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Barreneche-Calle LM, Marín-Arboleda RD, Gómez-Gómez SL, Agudelo-Suárez AA, Ramírez-Ossa DM. Dentoalveolar, periodontal and skeletal effects of maxillary expansion techniques assisted by temporary anchorage devices compared with conventional protocols in growing patients with transverse maxillary deficiency: A systematic review and meta-analysis. Int Orthod 2024; 22:100891. [PMID: 38865748 DOI: 10.1016/j.ortho.2024.100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared to conventional protocols. METHODS Five databases and grey literature were consulted, up to December 2023, focusing on intervention designs and excluding other type of studies. The quality assessment was conducted by using the adaptation for orthodontics of the CONSORT statement, the guidelines for reporting non-randomised studies, the RoB-2 tool, and the ROBINS-I tool. A descriptive summary and meta-analysis using RevMan 5.4 were performed. RESULTS Nine clinical trials were included (n=377 patients, mean age 13.2±0.6) with a diagnosis of transverse maxillary deficiency. The analysed studies showed qualitative dentoalveolar and periodontal changes after expansion, which were greater on the maxillary first premolars in tooth-borne appliances. Meta-analyses for some effects were included from two studies (n=64); patients who used tooth-borne appliances had greater effects of buccal intercoronal width between the premolars with statistically significant differences (Std Mean difference 2.34; 95% CI: 0.04-4.65 p=0.05). Conversely, those patients who used bone-borne or hybrid appliances had greater effects of buccal intercoronal width between molars with statistically significant differences (Std Mean difference -0.64; 95% CI: -1.38-0.10; p=0.09). CONCLUSIONS According to the studies analysed, all measurements increased in the intervention groups after expansion. Quantitative analyses show different findings at dentoalveolar level when tooth-borne, bone-borne or hybrid appliances are considered. Nevertheless, the results should be taken with caution due to the heterogeneity of the studies. The protocol was registered at PROSPERO (CRD42021283170), with no funding to report.
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Affiliation(s)
| | - Rober David Marín-Arboleda
- DDS, Posgraduate Orthodontic Program Student, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
| | - Sandra Liliana Gómez-Gómez
- DDS, Orthodontist, MSc in Epidemiology, Titular Professor and Department Chair, Department of Orthodontics, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
| | - Andrés A Agudelo-Suárez
- DDS, Public Health PhD, Titular Professor and Senior Researcher, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
| | - Diana Milena Ramírez-Ossa
- DDS, Orthodontist, Professor, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia.
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Echarri-Nicolás J, González-Olmo MJ, Echarri-Lobiondo P, Lagravère M, Romero M. Tooth-Bone-Borne vs Bone-Borne Rapid Maxillary Expanders on Dentoskeletal Changes. J Multidiscip Healthc 2024; 17:1877-1886. [PMID: 38706502 PMCID: PMC11068038 DOI: 10.2147/jmdh.s433693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose This study compared the insertion and thickness of the cortical bone, the parallelism of the midpalatal suture, and the skeletal transverse dimension using a microimplant-assisted rapid palatal expansion (MARPE) with those produced by bone-anchored maxillary expander (BAME) in adults. Patients and Methods The sample comprised 18 patients (mean age, 29.9±9.4 years) selected for the MARPE group and 18 (mean age 24.8±6.8 years) selected for the BAME group. Cone-Beam computed tomography scans taken just before and after the expansion. Results After treatment, there was a significant palatal depth decrease. In addition, maxillary and mandibular width were increased in both groups. Regarding the cortical bone insertion and cortical bone width, it is shown an increase in both groups but those changes are not significant. However, the anterior suture opening effect occurs more frequently in the BAME than in the MARPE device. There are no differences in the frequency of opening of the midpalatal suture in the cases treated with MARPE and BAME, in both cases the most frequent opening morphology is parallel, independently of midpalatal suture maturation. Conclusion There are no differences in the use of MARPE or BAME in the parallelism of the middle palatal suture, the cortical bone insertion, and thickness according to the maturation stages of the midpalatal suture but significantly increases the transverse dimensions of the maxillary skeleton.
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Affiliation(s)
- Javier Echarri-Nicolás
- Doctoral Program in Health Sciences, International PhD School, Rey Juan Carlos University (URJC), Móstoles, Madrid, Spain
| | | | | | - Manuel Lagravère
- Division of Orthodontics, Faculty of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Martin Romero
- Department of Orthodontics, University Rey Juan Carlos, Alcorcón, Madrid, Spain
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Ugolini A, Abate A, Donelli M, Gaffuri F, Bruni A, Maspero C, Lanteri V. Spontaneous Mandibular Dentoalveolar Changes after Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:501. [PMID: 38671718 PMCID: PMC11049362 DOI: 10.3390/children11040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. METHODS The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. RESULTS A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. CONCLUSIONS SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.
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Affiliation(s)
- Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Margherita Donelli
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Valentina Lanteri
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
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de Oliveira Chami V, da Rocha JG, Knorst JK, Fensterseifer CK, Ferrazzo VA, Serra-Negra JMC, Marquezan M. Effects of rapid maxillary expansion on sleep disturbance scale for children: A longitudinal CASE-series study. Orthod Craniofac Res 2024; 27:27-32. [PMID: 37282841 DOI: 10.1111/ocr.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/02/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effects of rapid maxillary expansion (RME) on Sleep Disturbance Scale for Children (SDSC) with maxillary atresia. MATERIALS AND METHODS The sample consisted of 27 paediatric patients evaluated through a Brazilian version of the SDSC, answered by their guardians at the following experimental time points: T0 (before installing the Hyrax expander), T1 (on the day of expander stabilization), T2 (3 months after expander stabilization), T3 (immediately after expander removal, following 6 months of retention), and T4 (3 months post-retention). Multilevel Poisson analysis adjusted for repeated measures was performed to compare outcomes across the assessment time points. RESULTS The mean age of patients was 9.1 years (SD = 1.46). The total SDSC scores decreased and were statistically significant from T2 onwards (P < .01), with a decrease of 24% at T4 compared with T1 (IRR 0.76; 95% CI 0.69-0.84). The mean scores at T4 were already lower than the cutoff point for risk of sleep disorders. Regarding the specific domains, there was a significant reduction in sleep breathing disorders, sleep-wake transition disorders, and disorders of excessive somnolence as of T2 (P < .01), T3 (P < .05) and T4 (P < .05), respectively. CONCLUSION RME in children with maxillary atresia had a positive effect on the reduction of total SDSC scores after 3 months of expander stabilization, sustained over 6 and 9 months and significant reduction in sleep breathing disorders domain, sleep-wake transition disorders domain, and disorders of excessive somnolence domain over time points.
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Affiliation(s)
- Vitória de Oliveira Chami
- Post-Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Jessica Klockner Knorst
- Post-Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Vilmar Antônio Ferrazzo
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Junia Maria Cheib Serra-Negra
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariana Marquezan
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Jang W, Choi YJ, Cha JY, Kang YG, Kim E, Kim KH. Three-dimensional evaluation of dentopalatal changes after rapid maxillary expansion in growing children. Am J Orthod Dentofacial Orthop 2024; 165:103-113. [PMID: 37768260 DOI: 10.1016/j.ajodo.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION In growing children with transverse malocclusion problems, various types of rapid maxillary expanders (RMEs) have been effectively used in skeletal and dental expansions. We evaluated 3-dimensional dentopalatal changes in growing children who underwent maxillary expansion using RMEs and bonded RMEs. METHODS We investigated dentopalatal changes in 20 patients treated with bonded RMEs, 19 with RMEs, and 38 control patients. Dental plaster models before and after expansion were scanned 3-dimensionally and superimposed to evaluate transverse expansion, expansion ratio, angular expansion, and palatal expansion height ratio. RESULTS Using bonded RMEs, similar anterior and posterior dental expansions were achieved with an efficiency of 69%-76% (expansion ratio), and palatal soft-tissue expansion occurred more apically in the posterior area (palatal expansion height ratio, 1.00) than in the anterior area (palatal expansion height ratio, 0.64). Using RMEs, a larger posterior dental expansion was achieved, with an efficiency of 106%-117% (expansion ratio), than anterior dental expansion (55%-60%), and palatal soft-tissue expansion occurred more apically in the posterior area (palatal expansion height ratio, 0.99) than anterior area (palatal expansion height ratio, 0.23). CONCLUSIONS Dental expansions in the anterior and posterior areas were similar using bonded RMEs, whereas the posterior dental expansions were larger than those of the anterior area using RMEs. The entire palatal soft-tissue slope expanded in the posterior area, whereas the occlusal part expanded in the anterior area using RMEs and bonded RMEs.
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Affiliation(s)
- Woowon Jang
- Yonsei Twins Orthodontic Dental Clinic, Seoul, South Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Yoon Goo Kang
- Department of Orthodontics, Kyung Hee University, Seoul, South Korea
| | - Euiseong Kim
- Department of Conservative Dentistry and Oral Research Center, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Institute of Craniofacial Deformity, Yonsei University, Seoul, South Korea.
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Gokturk M, Yavan MA. Comparison of the short-term effects of tooth-bone-borne and tooth-borne rapid maxillary expansion in older adolescents. J Orofac Orthop 2024; 85:43-55. [PMID: 35612594 DOI: 10.1007/s00056-022-00401-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the short-term effects of tooth-bone-borne and tooth-borne rapid maxillary expansion (RME) devices on dentofacial structures in older adolescents. METHODS The retrospective study reviewed pre- and posttreatment lateral and posteroanterior cephalometric images and orthodontic model records of patients who underwent maxillary expansion. Two groups were formed, in which the same upper jaw expansion protocol was applied with two different maxillary expansion devices: the first group consisted of 15 individuals treated with tooth-bone-borne (hybrid) RME (HRME; 9 girls and 6 boys; mean age, 16.9 ± 0.42 years) and the second group consisted of 15 individuals treated with tooth-borne (conventional) RME (CRME; 8 girls and 7 boys; mean age, 16.74 ± 0.54 years). Cephalometric and orthodontic model measurements were conducted on the records taken before and after treatment. RESULTS Significant skeletal and dental expansions were observed in both groups (p < 0.05). However, the increase in nasal width measurements in the HRME group (2.24 ± 0.61 mm) was significantly higher than the increase in the CRME group (1.12 ± 0.25 mm; p < 0.01). Buccal tipping of the premolars was significantly less in the HRME group (0.46 ± 0.35°) than in the CRME group (2.46 ± 0.63°; p < 0.01). The amount of tipping of the molars was higher in the HRME group (4.76 ± 0.88°) compared to the CRME group (2.9 ± 1.03°; p < 0.01). CONCLUSION Although the HRME device increase the nasal width in older adolescents to a greater extent, more dental side effects were seen at the maxillary first molars.
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Affiliation(s)
- Mustafa Gokturk
- Department of Orthodontics, Faculty of Dentistry, Adıyaman University, 02240, Adıyaman, Turkey
| | - Mehmet Ali Yavan
- Department of Orthodontics, Faculty of Dentistry, Adıyaman University, 02240, Adıyaman, Turkey.
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Colino-Gallardo P, Del Fresno-Aguilar I, Castillo-Montaño L, Colino-Paniagua C, Baptista-Sánchez H, Criado-Pérez L, Alvarado-Lorenzo A. Skeletal and Dentoalveolar Changes in Growing Patients Treated with Rapid Maxillary Expansion Measured in 3D Cone-Beam Computed Tomography. Biomedicines 2023; 11:3305. [PMID: 38137526 PMCID: PMC10740967 DOI: 10.3390/biomedicines11123305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
The skeletal and dental effects of rapid maxillary expansion (RME) have been extensively studied, but high-quality research is still needed to determine the three-dimensional (3D) effects of RME. The aim of this study was to compare skeletal and dentoalveolar parameters through cone-beam computed tomography (CBCT) pre- (T1) and post-treatment (T2) with respect to RME. Twenty growing patients (mean age 10.7 years) were treated with a Hyrax-type expander. A 3D CBCT was performed at T1 and T2, measuring nasal width, maxillary width, palatal height, maxillary arch perimeter, angulation of the upper first molar, and intermolar width. The mean palatal suture opening was 2.85 ± 0.62 mm (p < 0.0001). Nasal width increased 1.28 ± 0.64 mm and maxillary width 2.79 ± 1.48 mm (p < 0.0001). In contrast, palatal height was reduced 0.65 ± 0.64 mm (p < 0.0001). Regarding arch perimeter, the radicular perimeter increased 2.89 ± 1.80 mm, while the coronal perimeter increased 3.42 ± 2.09 mm (p < 0.0001). Molar angulation increased 5.62 ± 3.20° for the right molar and 4.74 ± 2.22° for the left molar (p < 0.0001). Intermolar width increased 5.21 ± 1.55 mm (p < 0.0001). Treatment with Hyrax produced a significant opening in the mean palatal suture. Also, a significant increase in nasal width, maxillary width, arch perimeter, molar angulation, and intermolar width, and a decrease in palatal height, were observed.
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Affiliation(s)
- Peri Colino-Gallardo
- Department of Dentistry, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.C.-G.); (I.D.F.-A.); (L.C.-M.); (C.C.-P.)
| | - Irene Del Fresno-Aguilar
- Department of Dentistry, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.C.-G.); (I.D.F.-A.); (L.C.-M.); (C.C.-P.)
| | - Laura Castillo-Montaño
- Department of Dentistry, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.C.-G.); (I.D.F.-A.); (L.C.-M.); (C.C.-P.)
| | - Carlos Colino-Paniagua
- Department of Dentistry, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain; (P.C.-G.); (I.D.F.-A.); (L.C.-M.); (C.C.-P.)
| | - Hugo Baptista-Sánchez
- Department of Oral Surgery, Universidad de Salamanca, 37007 Salamanca, Spain; (H.B.-S.); (A.A.-L.)
| | - Laura Criado-Pérez
- Department of Oral Surgery, Universidad de Salamanca, 37007 Salamanca, Spain; (H.B.-S.); (A.A.-L.)
| | - Alfonso Alvarado-Lorenzo
- Department of Oral Surgery, Universidad de Salamanca, 37007 Salamanca, Spain; (H.B.-S.); (A.A.-L.)
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Ahsan M, Narala B, Ednick M, Kier C. Something to consider: rapid palatal expansion for treatment of obstructive sleep apnea in pediatric patients. Curr Opin Pediatr 2023; 35:710-715. [PMID: 37678405 DOI: 10.1097/mop.0000000000001287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
PURPOSE OF REVIEW This review examines the potential of rapid palatal expansion (RPE) as a treatment for pediatric obstructive sleep apnea (OSA). The focus is on recent findings related to its efficacy, safety, patient selection, timing, appliance options, cost considerations, and long-term outcomes. RECENT FINDINGS Recent studies indicate that RPE can lead to significant improvements in pediatric OSA, with a 70% reduction in the Apnea Hypopnea Index (AHI) and increased oxygen saturation levels. It has been particularly effective in children with small or absent tonsils and has been found to reduce adenoid and tonsil size. Long-term follow-up studies suggest the need for ongoing monitoring, as some patients may experience relapse over time. SUMMARY RPE shows promise as an additional treatment for pediatric obstructive sleep apnea. It offers improvements in respiratory function and reduced symptoms in certain patients. However, long-term efficacy and safety require further investigation. Comparative studies and patient-reported outcomes are necessary to optimize treatment approaches. Collaboration between orthodontists, sleep specialists, and ear-nose-throat (ENT) specialists may be essential for optimal outcomes in pediatric OSA patients treated with RPE.
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Affiliation(s)
- Muhammad Ahsan
- Division of Pulmonary, Critical Care and Sleep Medicine, Stony Brook University Hospital
| | - Bhavya Narala
- Division of Pulmonary, Critical Care and Sleep Medicine, Stony Brook University Hospital
| | - Mathew Ednick
- Division of Pediatric Pulmonary, Pediatric Sleep Disorders Center, Stony Brook Children's Hospital, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
| | - Catherine Kier
- Division of Pediatric Pulmonary, Pediatric Sleep Disorders Center, Stony Brook Children's Hospital, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
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Liu B, Wang B, Wang Z, Meng Y, Li Y, Li L, Wang J, Zhai M, Liu R, Wei F. Near-Infrared Light-Controlled MicroRNA-21-Loaded Upconversion Nanoparticles to Promote Bone Formation in the Midpalatal Suture. ACS APPLIED MATERIALS & INTERFACES 2023; 15:43503-43514. [PMID: 37694956 DOI: 10.1021/acsami.3c08616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Rapid maxillary expansion (RME) is a common therapy for maxillary transverse deficiency. However, relapses after RME usually occur because of insufficient bone formation. MicroRNA-21 (miR-21) was reported as an important post-transcriptional modulator for osteogenesis. Herein, a photocontrolled miR-21 (PC-miR-21)-loaded nanosystem using upconversion nanoparticles (UCNPs) modified with poly(ether imide) (PEI), i.e., UCNPs@PEI@PC-miR-21, was constructed to promote bone formation in the midpalatal suture. UCNPs@PEI was constructed as the light transducer and delivery carrier. The UCNPs@PEI@PC-miR-21 nanocomplexes have good aqueous dispersibility and biocompatibility. The in vitro cell experiment suggested that UCNPs@PEI could protect PC-miR-21 from biodegradation and release PC-miR-21 into the cytoplasm under near-infrared light (NIR) irradiation. Furthermore, UCNPs@PEI@PC-miR-21 upregulated the expression of the osteogenic key markers, ALP, RUNX2, and COL1A1, at the levels of both genes and proteins. Besides, the results of the in vivo RME mice models further corroborated that photocontrollable UCNPs@PEI@PC-miR-21 accelerated bone formation with upregulating osteogenic markers of ALP, RUNX2, and osteoprotegerin and inducing fewer osteoclasts formation. In conclusion, UCNPs@PEI@PC-miR-21 nanoparticles with a NIR light could facilitate the remote and precise delivery of exogenous miR-21 to the midpalatal suture to promote bone formation during RME. This work represents a cutting-edge approach of gene therapy to promote osteogenesis in the midpalatal suture during RME and provides a frontier scientific basis for later clinical treatment.
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Affiliation(s)
- Bohui Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
- Department of Stomatology, Qingdao West Coast New Area Central Hospital, Qingdao 266555, China
| | - Bing Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Ziyao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Yiling Meng
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Yixuan Li
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Lan Li
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Jixiao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Mingrui Zhai
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Rui Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Fulan Wei
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
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Echarri-Nicolás J, González-Olmo MJ, Echarri-Labiondo P, Romero M. Changes in Molar Tipping and Surrounding Alveolar Bone with Different Designs of Skeletal Maxillary Expanders. Biomedicines 2023; 11:2380. [PMID: 37760821 PMCID: PMC10525421 DOI: 10.3390/biomedicines11092380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
This study compared the buccolingual angulation (BLA) of the upper and lower first permanent molars before and after using the different methods of microimplant-assisted expansion in adults and its influence on bone insertion loss. METHODS Cone-beam computed tomography scans taken before and after the expansion in 36 patients (29.9 ± 9.4 years) were used to assess dental and periodontal changes and compare changes between the groups. RESULTS This research shows a statistically significant increase in the BLA of the upper first molars. An increase of the BLA of the lower molars is also observed in MARPE. Regarding the comparison between cases treated with MARPE (4.42° ± 10.25°; 3.67° ± 9.56°) and BAME (-0.51° ± 4.61°; 2.34° ± 4.51°), it was observed that upper molar torque increased significantly less in cases treated with BAME. In cases with CWRU < 96° at T0, a slight bone insertion gain was observed at T1, whereas if CWRU ≥ 96°, a slight bone insertion loss was observed. Regarding the labial cortical bone loss, a slight gain of CBW was observed in all cases. This labial cortical enlargement (T0-T1) is greater in cases where the CWRU < 96° at T0. CONCLUSIONS Patients treated with MARPE show torque increase in the teeth selected to support the expansion appliance compared to cases treated with BAME. In cases where the BLA at T0 < 96°, an increase in thickness and cortical insertion is observed in the upper molars after treatment with disjunction appliances assisted with microscrews.
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Affiliation(s)
- Javier Echarri-Nicolás
- Doctoral Program in Health Sciences, International PhD School, Rey Juan Carlos University (URJC), 28922 Alcorcón, Spain;
| | | | | | - Martín Romero
- Department of Orthodontics, Rey Juan Carlos University, 28922 Alcorcón, Spain;
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11
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Leonardi R, Ronsivalle V, Isola G, Cicciù M, Lagravère M, Flores-Mir C, Lo Giudice A. External root resorption and rapid maxillary expansion in the short-term: a CBCT comparative study between tooth-borne and bone-borne appliances, using 3D imaging digital technology. BMC Oral Health 2023; 23:558. [PMID: 37573295 PMCID: PMC10422725 DOI: 10.1186/s12903-023-03280-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND The aim of the study was to analyze and compare external root resorption (ERR) in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). METHODS The sample included 40 subjects who received tooth-borne RME (TB group, average age: 13.1 ± 1.08 years) or bone-borne RME (BB group, average age: 14.5 ± 1.11 years) and Cone-beam computed tomography (CBCT) scans before treatment (T0) and after 3-month of retention (T1). A specific 3D Imaging technology was used to generate 3D models of posterior dentition (M1 = maxillary first molars, P2 = second premolars, P1 = first premolar) and calculate volumetric data (mean and percentage values) and shape changes, the latter obtained from deviation analysis between the radicular models at different time points. Evaluation of radicular length changes was performed for each tooth. Data were statistically analysed to perform intra-timing and inter-groups comparisons. RESULTS A significant reduction of radicular volume and length was found in posterior dentition in both groups (p < 0.05), and the M1 (volume) and its palatal root (length) were mostly involved in this response. No differences were found between M1, P1 and P2 (p > 0.05) when volumetric changes were calculated as percentage of the total volume. Deviation analysis revealed that the radicular areas mostly affected by shape change were the apex and bucco-medial side. The amount of ERR was significantly greater in TB group compared to BB group. CONCLUSIONS BB-RME treatment could reduce the amount of ERR at the post-expansion stage.
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Affiliation(s)
- Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Periodontology, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Catania, Italy
| | - Manuel Lagravère
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB, Canada
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy.
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12
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Kinzinger GSM, Lisson JA, Buschhoff C, Hourfar J. Age-dependent effects on palate volume and morphology during orthodontic RME treatment. Clin Oral Investig 2023; 27:2641-2652. [PMID: 36602590 PMCID: PMC10264469 DOI: 10.1007/s00784-022-04831-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/18/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Rapid maxillary expansion (RME) shows different age-dependent effects. It has been shown that RME leads to a parallel expansion prior to the age of 10, while later and especially from the age of 12, a V-shaped expansion happens (transverse, anterior > posterior; horizontal, inferior > superior). However, it is not clear to what extent these effects influence palatal volume and morphology and eventually maxillary functional space. The aim of the present study was to examine possible age-related effects of treatment with a dental anchored RME appliance upon volume and width/height ratio of the anterior and posterior palate. MATERIALS AND METHODS Sixty children and adolescents with documented treatment histories after RME were divided into three equal groups according to age at treatment begin (PG 1, < 10 years, n=20; PG 2, 10 ≤ 12 years, n=20; PG 3, > 12 years, n=20). Maxillary dental casts before and after therapy were digitised. Changes in palatal volume were determined using 3D analyses. RESULTS In all patients, the palatal volume increases significantly after RME. Older patients experienced smaller increases in total and posterior volume in absolute and percentage terms. The anterior palate volume increases are almost equal in all patients. Since palatal width increases more markedly than palatal height, the width/height ratio always increases. Except for the posterior region in PG 3, its increase is significant in all groups, both anteriorly and posteriorly. After successful RME, the palatal morphology appears normal anteriorly in PG 1, PG 2 and PG 3 and rather steep posteriorly in PG 3. CONCLUSIONS RME treatment with identical force application causes different, age-dependent effects upon palate volume and morphology. Width changes have a greater influence on palate volume than height changes. CLINICAL RELEVANCE It is preferable to use an RME prior to the age of 10 if homogeneous changes of the anterior and posterior palate regarding maxillary symmetry and functional space are desired.
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Affiliation(s)
| | | | | | - Jan Hourfar
- Department of Orthodontics, Saarland University, Homburg, Saar, Germany
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13
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Garcia-Nunez W, Vezina GC, Aras I. Comparison of 2 different wear protocols of vacuum-formed retainers with respect to the conventional parameters and 3-dimensional superimpositional analysis. Am J Orthod Dentofacial Orthop 2023; 163:743-755.e1. [PMID: 36890011 DOI: 10.1016/j.ajodo.2021.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 03/08/2023]
Abstract
INTRODUCTION This study aimed to compare the effectiveness of 2 different wear protocols of vacuum-formed retainers (VFR) in terms of angular and linear displacement of teeth using 3-dimensional (3D) superimpositional analysis and conventional model parameters. METHODS The study was conducted on 2 groups, each consisting of 17 patients randomly assigned to the part-time group or full-time group of VFR wearing after a nonextraction treatment. While conventional model measurements were assessed on 3D dental casts, 3D tooth movements were evaluated by digitally superimposed scans of casts acquired at 4-time points (debonding and 1, 3, and 6 months after debonding). Regarding conventional parameters, the difference between time-dependent changes among the groups was tested using the nonparametric Brunner-Langer and parametric linear mixed models. Considering 3D measurements, comparisons of groups were made using the Student t tests. RESULTS There were no significant intergroup differences regarding conventional model parameters at any time (P >0.05). Significant intergroup differences were observed regarding angular and linear relapses in the labiolingual direction for maxillary and mandibular incisors, as well as the rotational relapses for maxillary left canine and mandibular right lateral incisor, which were greater in the part-time group in the first month and at the end of 6 months (P <0.05). CONCLUSIONS Conventional model parameters appear to play a debatable role in evaluating the effectiveness of a retainer wear regimen. Three-dimensional analysis of tooth movements revealed that part-time VFR wear was less effective in retaining labiolingual and rotational tooth movements for the first month after debonding.
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Affiliation(s)
| | | | - Isil Aras
- School of Orthodontics, Brooks Rehabilitation College of Healthcare Sciences, Jacksonville University, Jacksonville, Fla.
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14
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Pasqua BDPM, André CB, Paiva JB, Tarraf NE, Wilmes B, Rino-Neto J. Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth-borne and tooth-bone-borne expanders: A randomized clinical trial. Orthod Craniofac Res 2022; 25:476-484. [PMID: 34951124 DOI: 10.1111/ocr.12559] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/18/2021] [Accepted: 12/15/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare, using cone-beam computed tomography, the dentoskeletal changes in rapid maxillary expansion with tooth-bone-borne (Hybrid Hyrax) and tooth-borne (Hyrax) appliances. SETTING AND SAMPLE POPULATION Forty-two patients who met the eligibility criteria (aged 11-14 years; transverse maxillary deficiency, posterior crossbite, and presence of upper first premolars and molars) were screened and allocated into two groups: HHG (treatment with Hybrid Hyrax) and HG (treatment with Hyrax). MAIN OUTCOME MEASURES The primary outcomes included nasomaxillary dimensional changes. CBCT was performed before and 3 months after the activation phase. Measurements were performed using Dolphin® . Baseline data were compared using one-way ANOVA. For intergroup comparison, ANCOVA was used to analyze the initial age, appliance activations (mm), and mid-palatal suture maturation data as covariates. Statistical significance was set at 5%. RESULTS The premolar region in HHG showed increased skeletal changes than in HG, with the difference being 1.5 mm (0.5; 2.6) in the nasal cavity (P = .004), 1.4 mm (0.3; 2.5) in the nasal floor (P = .019), and 1.1 mm (0.2; 2.1) in the maxilla (P = .022). The molar region in HHG showed increased skeletal changes with the difference being 0.9 mm (0.2; 1.5) in the nasal cavity (P = .005), and 0.9 mm (0; 1.8) in the maxilla (P = .042) than in HG. Premolar inclination was higher in HG. CONCLUSION Hybrid Hyrax showed more skeletal changes and fewer dental side effects, especially in the first premolar region. The amount of activation influenced the higher nasal skeletal changes in the Hybrid hyrax group.
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Affiliation(s)
| | | | - João Batista Paiva
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Nour Eldin Tarraf
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Benedict Wilmes
- Department of Orthodontics, University of Düsseldorf, Düsseldorf, Germany
| | - José Rino-Neto
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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15
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Yang Y, Chen D, Li Y, Zou J, Han R, Li H, Zhang J. Effect of Puerarin on Osteogenic Differentiation in vitro and on New Bone Formation in vivo. Drug Des Devel Ther 2022; 16:2885-2900. [PMID: 36060929 PMCID: PMC9433167 DOI: 10.2147/dddt.s379794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/17/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose Puerarin (C21H20O10) is a phytoestrogen that possesses various pharmacological effect, and several researches have revealed the relationship between puerarin and bone metabolism. This study was aimed to evaluate the potential influence of puerarin on the proliferation and osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (BMSCs) as well as on new bone formation following rapid maxillary expansion (RME) model in rats. Methods Rat BMSCs were adopted, and the cell proliferation was detected by cell-counting kit-8 (CCK-8) assay in vitro experiments. Alkaline phosphatase (ALP) activity and alizarin red staining were analyzed quantitatively to show extracellular matrix mineralization. The mRNA and protein expression levels were used to detect osteogenic differentiation of BMSCs. In vivo bone regeneration was analyzed in a rat RME model. Eighteen 6-week-old male Wistar rats were divided into 3 groups: group 1 without any treatment, group 2 received RME and saline solution (15mg/kg), group 3 received RME and puerarin solution (15mg/kg). After 2 weeks, micro-computed tomography (Micro-CT), hematoxylin and eosin (HE) staining, and Masson staining were used to detect the new bone formation and morphological changes. Besides, ALP and bone morphogenetic protein 2 (BMP2) expression levels in mid-palatal suture were evaluated by immunohistochemical staining. Results The results showed that puerarin upregulates cell proliferation dose-dependently. ALP activity and mineralized matrix generation were clearly enhanced at certain specific concentrations (10−5 and 10−6 mol/L); the expression levels of the osteoblast-related genes and proteins were increased. The measurement of micro-CT imaging revealed that puerarin significantly promoted new bone formation. Concomitantly, the histological examinations showed that puerarin solution enhanced osteogenesis in mid-palatal suture. Conclusion Those works indicated that puerarin regulates osteogenesis in vitro and exerts a beneficial impact on bone regeneration in vivo, revealing that puerarin treatment may become one of the potential keys for improving the stability and preventing relapse of RME.
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Affiliation(s)
- Yanran Yang
- Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Daiyun Chen
- Department of Orthodontics, School of Stomatology, Shandong First Medical University, Jinan, People’s Republic of China
| | - Yilin Li
- Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Jinghua Zou
- Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Ruiqi Han
- Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Hongkun Li
- Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Jun Zhang
- Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Correspondence: Jun Zhang, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China, Tel +86 13953109816, Fax +86 53188382923, Email
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16
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Inchingolo AD, Ferrara I, Viapiano F, Netti A, Campanelli M, Buongiorno S, Latini G, Carpentiere V, Ciocia AM, Ceci S, Patano A, Piras F, Cardarelli F, Nemore D, Malcangi G, Di Noia A, Mancini A, Inchingolo AM, Marinelli G, Rapone B, Bordea IR, Scarano A, Lorusso F, Di Venere D, Inchingolo F, Dipalma G. Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report. CHILDREN 2022; 9:children9071046. [PMID: 35884030 PMCID: PMC9317392 DOI: 10.3390/children9071046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Aim: In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. Methods: A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. Results: A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. Conclusions: From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Filippo Cardarelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angela Di Noia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
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Malmvind D, Golež A, Magnuson A, Ovsenik M, Bazargani F. Three-dimensional assessment of palatal area changes after posterior crossbite correction with tooth-borne and tooth bone-borne rapid maxillary expansion. Angle Orthod 2022; 92:483352. [PMID: 35793528 PMCID: PMC9374361 DOI: 10.2319/012822-85.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess and compare the three-dimensional treatment changes in palatal surface area and volume using either tooth-borne (TB) or tooth bone-borne (TBB) rapid maxillary expanders and to evaluate the long-term effects of the two devices and the incidence of the relapse between the groups. MATERIALS AND METHODS A total of 52 consecutive patients who met the eligibility criteria were recruited and allocated to either the TB group, mean age 9.3 years (standard deviation [SD], 1.3), or the TBB group, mean age 9.5 years (SD, 1.2). Study casts were taken before, directly after, 1 year after, and 5 years after expansion. Study casts were digitized, superimposed, and evaluated. Participants were randomly allocated in blocks of different sizes using the concealed allocation principle in a 1:1 ratio. RESULTS Changes in palatal volume, palatal surface area, and palatal projection area within and between the groups up to 5 years after expansion followed the same pattern and did not show any statistically significant differences between the groups. Relapse was seen in 15% of the patients. It seemed that open-bite and a Class III growth pattern could be assumed as prognosis-deteriorating factors in regard to stability of the treatment. CONCLUSIONS There were no significant differences between the TB and TBB groups in palatal volume, palatal shell area, or palatal projection area directly after expansion or at 1 year and 5 years after expansion, which implies that the two devices gave rise to the same immediate and long-term outcomes.
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Yacout YM, Abdalla EM, El Harouny NM. Skeletal and dentoalveolar effects of slow vs rapid activation protocols of miniscrew-supported maxillary expanders in adolescents: A randomized clinical trial. Angle Orthod 2022; 92:483292. [PMID: 35771652 PMCID: PMC9374350 DOI: 10.2319/112121-856.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare between skeletal and dentoalveolar effects of slow and rapid activation of miniscrew-supported expanders. MATERIALS AND METHODS A total of 30 patients were randomly allocated to two groups using block randomization and the allocation ratio 1:1. Both groups received maxillary expanders anchored using four miniscrews. Activation protocol was once every other day in the slow expansion (SME) group and twice daily in the rapid expansion (RME) group. Cone-beam computed tomography (CBCT) scans were obtained before expansion and after removal of the expanders. Transverse skeletal and dentoalveolar changes were measured using CBCT. RESULTS A total of 12 patients in the SME group (mean age, 14.30 ± 1.37 years) and 12 patients in the RME group (mean age, 15.07 ± 1.59 years) were analyzed. RME showed significantly greater widening of the mid-palatal suture at the level of first molars (mean difference [SME - RME] = -0.61 mm), and a greater increase in right and left molar buccal inclination (mean difference= -3.83° and -2.03°, respectively). Percentage of skeletal expansion relative to the jackscrew opening was not significantly different between the groups. Palatal inflammation was evident following appliance removal. Miniscrew mobility and bending were observed with RME. CONCLUSIONS Both SME and RME were effective in correcting skeletal transverse maxillary deficiency. However, RME resulted in more buccal tipping of maxillary molars and in miniscrew failures and bending.
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Jaramillo-Bedoya D, Villegas-Giraldo G, Agudelo-Suárez AA, Ramírez-Ossa DM. A Scoping Review about the Characteristics and Success-Failure Rates of Temporary Anchorage Devices in Orthodontics. Dent J (Basel) 2022; 10:78. [PMID: 35621531 PMCID: PMC9139455 DOI: 10.3390/dj10050078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/08/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
This study synthesized the scientific evidence concerning the main characteristics of the Temporary Anchorage Devices (TADs) used in orthodontics and reported the success-failure rates during treatment. For that means, this scoping review collected articles from previous research. A complementary search was carried out in the databases PubMed-MEDLINE, Scopus, LILACS, and EMBASE, focusing on original studies published from 2010 to 2020. We analyzed the main characteristics of the publications. As a result, 103 articles were included. Most of the research was conducted among different groups, who needed TADs principally in the maxilla and an interradicular location between the second premolar and first molar. AbsoAnchor, Dentos Inc., Daegu, Korea, was the most used brand of TADs. The most common characteristics of the devices and biomechanics were a diameter and length of 1.6 mm and 8 mm, a self-drilled system, a closed technique for placement, immediate loading, and forces that ranged between 40 and 800 g. Of the studies, 47.6% showed success rates ≥90%. In conclusion, high success rates were found for TADs, and differences were found according to sociodemographic and clinical variables. The studies showed variability in methodological design, and scientific publications were concentrated in certain countries. We recommend further scientific research on TADs using more standardized designs.
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Arnett GW, D'Agostino A, Grendene E, McLaughlin RP, Trevisiol L. Combined orthodontic and surgical open bite correction. Angle Orthod 2022; 92:431-445. [PMID: 35293981 DOI: 10.2319/123121-959.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To present a clinical description of the team's treatment techniques. MATERIALS AND METHODS In Part 1, 30 patients underwent segmental maxillary orthodontics, multisegment Le Fort I, and bilateral sagittal osteotomies of the mandible. Part 1 reported excellent occlusal stability at a mean follow-up of 49.43 months (range, 36-92 months). Cases presented in Part 2 were selected based on availability of excellent technique photographs. The same techniques described in Part 2 cases were used on all Part 1 patients. RESULTS The coordination of arch widths and forms, overbite, overjet, and maxillary curve of Spee corrections were stable using the team protocols for orthodontic and surgical treatment. CONCLUSIONS In the study group, long-term three-dimensionally stable occlusal results were achieved. To duplicate these results, specific orthodontic preparation, intraoperative surgical steps, and postsurgical steps must be carefully planned and executed. These steps are described in this article, Part 2.
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Arnett GW, Trevisiol L, Grendene E, McLaughlin RP, D'Agostino A. Combined orthodontic and surgical open bite correction. Angle Orthod 2022; 92:161-172. [PMID: 34986216 PMCID: PMC8887413 DOI: 10.2319/101921-779.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVES To examine the stability of combined surgical and orthodontic bite correction with emphasis on open-bite closure. All study patients were treated with strict and consistent orthodontic and surgical protocols. MATERIALS AND METHODS Study inclusion required all patients to have anterior open bites, maxillary accentuated curve of Spee, 36-month minimum follow-up, and no temporomandibular joint pathology. Thirty patients met the inclusion/exclusion criteria. Importantly, segmental upper arch orthodontic preparation (performed by EG) was used. Surgery consisted of a multisegment Le Fort I (MSLFI) combined with a bilateral sagittal osteotomies (BSSO). Surgery was performed (by ADA and LT) at the Department of Dentistry and Maxillofacial Surgery of the University of Verona, Italy. RESULTS The long-term open bite and overjet relapse were not statistically significant. The mean transverse relapse of the upper and lower molars was statistically significant. Of great importance, the upper and lower arch widths narrowed together, maintaining intercuspation of the posterior dentition which prevented anterior open bites from developing. CONCLUSIONS This study revealed stability of three-dimensional occlusal correction including anterior open bite. Stable open bite closure was achieved by using rigid protocols for orthodontic preparation, surgical techniques, surgical follow-up, and orthodontic finishing.
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Effectiveness of miniscrew-assisted rapid maxillary expansion: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:4509-4523. [PMID: 35211817 DOI: 10.1007/s00784-022-04415-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To compare the effectiveness and side effects of miniscrew-assisted rapid maxillary expansion (MARME) with conventional rapid maxillary expansion (RME) in the treatment of transverse maxillary deficiency. MATERIALS AND METHODS We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched in the MEDLINE, Embase, and Cochrane Central databases. The quality of included RCTs was evaluated using the Cochrane risk-of-bias tool. The primary outcome was the extent of dentoskeletal expansion achieved. Secondary outcomes were the dental and periodontal side effects. We calculated summary weighted mean differences (MD) with 95% confidence intervals (CI) using random-effects meta-analysis. RESULTS Six RCTs involving 287 participants met the inclusion criteria. Compared to conventional RME, MARME was associated with a greater palatal suture opening (mm) measured at the anterior nasal spine (MD = 1.21, 95% CI 0.75 to 1.66), first premolars (MD = 1.13, 95% CI 0.72 to 1.55), first molars (MD = 1.18, 95% CI 0.28 to 2.09), and posterior nasal spine (MD = 1.14, 95% CI 0.30 to 1.98), increased palatal width (mm) at the first molars (MD = 0.75, 95% CI 0.30 to 1.20), and reduced buccal inclination (degrees) of the first premolars (MD = - 6.06, 95% CI - 10.36 to - 1.76) and first molars (MD = - 3.17, 95% CI - 5.35 to - 0.99). CONCLUSIONS MARME is associated with the following advantages over traditional tooth-borne RME: increased palatal suture opening, increased palatal width, and reduced buccal tooth inclination. REGISTRATION This study is registered with PROSPERO, CRD42021256750. CLINICAL RELEVANCE MARME may be preferred over conventional RME in cases with fused mid-palatal sutures or where further buccal tooth inclination is undesirable.
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Camcı H, Salmanpour F. Effect of sinus proximity, alveolar bone level, and initial buccolingual inclination on behavior of maxillary first molar under expansion force: a finite element analysis. J World Fed Orthod 2021; 11:60-67. [PMID: 34973936 DOI: 10.1016/j.ejwf.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The primary aim of this study is to determine whether sinus proximity increases or decreases molar tipping under the force of expansion; a secondary aim is to compare the effect of the initial buccal inclination, alveolar bone loss, and sinus proximity to molar movement under expansion force, by assessing the stress distribution of the periodontal ligament and the changes in the moment/force (M/F) ratio). METHODS Twenty different 3-dimensional models were created by changing the buccal inclination (0°,5°,10°,15°, and 20°) value of maxillary molar and simulating different amounts of alveolar bone loss (0, 2,4, and 6 mm) in the basic model. Additionally, an artificial sinus was added to the basic model, and the penetration of the roots into the sinus to different levels (2, 4, and 6 mm) was simulated separately. Thus, 9 additional models were created. The M/F ratio, location of the center of resistance, and principal stresses on the periodontal ligament were analyzed for each of the 29 models separately in a finite element analysis. RESULTS The M/F ratio increased as initial buccal inclination or bone loss increased. As the amount of simultaneous penetration of 3 roots into the sinus increased, the M/F ratio decreased. Incremental changes of both the initial inclination value and the amount of bone loss resulted in higher maximum compressive stress on the apices of the buccal roots. CONCLUSIONS Increases in alveolar bone loss and buccal inclination caused increases in the periodontal stress. Penetration of the roots into the sinus provides bicortical anchorage and could prevent unwanted crown tipping.
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Affiliation(s)
- Hasan Camcı
- Assistant Professor, Afyonkarahisar Health Science University, Department of Orthodontics, Afyonkarahisar, Turkey.
| | - Farhad Salmanpour
- Resident, Afyonkarahisar Health Science University, Department of Orthodontics, Afyonkarahisar, Turkey
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Pain Reduction during Rapid Palatal Expansion Due to LED Photobiomodulation Irradiation: A Randomized Clinical Trial. LIFE (BASEL, SWITZERLAND) 2021; 12:life12010037. [PMID: 35054430 PMCID: PMC8779698 DOI: 10.3390/life12010037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 11/16/2022]
Abstract
Objective: The purpose of this research is to assess the analgesic efficiency of Photobiomodulation (PBM) in pain reduction in young patients during rapid maxillary expansion therapy. Materials and Methods: Thirty patients were included and allocated to an experimental group [Rapid Palatal Expansion (RPE) and PBM] and a control group (RPE only) at random. Inclusion criteria were skeletal age from CVS1 to CVS3, examined on the cephalometric lateral teleradiography, with cervical vertebra staging and completed eruption of upper first molar. Exclusion criteria were previous orthodontic treatment, bone disease, disability, or skeletal age from CVS4. Patients referred the pain they felt using a Numerical scale rate (NRS), ranging from 0 to 10, with specific intervals of time: 6 h, 12 h, 24 h, and from days 2 to 7. The Wilcoxon-Mann-Whitney test was used to evaluate differences in NRS reported values between the two groups. Results: The final sample included 30 patients, 14 males and 16 females, with a mean age of 7.8 ± 1.2 years. The pain that was felt at each time interval and the maximum score of pain were significantly lower in the experimental group (p < 0.05) and decreased faster in the experimental group, with a score test near to 0 after 2/3 days. Conclusions: PBM is efficient in reducing the intensity and the time of pain felt by young patients that undergo rapid maxillary expansion.
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Ugolini A, Agostino P, Silvestrini-Biavati A, Harrison JE, Batista KB. Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev 2021; 12:CD000979. [PMID: 34951927 PMCID: PMC8709729 DOI: 10.1002/14651858.cd000979.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. The prevalence of posterior crossbite is around 4% and 17% of children and adolescents in Europe and America, respectively. Several treatments have been recommended to correct this problem, which is related to such dental issues as tooth attrition, abnormal development of the jaws, joint problems, and imbalanced facial appearance. Treatments involve expanding the upper jaw with an orthodontic appliance, which can be fixed (e.g. quad-helix) or removable (e.g. expansion plate). This is the third update of a Cochrane review first published in 2001. OBJECTIVES To assess the effects of different orthodontic treatments for posterior crossbites. SEARCH METHODS Cochrane Oral Health's Information Specialist searched four bibliographic databases up to 8 April 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA Randomised controlled trials (RCTs) of orthodontic treatment for posterior crossbites in children and adults. DATA COLLECTION AND ANALYSIS Two review authors, independently and in duplicate, screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. A third review author participated to resolve disagreements. We used risk ratios (RR) and 95% confidence intervals (CIs) to summarise dichotomous data (event), unless there were zero values in trial arms, in which case we used odds ratios (ORs). We used mean differences (MD) with 95% CIs to summarise continuous data. We performed meta-analyses using fixed-effect models. We used the GRADE approach to assess the certainty of the evidence for the main outcomes. MAIN RESULTS We included 31 studies that randomised approximately 1410 participants. Eight studies were at low risk of bias, 15 were at high risk of bias, and eight were unclear. Intervention versus observation For children (age 7 to 11 years), quad-helix was beneficial for posterior crossbite correction compared to observation (OR 50.59, 95% CI 26.77 to 95.60; 3 studies, 149 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 4.71 mm, 95% CI 4.31 to 5.10; 3 studies, 146 participants; moderate-certainty evidence). For children, expansion plates were also beneficial for posterior crossbite correction compared to observation (OR 25.26, 95% CI 13.08 to 48.77; 3 studies, 148 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 3.30 mm, 95% CI 2.88 to 3.73; 3 studies, 145 participants, 3 studies; moderate-certainty evidence). In addition, expansion plates resulted in higher inter-canine distances (MD 2.59 mm, 95% CI 2.18 to 3.01; 3 studies, 145 participants; moderate-certainty evidence). The use of Hyrax is probably effective for correcting posterior crossbite compared to observation (OR 48.02, 95% CI 21.58 to 106.87; 93 participants, 3 studies; moderate-certainty evidence). Two of the studies focused on adolescents (age 12 to 16 years) and found that Hyrax increased the inter-molar distance compared with observation (MD 5.80, 95% CI 5.15 to 6.45; 2 studies, 72 participants; moderate-certainty evidence). Intervention A versus intervention B When comparing quad-helix with expansion plates in children, quad-helix was more effective for posterior crossbite correction (RR 1.29, 95% CI 1.13 to 1.46; 3 studies, 151 participants; moderate-certainty evidence), final inter-molar distance (MD 1.48 mm, 95% CI 0.91 mm to 2.04 mm; 3 studies, 151 participants; high-certainty evidence), inter-canine distance (0.59 mm higher (95% CI 0.09 mm to 1.08 mm; 3 studies, 151 participants; low-certainty evidence) and length of treatment (MD -3.15 months, 95% CI -4.04 to -2.25; 3 studies, 148 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and Haas for posterior crossbite correction (RR 1.05, 95% CI 0.94 to 1.18; 3 studies, 83 participants; moderate-certainty evidence) or inter-molar distance (MD -0.15 mm, 95% CI -0.86 mm to 0.56 mm; 2 studies of adolescents, 46 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and tooth-bone-borne expansion for crossbite correction (RR 1.02, 95% CI 0.92 to 1.12; I² = 0%; 3 studies, 120 participants; low-certainty evidence) or inter-molar distance (MD -0.66 mm, 95% CI -1.36 mm to 0.04 mm; I² = 0%; 2 studies, 65 participants; low-certainty evidence). There was no evidence of a difference between Hyrax with bone-borne expansion for posterior crossbite correction (RR 1.00, 95% CI 0.94 to 1.07; I² = 0%; 2 studies of adolescents, 81 participants; low-certainty evidence) or inter-molar distance (MD -0.14 mm, 95% CI -0.85 mm to 0.57 mm; I² = 0%; 2 studies, 81 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: For children in the early mixed dentition stage (age 7 to 11 years old), quad-helix and expansion plates are more beneficial than no treatment for correcting posterior crossbites. Expansion plates also increase the inter-canine distance. Quad-helix is more effective than expansion plates for correcting posterior crossbite and increasing inter-molar distance. Treatment duration is shorter with quad-helix than expansion plates. For adolescents in permanent dentition (age 12 to 16 years old), Hyrax and Haas are similar for posterior crossbite correction and increasing the inter-molar distance. The remaining evidence was insufficient to draw any robust conclusions for the efficacy of posterior crossbite correction.
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Affiliation(s)
- Alessandro Ugolini
- Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Paola Agostino
- Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | | | - Jayne E Harrison
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | - Klaus Bsl Batista
- Department of Preventive and Public Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Salmoria I, de Souza EC, Furtado A, Franzini CM, Custodio W. Dentoskeletal changes and their correlations after micro-implant-assisted palatal expansion (MARPE) in adults with advanced midpalatal suture ossification. Clin Oral Investig 2021; 26:3021-3031. [PMID: 34773143 DOI: 10.1007/s00784-021-04284-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate and correlate the dentoskeletal changes of adult patients after miniscrew-assisted rapid palatal expander (MARPE) in the two final stages of midpalatal suture ossification. MATERIALS AND METHODS This interventional pre-post clinical study consisted of 20 adults (24.9±1.8 years), with transverse maxillary atresia, divided into two subgroups (n=10) based on the ossification degree of the midpalatal suture: stage D, fusion completed in the palatine bone; and stage E, fusion anteriorly in the maxilla. Cone beam computed tomography (CBCT) in the pre- (T0) and post-treatment (T1) time intervals were used to evaluate the anterior and posterior sutural opening, activation of the expander screw, vestibular-lingual inclinations, and widths of first premolars and first molars. Maxillary interincisor diastema was measured on patients' plaster models in the same timepoints. The Wilcoxon-Mann-Whitney test, generalized linear models (GLM), and chi-square (χ2) test were employed. RESULTS All variables significantly increased after MARPE therapy regardless of the ossification degree (P<0.05). Patients with stage D suture presented wider interincisal diastema and maxillary suture opening (on both regions, anterior and posterior) when compared with patients with stage E (P<0.05). Maxillary interincisor diastema was positively associated with anterior and posterior suture opening for all subjects (P<0.05). MARPE therapy was unsuccessful in six patients, mostly presented by individuals with E maturation stage of the midpalatal suture. CONCLUSIONS After MARPE, a significant correction in the transverse defect of the maxillary basal bone was achieved for adults in the last two midpalatal suture maturation stages. CLINICAL RELEVANCE Adult patients in stage D of maxillary suture ossification are more susceptible to dentoskeletal changes following MARPE therapy as compared to patients with stage E.
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Affiliation(s)
- Igor Salmoria
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil
| | - Evaldo Chaves de Souza
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil
| | - Alvaro Furtado
- Department of Orthodontics, Centro Universitário Unifacvest: Centro Universitario Unifacvest, Florianópolis, SC, Brazil
| | - Cristina Maria Franzini
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil
| | - William Custodio
- Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil.
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Vidalón JA, Loú-Gómez I, Quiñe A, Diaz KT, Liñan Duran C, Lagravère MO. Periodontal effects of maxillary expansion in adults using non-surgical expanders with skeletal anchorage vs. surgically assisted maxillary expansion: a systematic review. Head Face Med 2021; 17:47. [PMID: 34753493 PMCID: PMC8579525 DOI: 10.1186/s13005-021-00299-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Describe and compare harmful periodontal effects as a consequence of maxillary expansion in adult patients with different types of anchorage devices in non-surgical expanders with skeletal anchorage and surgically assisted maxillary expansion. MATERIALS AND METHODS An exhaustive search was carried out on the electronic databases PubMed (MEDLINE), Embase, Cochrane and LILACS. Additionally, journal references and grey literature were searched without any restrictions. After the selection and extraction process; risk of bias was assessed by the ROB-1 Cochrane tool and Newcastle-Ottawa Scale (NOS) for randomized trials and cohort studies, respectively. RESULTS Of 621 studies retrieved from the searches, six were finally included in this review. One of them presented a low risk bias, while five were excellent respective to selection, comparability and outcomes. Results showed that maxillary expansion in adults using non-surgical expanders (bone-borne or tooth-bone-borne with bicortical skeletal anchorage) produce less harmful periodontal effects, such as: alveolar bending with an average range from 0.92° to 2.32°, compared to surgically assisted maxillary expansion (tooth-borne) of 6.4°; dental inclination with an average range from 0.07° to 2.4°, compared to surgically assisted maxillary expansion (tooth-borne) with a range from 2.01° to 5.56°. CONCLUSIONS Although limited, the current evidence seems to show that the bone-borne or tooth-bone-borne with bicortical skeletal anchorage produces fewer undesirable periodontal effects.
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Affiliation(s)
- José Antonio Vidalón
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ismael Loú-Gómez
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Aldo Quiñe
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karla T Diaz
- Stomatology Second Speciality, Universidad Privada San Juan Bautista, Lima, Peru
| | - Carlos Liñan Duran
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuel O Lagravère
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Orthodontic Graduate Program, ECHA 5-524, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada.
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Silveira GS, Abreu LG, Palomo JM, da Matta Cid Pinto LS, de Sousa AA, Gribel BF, Oliveira DD. Mini Hyrax vs Hyrax expanders in the rapid palatal expansion in adolescents with posterior crossbite: a randomized controlled clinical trial. Prog Orthod 2021; 22:30. [PMID: 34467450 PMCID: PMC8408292 DOI: 10.1186/s40510-021-00365-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/21/2021] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The aim of this study was to compare the dental effects, impact on quality of life, and pain perception of adolescents wearing Mini Hyrax and Hyrax expanders in rapid palatal expansion. METHODS Thirty-four adolescents aged 11 to 16 years, with maxillary transverse deficiency (unilateral or bilateral posterior crossbite), were randomly allocated into two groups, Mini Hyrax group and Hyrax group (1:1 ratio). Dental effects were evaluated by digitally superimposed pretreatment and postretention three-dimensional intraoral scans on the palatal rugaes using the software 3DSlicer. Impact on quality of life was assessed with the OHIP-14 questionnaire applied in the pretreatment, posttreatment and postretention. Visual analog scale was applied 24, 48, and 72 h and 7 days after the first activation of the expander. RESULTS Thirty of the 34 adolescents recruited completed the study. There were no statistically significant differences in dentoalveolar effects between groups. OHIP-14 scores across time among Mini Hyrax wearers were similar to those of the Hyrax wearers. The inter-group comparisons showed no difference between groups with respect to the OHIP-14 scores in posttreatment and postretention (p > 0.05). There were no differences in pain perception between groups. Considering intra-group comparison, the reduction in pain perception among adolescents in the Mini Hyrax group was gradual. Among adolescents in the Hyrax group, a statistically significant reduction between 48 and 72 h was observed. CONCLUSION There were no significant differences in dental effects, impact on quality of life and pain perception between adolescents wearing Mini Hyrax and Hyrax expanders in rapid palatal expansion.
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Affiliation(s)
- Giordani Santos Silveira
- School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juan Martin Palomo
- Department of Orthodontics, Case Western Reserve University, Cleveland, OH, USA
| | | | - Adriana Alkmim de Sousa
- School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Dauro Douglas Oliveira
- School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
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Yacout YM, Hassan MG, El-Harouni NM, Ismail HA, Zaher AR. Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.644002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this review was to evaluate the current evidence regarding post-treatment effects of tooth-bone-borne vs. bone-borne expanders. A search was conducted in MEDLINE via PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, and Open Gray; in addition to a hand search in reference lists of selected articles and creating a search alert in electronic databases. Selection criteria included randomized and prospective clinical trials comparing post-expansion skeletal and/or dento-alveolar effects of tooth-bone-borne expanders to those of bone-borne expanders. Following study retrieval and selection, relevant data was extracted, and risk of bias was assessed using the revised RoB 2 tool for randomized clinical trials. After examining 10 full text articles, one randomized clinical trial was finally included. The study compared the dento-alveolar effects of tooth-bone-borne and bone-borne expanders, following expansion and after 6 months, using digital dental casts. Using the RoB 2 tool, the study was judged overall to show some concerns. A definitive conclusion could not be drawn from this systematic review due to the scarcity of clinical trials tackling the research question. A need for future well-conducted research was highlighted in this review.
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Sánchez-Riofrío D, Viñas MJ, Ustrell-Torrent JM. CBCT and CAD-CAM technology to design a minimally invasive maxillary expander. BMC Oral Health 2020; 20:303. [PMID: 33148234 PMCID: PMC7641819 DOI: 10.1186/s12903-020-01292-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background A large number of articles in recent years studying the effects of non-surgically assisted tooth- versus bone-borne maxillary expanders in growing patients have found no significant differences in mid-palatal suture disjunction or even dentoalveolar changes. This suggests the need for new criteria and better use of current technology to make more effective devices and enhance the benefits of conventional treatments. This article describes a titanium grade V computer-aided design/computer-aided manufacturing (CAD/CAM) maxillary expander supported by two miniscrews, along with a 3D printed surgical guide. Methods The first step was to obtain a digitized model of the patient’s upper maxilla. To simplify the process and ensure the placement of the device in a high-quality bone area, the patients’ digital dental cast was superimposed with a cone beam computed tomography (CBCT) scan. Improved resistance to expansion forces was secured through the use of 2 mm-wide miniscrews, long enough for bicortical anchorage. Placement site and direction were assessed individually in order to achieve primary stability. We chose a site between the second premolars and first molars, while the inclination followed the natural contour of the palate vault. A 3D-printed, polyamide surgical guide was designed to ensure the correct placement of the device with a manual straight driver.
Results Favorable clinical results were presented with 3D images. We confirmed a mid-palatal suture parallel separation of 3.63 mm, along with a higher palatal volume, as well as increased intercanine and intermolar distance. Segmentation of the facial soft tissue showed an expansion of nasal airways and changes in nasal morphology. Conclusions Digital models, CBCT and CAD/CAM technology, are essential to accomplish the goals proposed in this article. Further studies are necessary to establish safer miniscrew placement sites and insertion angles so as to achieve greater in-treatment stability. Both the clinician and the patient can benefit from the use of current technology, creating new devices and updating traditional orthodontic procedures.
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Affiliation(s)
- Diego Sánchez-Riofrío
- Universitat de Barcelona, Feixa Llarga s/n. Pavelló de Govern 2ª pl. Office 2.7, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. .,Universidad Espíritu Santo, Samborondón Campus, Km. 2.5 vía La Puntilla, Samborondón, Ecuador.
| | - María J Viñas
- Faculty of Dentistry, Universidad Complutense de Madrid, Ciudad Universitaria, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Josep M Ustrell-Torrent
- Director Master of Orthodontics, Dental School, Universitat de Barcelona, Feixa Llarga s/n. Pavelló de Govern 2ª pl. Office 2.7, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
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A prospective cohort study on the effects of RME in the mandibular dentition of cleft subjects. J Oral Biol Craniofac Res 2020; 10:738-742. [DOI: 10.1016/j.jobcr.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/16/2020] [Accepted: 10/08/2020] [Indexed: 11/17/2022] Open
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Muñoz-Pereira ME, Haas-Junior OL, Da Silva Meirelles L, Machado-Fernández A, Guijarro-Martínez R, Hernández-Alfaro F, de Oliveira RB, Pagnoncelli RM. Stability and surgical complications of tooth-borne and bone-borne appliances in surgical assisted rapid maxillary expansion: a systematic review. Br J Oral Maxillofac Surg 2020; 59:e29-e47. [PMID: 33431313 DOI: 10.1016/j.bjoms.2020.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Abstract
The objective of this systematic review was to evaluate the stability and complications of tooth-borne (TB), bone-borne (BB) and hybrid (TB-BB) appliances in surgically assisted rapid maxillary expansion (SARME). Database searches were conducted (PubMed, Embase, Cochrane Library and SciELO), as well as a grey literature search (Google Scholar) and hand searches of reference lists. Forty-six articles were included after study selection (κ=0.854). After eligibility assessment, 16 articles and one article from the grey literature were processed (κ=0.866) and six articles were selected by hand searching, for a total of 23 articles included. Regarding stability, TB appliances showed width relapse rates ranging from 4 to 35% in canines, from 1 to 37% in premolars and from 0.2 to 49.5% in molars. In BB appliances, width relapse rates were 1.7-21% in canines, 1.5% in premolars and 4.6-11.5% in molars. In hybrid appliances, the width relapse rate was 14% in premolars, with a 1.8% overexpansion reported in the molar region. In TB and BB appliances, skeletal relapse rates were similar on the nasal floor (11-53% and 41.6%, respectively) and at the level of the maxilla (18% and 16%, respectively). The most common complications were bone resorption in TB appliances (18.14%) and appliance-related complications in BB appliances (17.9%). The risk of bias was high in 19 studies, medium in three studies and low in one study. The TB and BB appliances used in SARME were considered to have a high long-term stability. BB appliances appeared to have fewer relapses than TB appliances due to a more parallel distribution of forces exerted. However, relapse appears to be highly influenced by postorthodontic treatments, where arch-form coordination is achieved in the consolidation period with the purpose of overexpansion correction, alignment and final vertical adjustments. Further randomised controlled trials with long-term data and large sample sizes are needed to support evidence-based clinical decision-making and to allow meta-analytic studies of stability outcomes regarding the type of anchorage in SARME.
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Affiliation(s)
- M E Muñoz-Pereira
- Professor at Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Surgical Sciences, University of Costa Rica - San Pedro de Montes de Oca, San José́; PhD Program at Department of Oral and Maxillofacial Surgery, Pontifical University of Rio Grande do Sul (PUCRS)- Porto Alegre, RS, Brazil.
| | - O L Haas-Junior
- Professor at Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, RS. Brazil; Institute of Maxillofacial Surgery, Teknon Medical Center - Barcelona, Spain
| | - L Da Silva Meirelles
- PhD Program at Department of Oral and Maxillofacial Surgery, Pontifical University of Rio Grande do Sul (PUCRS)- Porto Alegre, RS, Brazil
| | - A Machado-Fernández
- PhD Program at Department of Oral and Maxillofacial Surgery, Pontifical University of Rio Grande do Sul (PUCRS)- Porto Alegre, RS, Brazil
| | - R Guijarro-Martínez
- Institute of Maxillofacial Surgery, Teknon Medical Center - Barcelona, Spain; Assistant Professor, Department of Orthodontics, Cardenal Herrera-CEU, Universidad de Valencia- Valencia, Spain
| | - F Hernández-Alfaro
- Department Head at Institute of Maxillofacial Surgery, Teknon Medical Center - Barcelona, Spain; Department Head Professor at Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya - Sant Cugat del Vallès, Barcelona, Spain
| | - R B de Oliveira
- Professor at Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, RS. Brazil
| | - R M Pagnoncelli
- Professor at Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, RS. Brazil
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Davami K, Talma E, Harzer W, Lagravère MO. Long term skeletal and dental changes between tooth-anchored versus Dresden bone-anchored rapid maxillary expansion using CBCT images in adolescents: Randomized clinical trial. Int Orthod 2020; 18:317-329. [PMID: 32245745 DOI: 10.1016/j.ortho.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to determine long-term skeletal and dental changes in tooth-anchored versus Dresden bone-anchored rapid maxillary expansion using CBCT images in adolescents. MATERIALS AND METHODS In all, 29 adolescent patients (11-17 years of age) needing skeletal expansion were randomly allocated to two different groups treated by either a Dresden bone-anchored expander or a conventional hyrax expander. Patients included did not have previous orthodontic treatment, were non-syndromic and had all teeth present in mouth. CBCT images were taken before expansion and two or more years after expansion. An independent T-test was used to determine the statistical significance between treatment groups and paired T-test was used to compare the results before and after expansion in each group. RESULTS Neither treatment group showed overall long-term different skeletal and dental changes in the transverse, anterior-posterior and vertical planes (P<0.05). Both treatment groups showed mild asymmetric skeletal expansion, but these were clinically insignificant. CONCLUSIONS Both expanders had similar skeletal and dental results. The greatest changes were in the transverse plane. Changes in vertical and anterior-posterior were negligible.
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Affiliation(s)
| | - Elissa Talma
- University of Minas Gerais, Structural Engineering School, Minas Gerais, Brazil
| | - Winfried Harzer
- Technical University of Dresden, department of Orthodontics, Fetscherstr. 72, D-01307 Dresden, Germany
| | - Manuel O Lagravère
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Orthodontic Graduate Program, ECHA 5-524, 11405-87 Ave, T6G 1C9 Edmonton, AB, Canada.
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Sayar G, Kılınç DD. Rapid maxillary expansion outcomes according to midpalatal suture maturation levels. Prog Orthod 2019; 20:27. [PMID: 31304569 PMCID: PMC6626764 DOI: 10.1186/s40510-019-0278-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/23/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This study aims to compare the relationship between skeletal and dental outcomes of rapid maxillary expansion (RME) treatment on cone beam computed tomography (CBCT) images between pre-pubertal peak (pre-peak) and post-pubertal peak (post-peak) patients. The null hypothesis was that there was no difference in the outcomes of RME treatment between the groups. METHODS Thirty-two patients who underwent RME treatment were classified according to midpalatal suture maturation levels and then divided into two groups as pre-peak and post-peak. Skeletal and dental measurements were performed on the CBCT images at T0 (pre-treatment stage) and at T1 (post-treatment stage). Paired sample t test was used to evaluate normally distributed data and P < 0.05 was taken as the significance level. RESULTS There were significant differences between T0 and T1 within the groups, but the changes between the pre-peak and post-peak patient groups were not statistically significant. CONCLUSION Non-significant changes were found between the two groups, and the null hypothesis was excepted.
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Affiliation(s)
- Gülşilay Sayar
- Department of Orthodontics, School of Dentistry, Istanbul Medipol University, Atatürk Bulvarı No: 27, 34083, Unkapanı-Fatih/Istanbul, Turkey.
| | - Delal Dara Kılınç
- Department of Orthodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey
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Khosravi M, Ugolini A, Miresmaeili A, Mirzaei H, Shahidi-Zandi V, Soheilifar S, Karami M, Mahmoudzadeh M. Tooth-borne versus bone-borne rapid maxillary expansion for transverse maxillary deficiency: A systematic review. Int Orthod 2019; 17:425-436. [PMID: 31280998 DOI: 10.1016/j.ortho.2019.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to compare dentoskeletal effects of bone-borne expanders with those of conventional expanders in adolescent and adults having transverse maxillary deficiency. METHODS All randomized clinical trials (RCTs) comparing the effects of bone-borne with those of tooth-borne expansion for treatment of maxillary transverse deficiency in adults and adolescents with maxillary transverse deficiency or posterior crossbite were included. The systematic search was irrespective of language and publication type. The electronic search was conducted from 1980 to January 2018. RESULTS The electronic searches retrieved 713 references after screening for eligibility criteria. Eight studies met the inclusion criteria for this systematic review involving 289 participants. Four studies compared rapid maxillary expansion (RME) between bone-borne and tooth-borne devices and indicated effectiveness of both devices on maxillary expansion. In the first molar region, there was no significant difference between two devices in either skeletal or dental expansion. Two studies compared the effects of bone-borne and tooth-borne device following SARME and suggested no significant difference regarding amount and pattern of expansion at various levels and in molar and premolar region between two groups. Two studies compared bone-borne and tooth-bone-borne devices. CONCLUSION Within the limit of the present evidence regarding maxillary expansion, it seems that both tooth-borne and bone-borne devices result in the same outcome in terms of the amount of maxillary expansion, dental tipping, stability and perceived pain both in RME and SARME procedure. PROSPERO registration: CRD42017061078.
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Affiliation(s)
- Mahdieh Khosravi
- Orthodontic Department Dental Faculty, 17 Shahrivar boulevard, Seman, Iran
| | - Alessandro Ugolini
- University of Genoa, Orthodontic Department, Largo Rosanna Benzi 10, Genova, Italy
| | - Amirfarhang Miresmaeili
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Hamed Mirzaei
- Faculty of Management of University of Tehran, Tehran, Iran
| | - Vahid Shahidi-Zandi
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Sepideh Soheilifar
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Manoochehr Karami
- Hamedan University of medical sciences, Department of Epidemiology School of Health, Shahid Fahmide boulevard, Hamedan, Iran
| | - Majid Mahmoudzadeh
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran.
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Krüsi M, Eliades T, Papageorgiou SN. Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis. Prog Orthod 2019; 20:9. [PMID: 30799516 PMCID: PMC6387979 DOI: 10.1186/s40510-019-0261-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/15/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The aim of the current systematic review was to compare the clinical effects of bone-borne or hybrid tooth-bone-borne rapid maxillary expansion (RME) with conventional tooth-borne RME in the treatment of maxillary deficiency. METHODS Nine databases were searched up to September 2018 for randomized clinical trials comparing bone-borne or hybrid tooth-bone-borne RME to conventional tooth-borne RME in patients of any age or sex. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. RESULTS A total of 12 papers on 6 unique trials with 264 patients (42.4% male; average age 12.3 years) were finally included. Limited evidence indicated that bone-borne RME was associated with greater suture opening at the first molar post-retention (1 trial; MD 2.0 mm; 95% CI 1.4 to 2.6 mm; moderate evidence quality) compared to tooth-borne RME, while no significant differences could be found regarding tooth inclination, nasal cavity width, and root resorption (very low to low evidence quality). Hybrid tooth-bone-borne RME was associated with less buccal tipping of the first premolar (2 trials; MD - 4.0°; 95% CI - 0.9 to - 7.1°; moderate evidence quality) and lower nasal airway resistance post-retention (1 trial; MD - 0.2 Pa s/cm3; 95% CI - 0.4 to 0 Pa s/cm3; moderate evidence quality) compared to tooth-borne RME, while no significant difference could be found regarding skeletal maxillary width, molar inclination, and analgesic use (low to moderate evidence quality). The main limitations affecting the validity of the present findings were (a) imprecision due to the inclusion of few trials with limited sample sizes that precluded robust detection of existing differences and (b) methodological issues of the included trials that could lead to bias. CONCLUSIONS Limited evidence from randomized trials indicates that bone-borne or hybrid tooth-bone-borne RME might present advantages in terms of increased sutural opening, reduced tooth tipping, and lower nasal airway resistance compared to conventional tooth-borne RME. However, the limited number of existing studies and issues in their conduct or reporting preclude the drawing of definite conclusions. REVIEW REGISTRATION PROSPERO ( CRD42017079107 ).
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Affiliation(s)
- Marietta Krüsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
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Li J, Wang X, Wang Y, Lu C, Zheng D, Zhang J. Isoquercitrin, a flavonoid glucoside, exerts a positive effect on osteogenesis in vitro and in vivo. Chem Biol Interact 2018; 297:85-94. [PMID: 30365939 DOI: 10.1016/j.cbi.2018.10.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 10/01/2018] [Accepted: 10/22/2018] [Indexed: 01/29/2023]
Abstract
Isoquercitrin (quercetin-3-O-β-d-glucopyranoside) possess various pharmacological effect as a biologically active compound. The aim of the present study was to investigate its potential effects on the proliferation and osteoblastic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) in vitro and bone formation in the mid-palatal suture during rapid maxillary expansion (RME) in vivo. Cell proliferation of rat BMSCs was detected by cell-counting kit- 8 (CCK-8) assay. Alkaline phosphatase (ALP) activity assay and alizarin red staining were used to evaluate osteogenic differentiation of BMSCs. Furthermore, the expression levels of osteogenesis-related genes including runt-related transcription factor 2 (Runx2), bone sialoprotein (BSP) and activating transcription factor 6 (ATF6) were measured by real-time RT-PCR. In vivo, thirty-six male 6-week-old Wistar rats with or without suture expansion receive systemic administration of isoquercitrin or saline solution. Micro-CT, HE and Masson staining were used to compare the morphological changes between the groups. Bone morphogenetic protein 2 (BMP2) expression in the suture was detected using immunohistochemical staining. Our results showed that isoquercitrin significantly promoted cell proliferation, ALP activity and mineral deposition in the range from 0.01 to 1 μM. Moreover, the expression levels of Runx2, BSP and ATF6 were also upregulated. The measurement of micro-CT imaging and histological examinations demonstrated that daily oral administration of isoquercitrin (10 mg/kg) increased bone formation compared to the other groups. Furthermore, the expression level of BMP2 was also augmented in the presence of isoquercitrin. Consequently, those findings showed that isoquercitrin exerts stimulatory effects on osteogenesis in vitro and in vivo, suggesting that isoquercitrin could be a potential candidate for preventing relapse following RME within palatal sutures.
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Affiliation(s)
- Jing Li
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, 250012, China; Department of Orthodontics, School of Stomatology, Shandong University, Jinan, 250012, China
| | - Xuxia Wang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, 250012, China; Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong University, Jinan, 250012, China
| | - Yingzi Wang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, 250012, China; Department of Orthodontics, School of Stomatology, Shandong University, Jinan, 250012, China
| | - Chengyan Lu
- Department of Stomatology, Zaozhuang Mining Group Central Hospital, Zaozhuang, 277800, China
| | - Dehua Zheng
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, 250012, China; Department of Orthodontics, School of Stomatology, Shandong University, Jinan, 250012, China
| | - Jun Zhang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, 250012, China; Department of Orthodontics, School of Stomatology, Shandong University, Jinan, 250012, China.
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Mohammed H, Wafaie K, Rizk MZ, Almuzian M, Sosly R, Bearn DR. Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis. Prog Orthod 2018; 19:36. [PMID: 30246217 PMCID: PMC6151309 DOI: 10.1186/s40510-018-0225-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 06/21/2018] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of this review was to systematically evaluate the failure rates of miniscrews related to their specific insertion site and explore the insertion site dependent risk factors contributing to their failure. Search methods An electronic search was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Knowledge, Scopus, MEDLINE and PubMed up to October 2017. A comprehensive manual search was also performed. Eligibility criteria Randomised clinical trials and prospective non-randomised studies, reporting a minimum of 20 inserted miniscrews in a specific insertion site and reporting the miniscrews’ failure rate in that insertion site, were included. Data collection and analysis Study selection, data extraction and quality assessment were performed independently by two reviewers. Studies were sub-grouped according to the insertion site, and the failure rates for every individual insertion site were analysed using a random-effects model with corresponding 95% confidence interval. Sensitivity analyses were performed in order to test the robustness of the reported results. Results Overall, 61 studies were included in the quantitative synthesis. Palatal sites had failure rates of 1.3% (95% CI 0.3–6), 4.8% (95% CI 1.6–13.4) and 5.5% (95% CI 2.8–10.7) for the midpalatal, paramedian and parapalatal insertion sites, respectively. The failure rates for the maxillary buccal sites were 9.2% (95% CI 7.4–11.4), 9.7% (95% CI 5.1–17.6) and 16.4% (95% CI 4.9–42.5) for the interradicular miniscrews inserted between maxillary first molars and second premolars and between maxillary canines and lateral incisors, and those inserted in the zygomatic buttress respectively. The failure rates for the mandibular buccal insertion sites were 13.5% (95% CI 7.3–23.6) and 9.9% (95% CI 4.9–19.1) for the interradicular miniscrews inserted between mandibular first molars and second premolars and between mandibular canines and first premolars, respectively. The risk of failure increased when the miniscrews contacted the roots, with a risk ratio of 8.7 (95% CI 5.1–14.7). Conclusions Orthodontic miniscrew implants provide acceptable success rates that vary among the explored insertion sites. Very low to low quality of evidence suggests that miniscrews inserted in midpalatal locations have a failure rate of 1.3% and those inserted in the zygomatic buttress have a failure rate of 16.4%. Moderate quality of evidence indicates that root contact significantly contributes to the failure of interradicular miniscrews placed between the first molars and second premolars. Results should be interpreted with caution due to methodological drawbacks in some of the included studies. Electronic supplementary material The online version of this article (10.1186/s40510-018-0225-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Khaled Wafaie
- School of Dentistry, University of Dundee, Dundee, UK
| | - Mumen Z Rizk
- School of Dentistry, University of Dundee, Dundee, UK
| | - Mohammed Almuzian
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Rami Sosly
- School of Dentistry, University of Dundee, Dundee, UK
| | - David R Bearn
- School of Dentistry, University of Dundee, Dundee, UK
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Taner L, Metin-Gürsoy G, Sarısu-Demircioğlu ND. Differential Benefit of Two Different Tooth-Borne Rapid Maxillary Expansion Appliances in Female Subjects. Turk J Orthod 2018; 31:67-72. [PMID: 30206564 DOI: 10.5152/turkjorthod.2018.17051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/08/2018] [Indexed: 11/22/2022]
Abstract
Objective The aim of the present study was to evaluate the effects of tooth-borne acrylic-bonded rapid maxillary expansion (RME) appliances with or without the anterior teeth anchorage on the skeletal and dentoalveolar structures, as well as soft tissues. Methods This study included 44 patients who were treated with two different tooth-borne bonded acrylic RME appliances. Lateral cephalometric radiographs were taken before the treatment (T0) and in the post-retention (T1) phase of the RME treatment. The posterior-bonded RME appliance group and full-bonded RME appliance group were created as the two different groups of treatment. The following statistical analyses were performed: intra- and inter-group comparisons were made using the paired t-test, Wilcoxon test, independent t-test, and Mann-Whitney U-test for normal and non-normal distribution data. Results Significant increases were observed in R1-A, R1-ANS, R1-U1, R1-AR, R1-St, R1-Li, and R1-Pn in both groups. R1-PNS, R1-Ls, R1-Sn, and R1-B' were found to be significantly larger at T1 than at T0 in the posterior-bonded RME appliance group. R2-A, R2-ANS, R2-L1, R2-A', and R2-Pn were significantly larger at T1 than at T0 in the full-bonded RME appliance group. The R2-A' was significantly different between the groups. Conclusion The soft tissue A point appears to be the most important differing matter between the two different RME appliances, and a full acrylic-bonded RME appliance may be beneficial for subjects with a maxillary retrognathic profile.
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Affiliation(s)
- Lale Taner
- Department of Orthodontics, Gazi University University School of Dentistry, Ankara, Turkey
| | - Gamze Metin-Gürsoy
- Department of Orthodontics, Gazi University University School of Dentistry, Ankara, Turkey
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