MARPE-페이스마스크 치료가 성장기 III급 부정교합 환자의 비강 용적에 미치는 영향

다국어 초록 (Multilingual Abstract)

Introduction : Class III malocclusion combines sagittal disharmony (maxillary retrusion and/or mandibular prognathism) with frequent transverse deficiency. Tooth- borne RME can widen the nasal floor, but skeletal/airway effects are inconsistent. MARPE enhances skeletal expansion; adding facemask (FM) protraction may further augment three-dimensional (3D) nasal remodeling. We compared MARPE alone versus MARPE+FM in growing patients using standardized CBCT-based outcomes(3D modeling). The primary endpoint was change in total nasal cavity volume; secondary endpoints were changes in maximum anteroposterior (A–P) length and maximum transverse width. Methods : Total of 32 patients included aged 8–14 years (16 per group: MARPE-only and MARPE+FM). DICOM data were processed in 3D Slicer using air–threshold segmentation with targeted manual refinement as needed, and boundaries were standardized using reproducible anatomical landmarks. Within-group comparisons used paired tests, and between-group comparisons of Δ used independent tests. All analyses were performed by a single experienced examiner according to a standard operating procedure. Result : There were no statistically significant between-group differences at baseline in initial values, age, or observation/treatment duration. Within-group analyses showed significant T0→T1 increases in total nasal cavity volume, maximum anteroposterior (A– P) length, and maximum transverse width in both cohorts (all p < 0.05). In between-group comparisons of change scores, the MARPE+FM group demonstrated significantly greater increases than the MARPE-only group in total nasal cavity volume and in maximum A– P length (both p < 0.05), whereas the increase in maximum transverse width did not differ between groups (p > 0.05). Conclusion : In growing Class III patients, both protocols significantly enlarged the nasal cavity; however, when maxillary protraction is clinically indicated, MARPE+FM not only achieves the primary objective of advancing the maxilla but also confers ancillary increases in anteroposterior (A–P) nasal length and total nasal cavity volume that are greater than those observed with MARPE alone. By contrast, when transverse normalization is the sole treatment objective, MARPE alone may be sufficient. Collectively, these findings support the selection of MARPE+FM in candidates for maxillary protraction, where concurrent anatomic—and potentially functional—benefits beyond transverse expansion are desired.

목차 (Table of Contents)

• Ⅰ. Introduction 1
• Ⅱ. Material and Methods 4
• Ⅲ. Results 10
• Ⅳ. Discussion 13
• Ⅴ. Conclusion 19
• References 20
• Korean Abstract 22