臺灣博碩士論文加值系統

Purpose: The purpose of this study was to illustrate the indicating factors correlated to the amount of maxillary protraction in pubertal patients with maxillary hypoplasia. Additionally, this study also presented a three dimensional (3D) surface distance difference method for linear comparison in 3D skull models.

Materials and Methods: A total of 54 pubertal subjects who were treated with 7 weeks of alternated rapid maxillary expansion and constriction protocol (Alt-RAMEC); maxillary protraction were included and classified into 20, 14, 20 patients of unilateral complete cleft lip and palate (UCLP), bilateral complete cleft lip and palate (BCLP) and non-cleft Class-III-group, respectively. The pretreatment (T0) and after protraction (T1) cone-beam computed tomography (CBCT) were taken. The midpalatal suture patency index (MSPI, suture-length/bone-length) was examined at four levels of maxilla on the axial sections of CBCT images at T0. The amount of maxillary protraction (AMP) around A-point, canine root tip, and piriform-aperture were measured. The AMP was compared among groups by one-way ANOVA, and the correlation of MSPI and AMP was tested by Pearson correlation analysis.

Results: The AMP was not significantly different among groups (p>0.05). The AMP significantly correlated to MSPI at the coronal third level but not the basal bone level of the UCLP- (r= 0.78, p < 0.01), BCLP- (r =0.85, p <0.001), and non-cleft Class-III- (r =0.71, p <0.001) groups.

Conclusion: The patency of midpalatal suture at coronal third level affects the amount of maxillary orthopedic protraction in pubertal patients with maxillary hypoplasia.

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Preface or Acknowledgments………………………………………………… iii
English Abstract………………………………………………………………… iv
Table of Contents……………………………………………………………… vi
List of Figures ……………………………………………………………… viii
List of Tables ………………………………………………………………… ix
Chapter 1 Introduction…………………………………………………………. 1
Chapter 2 Systematic Review …………………………………………………. 6
2.1 Introduction …………………………………………………………… 6
2.2 Method ……..………………………………………………………… 8
2.2.1 PICO ……………………………………………………………… 8
2.2.2 Criteria for considering studies for systematic review……………. 9
2.2.3 Literature search strategy ….……………………………………… 10
2.2.4 Selection of studies...……………………………………………… 11
2.2.5 Quality assessment……………………..………………………… 11
2.2.6 Data extraction……………………..…………………………..… 12
2.2.7 Statistical analysis……………………..……………………….… 12
2.3 Results ……………………………...………………………………... 12
2.3.1 Literature search and quality evaluation of the included studies…. 12
2.3.2 Systematic results………………..……………..……………...… 13
2.4 Discussion ……………………………...…………..………………... 18
2.5 Conclusions ……………………………...…………………………... 21
Chapter 3 Purpose and hypotheses ………………………………...…………. 22
Chapter 4 Material and Methods………………………………......…………. 23
4.1 Study design ……………………………………………………………23
4.2 Subject Selection..…………………………………………………… 23
4.3 Sampling data and power analysis ………………………………… 25
4.4 Treatment Protocols ………………………………………………… 26
4.5 Data collection..……………………………………………………… 27
4.6 Measurement ..………………………….…………………………… 28
4.7 Statistical analysis..………………………………………………….. 31
Chapter 5 Results ………………….……………………………...………….. 32
Chapter 6 Discussion ……………………………………………...…………. 35
Chapter 7 Conclusions……………. ……………………………...……….…. 41
Bibliography or References……………………………………………………. 42
List of figures………………………………………………………….……….. 54
List of tables………………………………………..………………….……….. 63
Appendix……………………………………………………………………….. 74




 
List of Figures
Figure 2.1 PRISMA flow diagram……………………………………………. 54
Figure 2.2 Meta-analysis……………………………………...………………. 55
Figure 4.1 Summary of the treatment protocol.………………………………. 56
Figure 4.2 3D models surface based registration……………………………... 57
Figure 4.3 Regions of interest (3D models) …………………………………... 58
Figure 4.4 The proposed 3D surface distance difference method ……………. 59
Figure 4.5 Four levels of midpalatal suture patency index (MSPI) observation and measurement…………………….……………………………………………. 60
Figure 5.1 ROC curve for diagnostic test ...…………………………………... 61
Figure 5.2 Sensitivity and Specificity test results……………………………... 62

 
Lists of Tables
Table 2.1 Literature search strategy for all databases…………………………. 63
Table 2.2 Systematic review quality evaluation………………………………. 65
Table 2.3 Summarized demographic data of sample from six studies included in the systematic review ……………………………….…………………………...66
Table 2.4 Summarized systemic data for three dimensional and method of assessment……………………………….………….………………………… 67
Table 4.1 Clinical protocol of Alt-RAMEC………………………………... 68
Table 4.2 Description of landmarks and regions of interest………………….. 69
Table 5.1 Initial demographic and characteristic data ………………….……. 70
Table 5.2 Intragroup and intergroup comparison of amount of maxillary protraction (AMP).……. ……………….…………………………………………………. 71
Table 5.3 AMP comparing between groups……………….…………………. 72
Table 5.4 Correlation analysis of AMP and MSPI ….………………..………. 73

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