Zusammenfassung
Die vorliegende Pilotstudie beschreibt unsere Untersuchungen zum Verhalten der oberen
ersten bleibenden Molaren nach Gaumennahterweiterung (GNE) im Wechselgebiss bei Patienten
mit und ohne seitlichen Kreuzbiss. Dabei wurden die oberen Milcheckzähne und die oberen
zweiten Milchmolaren zur Verankerung herangezogen. Bei 19 Patienten (13 weiblich,
6 männlich) mit ein- oder beidseitigem Kreuzbiss der Sechsjahrmolaren wurden Geräte
zur forcierten Erweiterung der Gaumennaht an den oberen zweiten Milchmolaren und den
Milcheckzähnen festzementiert (Gruppe A). Dieselbe Art von Apparatur wurde bei 13 Patienten
(10 weiblich, 3 männlich) ohne seitlichen Kreuzbiss eingesetzt (Gruppe B). Nach einer
durchschnittlichen Aktivierungsperiode von 15 Tagen und einer Expansion der Maxilla
um 6–8 mm wurde die Schraube fixiert und die Apparatur noch 5–10 Monate lang zur Retention
im Mund belassen. Die oberen Sechsjahrmolaren wurden weder aktiv, noch passiv retiniert.
Zu den folgenden Zeitpunkten wurden kieferorthopädische Modelle angefertigt und ausgewertet:
vor Beginn der Behandlung (T1), nach Abschluss der aktiven Dehnphase (T2) und nach
Entfernen der Apparatur (T3). In Gruppe A betrug die intermolare Distanz zum Zeitpunkt T1
40,6 mm, bei T2 46,0 mm und zum Zeitpunkt T3 46,3 mm. In Gruppe B betrug die intermolare
Distanz 42,4 mm zum Zeitpunkt T1, 46,3 mm bei T2 und 45,4 mm zum Zeitpunkt T3. Die
Kreuzbisse in Gruppe A wurden überstellt; dabei vergrößerte sich die intermolare Distanz
zwischen den bleibenden Molaren spontan und blieb stabil. Diese spontane Expansion
betrug im Durchschnitt etwa die Hälfte der Expansion der Schraube / der zur Verankerung
herangezogenen Milchzähne.
Abstract
This preliminary report describes our evaluation of the behavior of permanent maxillary
first molars subsequent to rapid maxillary expansion (RME) in the mixed dentition
in crossbite and non-crossbite cases; maxillary deciduous canines and second molars
were used as anchorage. The RME appliance was cemented on the maxillary deciduous
second molars and canines in 19 (13 females, 6 males) patients with unilateral or
bilateral permanent molar crossbites (Group A) and in 13 (10 females, 3 males) patients
who had no lateral crossbites (Group B). After a mean appliance activation period
of 15 days for 6–8 mm expansion, the appliance was stabilized and kept in place as
retention for 5–10 months. Neither active nor passive retention was applied on first
permanent molars. Dental casts were produced and evaluated at different points of
time: Before treatment (T1), after active expansion (T2), after removal of the RME
appliance (T3). In Group A, the mean maxillary permanent intermolar width was 40.6 mm
at T1, 46.0 mm at T2, and 46.3 mm at T3. In Group B, 42.4 mm at T1, 46.3 mm at T2,
and 45.4 mm at T3. In Group A the crossbite was corrected; the maxillary permanent
intermolar distance increased spontaneously and remained stable. The mean spontaneous
expansion of permanent maxillary molars was approximately half of the mean expansion
of the screw / the anchor deciduous teeth.
Schlüsselwörter
Frühbehandlung - seitlicher Kreuzbiss - Wechselgebiss - Gaumennahterweiterung
Key words
early treatment - lateral crossbite - mixed dentition - rapid maxillary expansion
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Dr. M. Cozzani
Via Fontevivo 21N
I-19125 La Spezia, Italien
Email: maurocozzani@libero.it