und Stichprobe: Insgesamt 31 Patienten mit Klasse III (17 männlich, 14 weiblich) wurden nach einem modifizierten Alt-RAMEC/FM-Protokoll in der Abteilung für Kieferorthopädie der Universität Florenz behandelt.

Material und Methoden: Sämtliche Patienten wurden zu Beginn (T1, Durchschnittsalter 6,4±0,8 Jahre) und am Ende der orthopädischen Therapie (T2, Durchschnittsalter 8,1±0,9 Jahre) untersucht. Sie wurden mit einer vergleichbar zusammengesetzten Gruppe aus 31 Klasse-III-Patienten (16 männlich, 15 weiblich) verglichen, die mit forcierter Gaumennahterweiterung und Gesichtsmaske (RME/FM) behandelt worden waren, sowie mit einer passenden Kontrollgruppe aus 21 unbehandelten Patienten mit Klasse-III-Malokklusion (9 männlich, 12 weiblich). Der Vergleich wurde mithilfe von ANOVA und der Benjamini-Hochberg-Korrektur für multiple Testverfahren durchgeführt.

Ergebnisse: Sowohl das Alt-RAMEC/FM- als auch das RME/FM-Protokoll hatten günstige Auswirkungen und führten zur Korrektur der Klasse III. Beim Alt-RAMEC-Protokoll kam es im Vergleich zum RME/FM-Protokoll zu einer effektiveren Nachentwicklung des Oberkiefers (SNA +1,2°) und zu größeren intermaxillären Veränderungen (ANB +1,7°). In Hinblick auf skelettale Veränderungen des Unterkiefers und auf die vertikalen skelettalen Lagebeziehungen ergaben sich keinerlei signifikante Unterschiede zwischen beiden Protokollen.

Schlussfolgerung: Im Vergleich zur RME/FM-Therapie hatte das Alt-RAMEC/FM-Protokoll günstigere kurzfristige Auswirkungen auf die Therapie von heranwachsenden Klasse-III-Patienten.

Abstract

Objectives: To assess the effects of a modified alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol in combination with facemask (FM) in Class III growing patients.

Setting and Sample Population: 31 Class III patients (17 males, 14 females) were treated with a modified Alt-RAMEC/FM protocol at the Department of Orthodontics of the University of Florence.

Material and Methods: All patients were evaluated at the beginning (T1, mean age 6.4±0.8 years) and at the end of orthopedic therapy (T2, mean age 8.1±0.9 years), and they were compared to a matched sample of 31 Class III patients (16 males and 15 females) treated with rapid maxillary expansion and facemask (RME/FM) and to a matched control group of 21 subjects (9 males and 12 females) with untreated Class III malocclusion. The 3 groups were compared with ANOVA with Benjamini-Hochberg correction for multiple tests.

Results: Both the Alt-RAMEC/FM and the RME/FM protocols showed significantly favorable effects leading to correction of the Class III malocclusion. The Alt-RAMEC/FM protocol produced a more effective advancement of the maxilla (SNA +1.2°) and greater intermaxillary changes (ANB +1.7°) vs. the RME/FM protocol. No significant differences were recorded as for mandibular skeletal changes and vertical skeletal relationships.

Conclusion: The Alt-RAMEC/FM protocol induced more favorable skeletal short-term effects compared with RME/FM therapy in Class III growing patients.

Schlüsselwörter

Angle Klasse-III-Malokklusion - Kephalometrie - Frühbehandlung

Key words

angle class III malocclusion - cephalometry - interceptive treatment

* Dieser Artikel wurde im englischen Original veröffentlicht in: Orthod Craniofac Res 17 (4), 259–269.


 

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