Биология ва тиббиёт муаммолари 2026, №5 (171)

Subject of the article

КАТТАЛАРДА ЮҚОРИ ЖАҒНИНГ КЎНДАЛАНГ ЕТИШМОВЧИЛИГИ: МИНИВИНТЛИ ВА ЖАРРОҲЛИК ЁРДАМИДА КЕНГАЙТИРИШ ЎРТАСИДА ТАНЛОВ (531-538)

Authors

Абдусаитов Шаҳзод Мусурмонович, Хазратов Алишер Исамиддинович

Institution

Самарқанд давлат тиббиёт университети, Ўзбекистон Республикаси, Самарқанд ш.

Abstract

Мақсад: ўрта танглай чокининг морфологияси ва етилиши, жарроҳлик ёрдамида ҳамда минивинтли кенгайтиришнинг самарадорлиги ва асоратлари, шунингдек катталарда жарроҳликсиз усул муваффақиятининг предикторлари ҳақидаги маълумотларни умумлаштириш. Материал ва усуллар: 1977–2026 йилларда чоп этилган хорижий нашрлар «maxillary transverse deficiency», «midpalatal suture maturation», «SARPE», «MARPE», «maxillary skeletal expander» сўровлари бўйича таҳлил қилинди; шарҳга 61 та манба киритилди. Натижалар: аномалиянинг тарқалиш кўрсаткичлари турли популяцияларда сезиларли фарқ қилади, чунки муаллифлар турли ёш гуруҳлари ва қайд этиш мезонларидан фойдаланади, катталарда эса скелет етишмовчилигининг ҳақиқий частотаси паст баҳоланади. Конус-нурли компьютер томографияси маълумотлари бўйича чок етилишининг беш босқичи (A–E) ажратилади; босқичнинг ёш билан боғлиқлиги суст ва эрта босқичлар катта ёш гуруҳларида ҳам учрайди. Жарроҳлик ёрдамида кенгайтириш (SARPE) кенгайишнинг барқарор скелет компонентини беради, аммо умумий оғриқсизлантириш, касалхонага ётқизиш ва қатор асоратлар билан боғлиқ. Минивинтли скелет экспансияси (MARPE) асосан маҳаллий ва қайтар асоратлар билан скелет кенгайишини таъминлайди, бироқ усулнинг далил базаси кўпроқ ретроспектив тадқиқотларга таянади. Хулоса: катта ёшли беморда усулни танлаш ёшга эмас, чокни бевосита баҳолашга асосланиши керак; MARPE ва SARPE ни ягона морфометрик протокол, оғриқ ва ҳаёт сифатини баҳолаш билан таққослаган проспектив тадқиқотлар йўқ, чокнинг муваффақиятли очилиши предикторларининг чегаравий қийматлари аниқланмаган.

Key words

юқори жағнинг кўндаланг етишмовчилиги, ўрта танглай чоки, минивинтли скелет экспансияси, жарроҳлик ёрдамида кенгайтириш, конус-нурли компьютер томографияси.

Literature

1. Алимирзоев А.Ф., Ризаев Ж.А., Хазратов А.И. Оптимизация методов ранней диагностики де-формаций челюстно-лицевой области при преж-девременном удалении зубов // Проблемы биоло-гии и медицины. - 2026. - № 4 (170). - С. 20–23. 2. Ризаев Ж.А., Муслимова Д.М., Ризаева С.М., Рахманова О.А. Влияние базиса ортодонтических аппаратов на ткани твёрдого нёба на различных этапах расширения верхней челюсти // Стомато-логия (Stomatologiya). - 2018. - Т. 1, № 2 (71). - С. 41–42. - DOI: 10.71337/inlibrary.uz.stomatologiya.1720. 3. Ризаев Ж.А., Кубаев А.С., Абдукадыров А.А. Предоперационное планирование хирургического лечения верхней ретро-микрогнатии // Журнал биомедицины и практики. - 2020. - Специальный выпуск, № 2. - С. 866–873. 4. Ризаев Ж.А., Кубаев А.С., Бузрукзода Ж.Д. Со-временный подход к комплексной реабилитации пациентов с приобретёнными дефектами верхней челюсти (обзор литературы) // Журнал стоматоло-гии и краниофациальных исследований. - 2021. - Т. 2, № 3. - С. 77–83. - DOI: 10.26739/2181-0966-2021-3-15. 5. Ризаев Ж.А., Шамсиев Ж.А., Шамсиев Р.А., Зайниев С.С. Сопутствующие пороки развития у детей с врождённой расщелиной губы и нёба // Журнал стоматологии и краниофациальных ис-следований. - 2020. - Т. 1, № 1. - С. 48–51. - DOI: 10.26739/2181-0966-2020-1-11. 6. Ризаев Ж.А., Кубаев А.С., Абдукадиров А.А. Состояние риномаксиллярного комплекса и его анатомо-функциональных изменений у взрослых больных с верхней микрогнатией // Журнал теоре-тической и клинической медицины. - 2020. - № 3. - С. 162–165. 7. Ризаев Ж.А., Кубаев А.С., Олимжонов К.Ж. Юз-жағ соҳасида суяк-реконструктив операцияла-ридан кейин беморларни комплекс реабилитация қилиш // Биология ва тиббиёт муаммолари. - 2022. - № 4 (137). - С. 167–169. 8. Ahn J.W., Choi J.Y., Kim S.H. Is midpalatal su-ture maturation the major predictor of the success rate of pure bone-borne maxillary skeletal expander? A CBCT study // Seminars in Orthodontics. - 2025. - Vol. 31, № 2. - P. 290–298. - DOI: 10.1053/j.sodo.2024.04.012. 9. Angelieri F., Cevidanes L.H.S., Franchi L., Gon-çalves J.R., Benavides E., McNamara J.A. Jr. Mid-palatal suture maturation: classification method for individual assessment before rapid maxillary expan-sion // American Journal of Orthodontics and Den-tofacial Orthopedics. - 2013. - Vol. 144, № 5. - P. 759–769. - DOI: 10.1016/j.ajodo.2013.04.022. 10. Angelieri F., Franchi L., Cevidanes L.H.S., McNamara J.A. Jr. Diagnostic performance of skele-tal maturity for the assessment of midpalatal suture maturation // American Journal of Orthodontics and Dentofacial Orthopedics. - 2015. - Vol. 148, № 6. - P. 1010–1016. - DOI: 10.1016/j.ajodo.2015.06.016. 11. Angelieri F., Franchi L., Cevidanes L.H.S., Gon-çalves J.R., Nieri M., Wolford L.M., McNamara J.A. Jr. Cone beam computed tomography evaluation of midpalatal suture maturation in adults // Interna-tional Journal of Oral and Maxillofacial Surgery. - 2017. - Vol. 46, № 12. - P. 1557–1561. - DOI: 10.1016/j.ijom.2017.06.021. 12. Anttila A. Feasibility and long-term stability of surgically assisted rapid maxillary expansion with lateral osteotomy // European Journal of Orthodon-tics. - 2004. - Vol. 26, № 4. - P. 391–395. - DOI: 10.1093/ejo/26.4.391. 13. Balasubramanian S., Kalaskar R., Kalaskar A. Rapid maxillary expansion and upper airway volume: systematic review and meta-analysis on the role of rapid maxillary expansion in mouth breathing // In-ternational Journal of Clinical Pediatric Dentistry. - 2022. - Vol. 15, № 5. - P. 617–630. - DOI: 10.5005/jp-journals-10005-2421. 14. Brucculeri L., Pellitteri F., Monterossi A.S., Pao-letto E., Maino G., Lombardo L. Tricortical versus bicortical anchorage in a double-screw tandem skele-tal expander and a single-screw maxillary anchorage rapid palatal expander: a finite element analysis // Korean Journal of Orthodontics. - 2024. - Vol. 56, № 2. - P. 117–126. - DOI: 10.4041/kjod23.270. 15. Brunetto D.P., Sant’Anna E.F., Machado A.W., Moon W. Non-surgical treatment of transverse defi-ciency in adults using microimplant-assisted rapid palatal expansion (MARPE) // Dental Press Journal of Orthodontics. - 2017. - Vol. 22, № 1. - P. 110–125. - DOI: 10.1590/2177-6709.22.1.110-125.sar. 16. Byloff F.K. Skeletal and dental changes follow-ing surgically assisted rapid palatal expansion // Eu-ropean Journal of Orthodontics. - 2004. - Vol. 26, № 4. - P. 403–409. - DOI: 10.1093/ejo/26.4.403. 17. Cantarella D., Karanxha L., Zanata P., Moschik C., Torres A., Savio G., Del Fabbro M., Moon W. Digital planning and manufacturing of maxillary skeletal expander for patients with thin palatal bone // Medical Devices: Evidence and Research. - 2021. - Vol. 14. - P. 299–311. - DOI: 10.2147/MDER.S331127. 18. Cesur Aydin K., Tekin A., Gas S. Midpalatal suture maturation in young individuals: cone-beam computed tomography evidence challenging age-based treatment decisions // Journal of Craniofacial Surgery. - 2026. - DOI: 10.1097/SCS.0000000000012966. 19. Chen W., Zhang K., Liu D. Palatal bone thick-ness at the implantation area of maxillary skeletal expander in adult patients with skeletal Class III malocclusion: a cone-beam computed tomography study // BMC Oral Health. - 2021. - Vol. 21, № 1. - DOI: 10.1186/s12903-021-01489-0. 20. Chhatwani S., Arman A., Möhlhenrich S.C., et al. Performance of dental students, orthodontic resi-dents, and orthodontists for classification of midpal-atal suture maturation stages on cone-beam comput-ed tomography scans // BMC Oral Health. - 2024. - Vol. 24, № 1. - DOI: 10.1186/s12903-024-04163-3. 21. Choi J.Y., Chaudhry K., Parks E., Ahn J.H. Prevalence of posterior alveolar bony dehiscence and fenestration in adults with posterior crossbite: a CBCT study // Progress in Orthodontics. - 2020. - Vol. 21, № 1. - Art. 8. - DOI: 10.1186/s40510-020-00308-6. 22. Dusmukhamedov D.M., Rizaev J.A., Dusmu-khamedov M.Z., Yuldashev A.A. Characteristics of clinical-morphometric parameters and evaluation of results of surgical treatment of patients with gnathic forms of occlusion anomalies // International Journal of Psychosocial Rehabilitation. - 2020. - Vol. 24, № 4. - P. 2156–2169. - DOI: 10.37200/IJPR/V24I4/PR201326. 23. Dusmukhamedov M.Z., Rizaev J.A., Dusmu-khamedov D.M., Khadjimetov A.A., Yuldashev A.A. Compensator-adaptive reactions of patients’ organism with gnathic form of dental occlusion anomalies // International Journal of Psychosocial Rehabilitation. - 2020. - Vol. 24, № 4. - P. 2142–2155. - DOI: 10.37200/IJPR/V24I4/PR201325. 24. Fastuca R., Turiaco H., Assandri F., Zecca P.A., Levrini L., Caprioglio A. Condylar changes in chil-dren with posterior crossbite after maxillary expan-sion: tridimensional evaluation // Children. - 2021. - Vol. 8, № 1. - Art. 38. - DOI: 10.3390/children8010038. 25. Figueiredo L.M., Calixto Barros D.M., Veloso N.C., Lisboa C.O., Mourão C.F., Cury-Saramago A.A., Mattos C.T., de Albuquerque Calasans-Maia J. Is there a difference in mid-palatal suture density after rapid maxillary expansion, surgically assisted rapid maxillary expansion, and miniscrew-assisted rapid palatal expansion? A systematic review and meta-analysis // Applied Sciences. - 2023. - Vol. 13, № 19. - Art. 10841. - DOI: 10.3390/app131910841. 26. Gao L., Sun J., Zhou X., Yu G. In vivo methods for evaluating human midpalatal suture maturation and ossification: an updated review // International Orthodontics. - 2022. - Vol. 20, № 2. - Art. 100634. - DOI: 10.1016/j.ortho.2022.100634. 27. Hamedi-Sangsari A., Chinipardaz Z., Carrasco L. Following surgically assisted rapid palatal expansion, do tooth-borne or bone-borne appliances provide more skeletal expansion and dental expansion? // Journal of Oral and Maxillofacial Surgery. - 2017. - Vol. 75, № 10. - P. 2211–2222. - DOI: 10.1016/j.joms.2017.04.019. 28. Handelman C.S. Adult nonsurgical maxillary and concurrent mandibular expansion: treatment of maxillary transverse deficiency and bidental arch constriction // Seminars in Orthodontics. - 2012. - Vol. 18, № 2. - P. 134–151. - DOI: 10.1053/j.sodo.2011.10.012. 29. Hartono N., Soegiharto B.M., Widayati R. The difference of stress distribution of maxillary expan-sion using rapid maxillary expander (RME) and max-illary skeletal expander (MSE): a finite element analysis // Progress in Orthodontics. - 2018. - Vol. 19, № 1. - DOI: 10.1186/s40510-018-0229-x. 30. Jesus A.S., Oliveira C.B., Murata W.H., Gon-çales E.S., Pereira-Filho V.A., Santos-Pinto A. Na-somaxillary effects of miniscrew-assisted rapid pala-tal expansion and two surgically assisted rapid pala-tal expansion approaches // International Journal of Oral and Maxillofacial Surgery. - 2021. - Vol. 50, № 8. - P. 1059–1068. - DOI: 10.1016/j.ijom.2020.12.014. 31. Kapetanović A., Theodorou C.I., Bergé S.J., Schols J.G.J.H., Xi T. Efficacy of miniscrew-assisted rapid palatal expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis // European Journal of Orthodontics. - 2021. - Vol. 43, № 3. - P. 313–323. 32. Kapetanović A., Odrosslij B.T.C., Baan F., Bergé S.J., Nolte J.W., Schols J.G.J.H., Xi T. Efficacy of miniscrew-assisted rapid palatal expansion (MARPE) in late adolescents and adults with the Dutch Maxil-lary Expansion Device: a prospective clinical cohort study // Clinical Oral Investigations. - 2022. - Vol. 26, № 10. - P. 6253–6263. 33. Kapetanović A., Kuijpers M.A.R., Bergé S.J., Schols J.G.J.H., Xi T. What is the oral health-related quality of life following miniscrew-assisted rapid palatal expansion (MARPE)? A prospective clinical cohort study // BMC Oral Health. - 2022. - Vol. 22, № 1. - Art. 423. 34. Kapetanović A., Noverraz R.R.M., Bruggink R., Baan F., Bergé S.J., Xi T., Schols J.G.J.H. What is the impact of miniscrew-assisted rapid palatal expan-sion on the midfacial soft tissues? A prospective three-dimensional stereophotogrammetry study // Clinical Oral Investigations. - 2023. - Vol. 27, № 9. - P. 5343–5351. 35. Kim H., de Castro A.C.R., Hong C., Lee K.J. Success and failure in miniscrew-assisted rapid pala-tal expansion: biologic and biomechanical clues // Seminars in Orthodontics. - 2025. - Vol. 31, № 2. - P. 280–289. - DOI: 10.1053/j.sodo.2024.07.006. 36. Koudstaal M.J., Smeets J.B.J., Kleinrensink G.J., Schulten A.J.M., van der Wal K.G.H. Relapse and stability of surgically assisted rapid maxillary expan-sion: an anatomic biomechanical study // Journal of Oral and Maxillofacial Surgery. - 2009. - Vol. 67, № 1. - P. 10–14. - DOI: 10.1016/j.joms.2007.11.026. 37. Kurt G., Altug-Atac A.T., Atac M.S., Karasu H.A. Stability of surgically assisted rapid maxillary expansion and orthopedic maxillary expansion after 3 years’ follow-up // The Angle Orthodontist. - 2010. - Vol. 80, № 4. - P. 613–619. - DOI: 10.2319/092409-530.1. 38. Lee J., Choi S., Choi Y.J., Lee K., Yu H. Evalua-tion of miniscrew-assisted rapid palatal expansion success by comparing width of circummaxillary su-tures before expansion in adult male patients // The Angle Orthodontist. - 2023. - Vol. 93, № 2. - P. 176–184. - DOI: 10.2319/062722-456.1. 39. Lim H.M., Park Y.C., Lee K.J., Kim K.H., Choi Y.J. Stability of dental, alveolar, and skeletal chang-es after miniscrew-assisted rapid palatal expansion // Korean Journal of Orthodontics. - 2017. - Vol. 47, № 5. - P. 313–322. - DOI: 10.4041/kjod.2017.47.5.313. 40. Magnusson A., Bjerklin K., Nilsson P., Mar-cusson A. Surgically assisted rapid maxillary expan-sion: long-term stability // European Journal of Or-thodontics. - 2009. - Vol. 31, № 2. - P. 142–149. - DOI: 10.1093/ejo/cjn074. 41. Ni J., Song S., Zhou N. Impact of surgical or-thodontic treatment on quality of life in Chinese young adults with Class III malocclusion: a longitu-dinal study // BMC Oral Health. - 2019. - Vol. 19, № 1. - DOI: 10.1186/s12903-019-0782-9. 42. Olszewski R., Wisniewski M. Complications in surgically assisted rapid maxillary expansion: a sys-tematic review of the medical literature // NEMESIS. - 2019. - Vol. 8, № 1. - P. 20. - DOI: 10.14428/nemesis.v8i1.31583. 43. Parihar A.S., Thomas A., Ajmera H., Mittal N., Kumar V., Roy A. Periodontal health outcomes fol-lowing mini-screw-assisted rapid palatal expansion versus surgically assisted rapid palatal expansion: a comparative analysis // Journal of Pharmacy and Bi-oallied Sciences. - 2025. - Vol. 17, Suppl. 3. - P. S2715–S2717. - DOI: 10.4103/jpbs.jpbs_1191_25. 44. Park J.H. Addressing miniscrew-assisted rapid palatal expander complications // AJO-DO Clinical Companion. - 2022. - Vol. 2, № 5. - P. 421–422. - DOI: 10.1016/j.xaor.2022.07.002. 45. Rizaev J.A., Kubaev A.S. Preoperative mistakes in the surgical treatment of upper retro micrognatia // International Journal of Pharmaceutical Research. - 2020. - Vol. 12, № 1. - P. 1208–1212. - DOI: 10.31838/IJPR/2020.12.01.198. 46. Sakai R.H.U., Marson F.A.L., Sakuma E.T.I., Ribeiro J.D., Sakano E. Correlation between acoustic rhinometry, computed rhinomanometry and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency // Brazilian Journal of Otorhinolaryngology. - 2018. - Vol. 84, № 1. - P. 40–50. - DOI: 10.1016/j.bjorl.2016.10.015. 47. Satiti R., Susanto H., Narwidina A. Transverse maxillary dimensions and upper airway morphology in mouth- and nasal-breathing children aged 10–12 years: a CBCT-based study // Journal of Oral Biology and Craniofacial Research. - 2025. - Vol. 15, № 5. - P. 1064–1070. - DOI: 10.1016/j.jobcr.2025.07.009. 48. Savoldi F., Wong K.K., Yeung A.W.K., et al. Midpalatal suture maturation staging using cone beam computed tomography in patients aged be-tween 9 to 21 years // Scientific Reports. - 2022. - Vol. 12, № 1. - DOI: 10.1038/s41598-022-08293-y. 49. Sayar G., Kılınç D.D. Rapid maxillary expansion outcomes according to midpalatal suture maturation levels // Progress in Orthodontics. - 2019. - Vol. 20, № 1. - DOI: 10.1186/s40510-019-0278-9. 50. Shayani A., Merino-Gerlach M.A., Garay-Carrasco I.A., Navarro-Cáceres P.E., Sandoval-Vidal H.P. Midpalatal suture maturation stage in 10- to 25-year-olds using cone-beam computed tomogra-phy: a cross-sectional study // Diagnostics. - 2023. - Vol. 13, № 8. - Art. 1449. - DOI: 10.3390/diagnostics13081449. 51. Sicca N., Benedetti G., Nieri A., Vitale S., Lop-poni G., Mura S., Verdecchia A., Spinas E. Compar-ison of side effects between miniscrew-assisted rapid palatal expansion (MARPE) and surgically assisted rapid palatal expansion (SARPE) in adult patients: a scoping review // Dentistry Journal. - 2025. - Vol. 13, № 2. - Art. 47. - DOI: 10.3390/dj13020047. 52. Song G., Park J.H., Lee S., Chung D., Moon W. The effect of the anteroposterior position of minis-crew-assisted rapid palatal expansion on the expan-sion outcomes in mature patients // Orthodontics & Craniofacial Research. - 2025. - DOI: 10.1111/ocr.70083. 53. Starch-Jensen T., Blæhr T.L. Transverse expan-sion and stability after segmental Le Fort I osteoto-my versus surgically assisted rapid maxillary expan-sion: a systematic review // Journal of Oral and Max-illofacial Research. - 2016. - Vol. 7, № 4. - DOI: 10.5037/jomr.2016.7401. 54. Taylor N., Johnson P. Surgically assisted rapid maxillary expansion // Orthognathic Surgery. - 2016. - P. 620–629. - DOI: 10.1002/9781119004370.ch36. 55. Wertz R., Dreskin M. Midpalatal suture opening: a normative study // American Journal of Orthodon-tics. - 1977. - Vol. 71, № 4. - P. 367–381. - DOI: 10.1016/0002-9416(77)90241-X. 56. Wilmes B. “Appliance first” or “bone first” for miniscrew assisted rapid palatal expansion? // APOS Trends in Orthodontics. - 2022. - Vol. 12. - P. 3–6. - DOI: 10.25259/APOS_57_2022. 57. Winsauer H., Walter A., Jaeschke D., Winsauer C., Muchitsch A., Wendl B. Pure bone-borne palatal expander anchored on orthodontic mini-implants: Micro-4 or Micro-6 Expander // Journal of Stomatol-ogy. - 2015. - Vol. 68, № 1. - P. 6–18. - DOI: 10.5604/00114553.1144370. 58. Ye G., Li Q., Guo Z., Yu X., Xu Y., Ding W., Wang H., Yu M. Comparative evaluation of trans-verse width indices for diagnosing maxillary trans-verse deficiency // BMC Oral Health. - 2024. - Vol. 24, № 1. - Art. 806. - DOI: 10.1186/s12903-024-04580-4. 59. Yoon A., Payne J., Suh H., Phi L., Chan A., Oh H. A retrospective analysis of the complications as-sociated with miniscrew-assisted rapid palatal expan-sion // AJO-DO Clinical Companion. - 2022. - Vol. 2, № 5. - P. 423–430. - DOI: 10.1016/j.xaor.2022.08.001. 60. Zhu M., Yang P., Bian C., et al. Convolutional neural network-assisted diagnosis of midpalatal su-ture maturation stage in cone-beam computed to-mography // Journal of Dentistry. - 2024. - Vol. 141. - Art. 104808. - DOI: 10.1016/j.jdent.2023.104808. 1. 61. Zhu Z., Zhou N., Qian W., Ye N. Evaluating midpalatal suture maturation using cone-beam com-puted tomography in East Asian individuals aged 16–50 years // BMC Oral Health. - 2025. - Vol. 25, № 1. - DOI: 10.1186/s12903-025-06883-6.