1
|
Santagata M, Tartaro G, Guida D, D'Amato S, Boschetti CE, Chirico F. Surgically assisted rapid maxillary expansion: current concepts of minimally invasive approaches. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00218-2. [PMID: 39013735 DOI: 10.1016/j.ijom.2024.07.007] [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: 11/08/2023] [Revised: 06/30/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
Studies have consistently shown an association of the Le Fort I osteotomy with undesirable adverse events in the nasolabial region, including lengthening and thinning of the upper lip, a reduction in upper vermilion exposure, and nasal base enlargement. Various minimally invasive techniques have been developed based on knowledge collected over recent decades on the aetiopathogenesis of these aesthetic impairments. The common scope of these techniques is to reduce the damage to the facial soft tissues and achieve a sound and spontaneous healing process, avoiding those procedures that are commonly used to counteract undesirable aesthetic changes. This paper provides a summary of the aetiopathogenesis of these adverse events, as well as an overview of current concepts in minimally invasive surgically assisted rapid maxillary expansion (miSARME).
Collapse
Affiliation(s)
- M Santagata
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Tartaro
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - D Guida
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S D'Amato
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C E Boschetti
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Chirico
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.
| |
Collapse
|
2
|
Zeng W, Yan S, Yi Y, Chen H, Sun T, Zhang Y, Zhang J. Long-term efficacy and stability of miniscrew-assisted rapid palatal expansion in mid to late adolescents and adults: a systematic review and meta-analysis. BMC Oral Health 2023; 23:829. [PMID: 37924088 PMCID: PMC10623697 DOI: 10.1186/s12903-023-03574-y] [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: 12/08/2022] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The purpose of this study is to investigate the long-term efficacy and stability of Miniscrew-assisted Rapid Palatal Expansion (MARPE), including its primary outcomes, namely the nasomaxillary complex transverse skeletal and dental expansion, and related secondary outcomes. METHODS Electronic databases and manual literature searches, up to October 31, 2022, were performed. The eligibility criteria were the following: studies on patients with transverse maxillary deficiency treated with MARPE in adults and adolescents over 13.5 years of age. RESULTS Ultimately, twelve articles were included in the analysis, one prospective and eleven retrospective observational studies. Five studies showed a moderate risk of bias, while the remaining seven studies were at a serious risk of bias. The GRADE quality of evidence was very low. MARPE is an effective treatment modality for transverse maxillary deficiency (mean success rate: 93.87%). Patients showed increased mean in the skeletal and dental transverse expansion. The basal bone composition, mean alveolar bone and mean dental expansion accounted for 48.85, 7.52, and 43.63% of the total expansion, respectively. There was a certain degree of skeletal and dental relapse over time. MARPE could also cause dental, alveolar, and periodontal side effects, and have an impact on other craniofacial bones, upper airway, and facial soft tissue. CONCLUSIONS MARPE is an effective treatment for transverse maxillary deficiency, with a high success rate and a certain degree of skeletal and dental relapse over time.
Collapse
Affiliation(s)
- Weiqian Zeng
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Shuyun Yan
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yating Yi
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Hao Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Tongke Sun
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Yimeng Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China
| | - Jun Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, 250012, Jinan, Shandong, China.
| |
Collapse
|
3
|
Buyukcavus MH, Aydogan Akgun F, Solak S, Ucar MHB, Fındık Y, Baykul T. Facial recognition by cloud-based APIs following surgically assisted rapid maxillary expansion. J Orofac Orthop 2023:10.1007/s00056-023-00494-y. [PMID: 37773456 DOI: 10.1007/s00056-023-00494-y] [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: 04/13/2022] [Accepted: 07/25/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION This study aimed to investigate whether the facial soft tissue changes of individuals who had undergone surgically assisted rapid maxillary expansion (SARME) would be detected by three different well-known facial biometric recognition applications. METHODS To calculate similarity scores, the pre- and postsurgical photographs of 22 patients who had undergone SARME treatment were examined using three prominent cloud computing-based facial recognition application programming interfaces (APIs): AWS Rekognition (Amazon Web Services, Seattle, WA, USA), Microsoft Azure Cognitive (Microsoft, Redmond, WA, USA), and Face++ (Megvii, Beijing, China). The pre- and post-SARME photographs of the patients (relaxed, smiling, profile, and semiprofile) were used to calculate similarity scores using the APIs. Friedman's two-way analysis of variance and the Wilcoxon signed-rank test were used to compare the similarity scores obtained from the photographs of the different aspects of the face before and after surgery using the different programs. The relationship between measurements on lateral and posteroanterior cephalograms and the similarity scores was evaluated using the Spearman rank correlation. RESULTS The similarity scores were found to be lower with the Face++ program. When looking at the photo types, it was observed that the similarity scores were higher in the smiling photos. A statistically significant difference in the similarity scores (P < 0.05) was found between the relaxed and smiling photographs using the different programs. The correlation between the cephalometric and posteroanterior measurements and the similarity scores was not significant (P > 0.05). CONCLUSION SARME treatment caused a significant change in the similarity scores calculated with the help of three different facial recognition programs. The highest similarity scores were found in the smiling photographs, whereas the lowest scores were found in the profile photographs.
Collapse
Affiliation(s)
| | - Filiz Aydogan Akgun
- Faculty of Dentistry, Department of Orthodontics, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Serdar Solak
- Faculty of Technology, Department of Information Systems Engineering, Kocaeli University, Kocaeli, Turkey
| | | | - Yavuz Fındık
- Faculty of Dentistry, Department of Department of Oral and Maxillofacial Surgery, Süleyman Demirel University, Isparta, Turkey
| | - Timucin Baykul
- Faculty of Dentistry, Department of Department of Oral and Maxillofacial Surgery, Süleyman Demirel University, Isparta, Turkey
| |
Collapse
|
4
|
Chacón G, Saleh MHA, Fleming C, Leon N, Wang HL. Papilla reconstruction for an iatrogenic RT3 gingival defect using a tuberosity soft tissue graft: A case report. Clin Adv Periodontics 2023; 13:163-167. [PMID: 36636761 DOI: 10.1002/cap.10233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Orthognathic surgery is a reliable and safe method to improve maxillo-mandibular malformations. However, it is a complex procedure that can affect deeper structures and the terminal blood supply of specific areas, thereby affecting the results. Occasionally, despite careful digital planning and diagnosis, esthetic complications may occur, such as scarring or mucogingival alterations, including localized aseptic necrosis with associated recessions. In more severe cases, larger fragments of necrosis may be involved. METHODS AND RESULTS The aim of this case report was to present a case, including diagnosis, treatment plan, periodontal plastic surgical technique, and follow-up for a recession type 3 (RT3) defect. This RT3 gingival defect was associated with necrotic crestal bone exposure in the anterior esthetic area resulting from a complication after orthognathic surgery. CONCLUSIONS Partial reconstruction of the interdental papilla can be possible through consideration of the defect characteristics, use of microsurgical principles, and utilization of a suitable connective tissue grafting technique. KEY POINTS Why is this case new information? To the authors' knowledge, there is very limited clinical and scientific evidence regarding the management of esthetic complications associated with ischemic necrosis resulting from orthognathic surgeries. This case study identified the management of papillary reconstructions of these mucogingival defects. What are the keys to the successful management of this case? For an ideal case management, adequate plaque and infection control and timely notice of the defect appearance are critical. Additionally, proper surgical soft tissue management of the affected papillae and surrounding area is required. Finally, the type of connective tissue graft to be used, its management and fixation, and proper postoperative protocols are needed for case success. What are the primary limitations to success in this case? Despite the limitations of this study, the authors consider that the treatment of mucogingival complications related to orthognathic surgeries is possible, using microsurgical concepts and connective tissue grafts to reconstruct papillae.
Collapse
Affiliation(s)
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Christina Fleming
- Department of Periodontics, University of Louisville, Louisville, Kentucky, USA
| | | | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| |
Collapse
|
5
|
Krijt LL, Kapetanović A, Sijmons WJL, Bruggink R, Baan F, Bergé SJ, Noverraz RRM, Xi T, Schols JGJH. What is the impact of miniscrew-assisted rapid palatal expansion on the midfacial soft tissues? A prospective three-dimensional stereophotogrammetry study. Clin Oral Investig 2023; 27:5343-5351. [PMID: 37507601 PMCID: PMC10492756 DOI: 10.1007/s00784-023-05154-4] [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: 10/05/2022] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES To evaluate the midfacial soft tissue changes of the face in patients treated with miniscrew-assisted rapid palatal expansion (MARPE). MATERIALS AND METHODS 3D facial images and intra-oral scans (IOS) were obtained before expansion (T0), immediately after completion of expansion (T1), and 1 year after expansion (T2). The 3D images were superimposed and two 3D distance maps were generated to measure the midfacial soft tissue changes: immediate effects between timepoints T0 and T1 and overall effects between T0 and T2. Changes of the alar width were also measured and dental expansion was measured as the interpremolar width (IPW) on IOS. RESULTS Twenty-nine patients (22 women, 7 men, mean age 25.9 years) were enrolled. The soft tissue in the regions of the nose, left of philtrum, right of philtrum, and upper lip tubercle demonstrated a statistically significant anterior movement of 0.30 mm, 0.93 mm, 0.74 mm, and 0.81 mm, respectively (p < 0.01) immediately after expansion (T0-T1). These changes persisted as an overall effect (T0-T2). The alar width initially increased by 1.59 mm, and then decreased by 0.08 mm after 1 year, but this effect was not significant. The IPW increased by 4.58 mm and remained stable 1 year later. There was no significant correlation between the increase in IPW and alar width (r = 0.35, p = 0.06). CONCLUSIONS Our findings indicate that MARPE results in significant but small changes of the soft tissue in the peri-oral and nasal regions. However, the clinical importance of these findings is limited. CLINICAL RELEVANCE MARPE is an effective treatment modality to expand the maxilla, incurring only minimal and clinically insignificant changes to the midfacial soft tissues.
Collapse
Affiliation(s)
- Laura L Krijt
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, Dentistry 309, 6500, HB, Nijmegen, the Netherlands.
| | - Aldin Kapetanović
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, Dentistry 309, 6500, HB, Nijmegen, the Netherlands
| | - Wouter J L Sijmons
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, Dentistry 309, 6500, HB, Nijmegen, the Netherlands
| | - Robin Bruggink
- Radboudumc 3D Lab, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, the Netherlands
| | - Frank Baan
- Radboudumc 3D Lab, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, the Netherlands
| | - Stefaan J Bergé
- Department of Oral and Maxillofacial Surgery, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, the Netherlands
| | - René R M Noverraz
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, Dentistry 309, 6500, HB, Nijmegen, the Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, the Netherlands
| | - Jan G J H Schols
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboudumc Graduate School, Radboud University Medical Center, PO Box 9101, Dentistry 309, 6500, HB, Nijmegen, the Netherlands
| |
Collapse
|
6
|
Koç O, Pamukçu H, Kocabalkan AA. Comparison of 3 different bone-borne type expansion appliances used in surgically-assisted rapid palatal expansion: A finite element analysis. Am J Orthod Dentofacial Orthop 2023; 163:e23-e33. [PMID: 36572581 DOI: 10.1016/j.ajodo.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION This study aimed to compare the effects of 3 different bone-borne type expansion appliances used in the surgically-assisted rapid palatal expansion (SARPE) by finite element analysis. METHODS Three different miniscrew-supported palatal expansion appliances were modeled. Median and lateral osteotomies were performed without pterygomaxillary suture separation. Model I consisted of a palatal expander with 2 miniscrews placed 4 mm far from the midpalatal suture. In model II, 2 miniscrews were located at the alveolar ridge between the first molar and the second premolar. In model III, 4 miniscrews were placed as a combination of the first and second models. Stress distributions and amount of displacements were evaluated with Ansys software (version 19.2; Ansys, Canonsburg, Pa) for 5-mm expansion in a symmetrical finite element analysis model to reflect the clinical situation. RESULTS SARPE simulation using miniscrew-assisted maxillary expanders for all models showed a rotation and tipping of the maxilla. The largest displacement was found for the anterior part of the palate in model II and the posterior part in model III. Although a wedge-shaped expansion pattern was observed in all models, this form was more prominent in model II. The highest stress value (0.91 MPa) was measured in model I, and the lowest value (0.004 MPa) was measured in model II for the anterior nasal spine region. The highest stress value (0.51 MPa) was measured in model III, and the lowest value (0.12 MPa) was measured in model II for the posterior nasal spine region. The lowest stress values were measured in model II for all the craniofacial and maxillofacial structures. CONCLUSIONS Among the models, the lowest stress distribution conditions for craniofacial and maxillofacial structures were found in model II. The largest displacement was found at the incisors and anterior part of the maxilla for model II. The greatest displacement was found at the posterior region for model III.
Collapse
Affiliation(s)
- Osman Koç
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
| | - Hande Pamukçu
- Department of Orthodontics, School of Dentistry, Başkent University, Ankara, Turkey
| | | |
Collapse
|
7
|
Karabiber G, Yılmaz HN. Does unilateral surgically assisted rapid maxillary expansion (SARME) lead to perinasal asymmetry? J Orofac Orthop 2023; 84:1-9. [PMID: 34357410 DOI: 10.1007/s00056-021-00333-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/25/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVE True unilateral posterior crossbite (TUPC) requires unilateral expansion to prevent nonocclusion at the noncrossbite (NC) side. The recommended osteotomies for TUPC after sutural closure are anterior, lateral, and posterior osteotomies only on the crossbite (C) side and median osteotomy of the midpalatal suture, i.e., unilateral surgically assisted rapid maxillary expansion (SARME). The goal was to assess airway and perinasal soft tissue outcomes after SARME. METHODS Data from 16 patients (8 males, 8 females; mean age 18.38 ± 1.45 years) were retrospectively assessed after unilateral SARME. The expansion (twice daily: 0.5 mm/day) and retention periods comprised 3 weeks and 6 months, respectively. Stereophotogrammetric images were used for soft tissue assessment; cone beam computed tomography (CBCT) was used to evaluate the anterior nasal airway. Statistical analyses were performed. RESULTS Using linear measurements, soft tissue distances of the alar base and alare to midsagittal plane (MSP) were significantly increased on the C side. A significant decrease was observed for the distance from the lower nostril point to the MSP on the NC side compared to a significant increase on the C side. Comparing the C and NC sides, the changes were significantly higher on the C side for all parameters except the upper nostril point to the MSP distance. Cheek volume was significantly higher on the C side. Volume changes of the anterior nasal airway (ANA) were significantly increased on the C side, but volume changes between NC and C were not significantly different. CONCLUSIONS Unilateral SARME led to significant expansion of ANA on the C side, but did not lead to asymmetry in the nasal region or have adverse effects on the airway or perinasal soft tissues. Thus, this novel treatment method may be useful in the treatment of patients with TUPC.
Collapse
Affiliation(s)
- Gülden Karabiber
- Faculty of Dentistry, Department of Orthodontics, İstanbul Medeniyet University, Fatih Mah., Eski Ankara Asfaltı Cad., No:28 Tuzla/Orhanlı, 34956, Istanbul, Turkey.
| | - Hanife Nuray Yılmaz
- Faculty of Dentistry, Department of Orthodontics, Marmara University, Istanbul, Turkey
| |
Collapse
|
8
|
Wallner J, Denoiseux B, Van de Casteele E, Bila M, Van Hemelen G, Nadjmi N, Vercruysse H. Do sex and age influence nasal soft tissue widening after bone-borne transpalatal distraction ? J Oral Maxillofac Surg 2022; 80:1613-1627. [DOI: 10.1016/j.joms.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 06/03/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022]
|
9
|
Evaluation of Sagittal and Vertical Changes in Maxillary Dental, Skeletal, and Soft Tissue Following Surgically Assisted Rapid Maxillary Expansion: A Retrospective Longitudinal Study. J Craniofac Surg 2022; 33:e398-e401. [DOI: 10.1097/scs.0000000000008256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
10
|
Two- and Three-Segment Surgically Assisted Rapid Maxillary Expansion: A Clinical Trial. Plast Reconstr Surg 2021; 148:1086-1097. [PMID: 34705783 DOI: 10.1097/prs.0000000000008491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The literature shows no consensus on whether two- or three-segment surgically assisted rapid maxillary expansion is the best operative technique. METHODS The present clinical trial was designed to compare the outcome of two- and three-segment osteotomy surgically assisted rapid maxillary expansion. Thirty-two adult patients with transverse maxillary deficiency greater than or equal to 5 mm were randomly assigned to two- and three-segment groups (n = 16). Dimensional and psychological assessments (Oral Health Impact Profile and Brazilian Orthognathic Quality of Life Questionnaire) were carried out before surgical intervention and at one of the following time points: completion of expansion, removal of expanding device, 6 months after completion of expansion, or 10 months after completion of expansion. Dimensional assessments for asymmetric expansion of the maxilla and for changes in the area and volume of the palatine vault were performed on digital data from tomographic and laser scanning with the aid of an engineering inspection software. RESULTS No statistically significant differences were found in asymmetry or stability outcomes between groups. The psychological benefit provided by the three-segment technique did not spread through the domains of the quality-of-life questionnaires. CONCLUSIONS The current findings suggest that three-segment surgically assisted rapid maxillary expansion outcomes do not exceed those obtained with its two-segment counterpart regarding symmetry of maxillary expansion and stability of area and volume of the palatine vault. Furthermore, psychological nuances evidenced in two- and three-segment groups with the tools used play a limited, short-lasting role, or a specific, more sensitive assessment tool needs to be developed. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.
Collapse
|
11
|
Jesus AS, Oliveira CB, Murata WH, Gonçales ES, Pereira-Filho VA, Santos-Pinto A. Nasomaxillary effects of miniscrew-assisted rapid palatal expansion and two surgically assisted rapid palatal expansion approaches. Int J Oral Maxillofac Surg 2021; 50:1059-1068. [PMID: 33478814 DOI: 10.1016/j.ijom.2020.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/18/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
This retrospective study was performed to evaluate nasomaxillary changes in 36 patients at an advanced stage of skeletal maturity who underwent miniscrew-assisted rapid palatal expansion (MARPE) or surgically assisted rapid palatal expansion (SARPE) with/without an alar base cinch. Cone beam computed tomography images taken before and after expansion were analysed. Changes in the width of the dental arch (D66S, D66I), maxillary base (MxMol), and nasal floor and nasal cavity in the molar and canine regions (NaFMol, NaFCan, NaCMol, NaCCan) were compared, as well as changes in the choanal aperture (CA) and nasal soft tissue (NW). The MARPE technique produced smaller dental changes (D66S; P=0.025) and greater nasomaxillary expansion (MxMol, P=0.010; NaCMol, P=0.016; NaCCan, P=0.017; NaFMol, P=0.001; CA, P=0.002) than both SARPE techniques. Changes in NW did not differ significantly between the groups (P=0.200). MARPE uniformly increased the anterior and posterior widths of the nasal cavity. SARPE expanded the nasal cavity in a 'V-shape' pattern. Changes in the nasal cavity and choanal aperture related to the amount of dental arch expansion were greater for MARPE than for SARPE. All three approaches increased the width of the nasal soft tissue, although the cinch in SARPE limited this increase.
Collapse
Affiliation(s)
- A S Jesus
- Department of Orthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil.
| | - C B Oliveira
- Department of Orthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
| | - W H Murata
- Department of Orthodontics, São Leopoldo Mandic School and Dental Institute, Campinas, SP, Brazil
| | - E S Gonçales
- Department of Stomatology, Bauru School of Dentistry, São Paulo University, Bauru, Brazil
| | - V A Pereira-Filho
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
| | - A Santos-Pinto
- Department of Orthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
| |
Collapse
|
12
|
Mota de Paulo JP, Herbert de Oliveira Mendes F, Gonçalves Filho RT, Marçal FF. Combined Orthodontic-Orthognathic Approach for Dentofacial Deformities as a Risk Factor for Gingival Recession: A Systematic Review. J Oral Maxillofac Surg 2020; 78:1682-1691. [PMID: 32615098 DOI: 10.1016/j.joms.2020.05.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/02/2020] [Accepted: 05/21/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE The objective of this systematic review was to evaluate the risk of development of gingival recession (GR) as a result of the combined orthodontic-orthognathic approach. MATERIALS AND METHODS The PubMed, Google Scholar, ClinicalTrials.gov, and Cochrane Library databases were searched. Included articles mentioned gingival parameters in their materials and methods sections; specifically, they evaluated GR, which was measured before and after the surgical procedure. Study parameters such as methodology, evaluation period, sample characteristics, and follow-up were extracted by 2 authors independently. RESULTS In total, 133 relevant articles were identified from the databases; after screening and full-text analysis, 9 studies were included in this systematic review. Meta-analysis could not be conducted because of considerable heterogeneity in methods. The incidence of GR in the range of 0.5 to 3.0 mm as a significant clinical finding after orthognathic surgery showed statistically significant differences in all included articles. Among patients with GR, the mean age was 23.0 to 29.5 years and the mandibular incisors were the most common site. However, no case of recession greater than 3.0 mm was associated with surgery. CONCLUSIONS On the basis of the findings of this review, GR of approximately 0.5 to 3.0 mm is a common finding after the combined orthodontic-orthognathic approach. Although periodontal damage up to 3 mm can be observed as an isolated finding in mainly the incisors, true recession is not associated with orthognathic surgery in general.
Collapse
Affiliation(s)
- João Paulo Mota de Paulo
- Graduation Student in Dentistry, Department of Clinical Dentistry, Christus University Center, Fortaleza, Brazil
| | | | | | - Felipe Franco Marçal
- Professor, Department of Clinical Dentistry, Christus University Center, Fortaleza, Brazil.
| |
Collapse
|
13
|
Nasal soft tissue changes after two different approaches for surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg 2019; 48:957-961. [PMID: 30765138 DOI: 10.1016/j.ijom.2019.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/05/2018] [Accepted: 01/25/2019] [Indexed: 11/22/2022]
Abstract
The aim of the study was to evaluate the nasal soft tissue changes in patients who underwent surgically assisted rapid maxillary expansion (SARME) using two different surgical approaches. Thirty-two patients were included in the study, and divided into two groups according to the type of surgical approach: in group A (n=17), SARME performed with standard Le Fort I circumvestibular approach with alar base cinch and anterior nasal spine (ANS) exposure; and in group B (n=15) operations were performed with the same standard Le Fort I circumvestibular approach with only alar base cinch. Measurements of height and width of the philtrum, nasal and subnasal width, and columella width were taken from three-dimensional facial images obtained before surgery (T1), after the distraction phase (T2) and 6 months postoperatively (T3). The mean maxillary expansion was 7.3±0.7mm for group A and 7.5±1.5mm for group B, without any significant difference between groups (P=0.59). Both groups presented an increase in all vaules in T2 and T3. The approach used in group A resulted in smaller changes in the columella width. The results of the present study show that there is no need for intraoperative releasing of the soft tissues around the anterior nasal spine during SARME if columella width is sufficient. However, further randomized studies based on large patient groups are needed before final conclusions on this topic can be reached.
Collapse
|
14
|
Kayalar E, Schauseil M, Hellak A, Emekli U, Fıratlı S, Korbmacher-Steiner H. Nasal soft- and hard-tissue changes following tooth-borne and hybrid surgically assisted rapid maxillary expansion: A randomized clinical cone-beam computed tomography study. J Craniomaxillofac Surg 2019; 47:1190-1197. [PMID: 31307850 DOI: 10.1016/j.jcms.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/26/2018] [Accepted: 01/04/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The aim of this study was to assess the effects of tooth/bone-borne (hybrid) and tooth-borne (TB) surgically assisted rapid maxillary expansion (SARME) on the width of the nasal soft and hard tissue. PATIENTS AND METHODS Twenty skeletally mature patients (nine males and 11 females; mean age 19.4 years) with transverse maxillary hypoplasia were randomly assigned to hybrid or TB devices. The patients had undergone SARME operations, performed by the same surgical team using the same procedure (Le Fort I osteotomy with pterygomaxillary dysjunction, midline osteotomy, and no down-fracture). Nasal soft- and hard-tissue changes were analyzed using CBCT preoperatively (T0), at the end of the active expansion phase (T1), and after 6 months of retention (T2). The study was approved by the relevant ethics committee. RESULTS The skeletal and soft-tissue nasal parameters increased significantly in the T0-T1 and T0-T2 periods in both groups (P < 0.05). No statistically significant differences between the groups were observed. The mean piriform aperture width increased from 1.26 mm in T0-T1 to 0.97 mm in T1-T2 and 2.17 mm in T0-T2 (P < 0.008). In the soft tissue, the alar base width increased to 2.78 mm and the alar width to 2.95 mm in T0-T2 (P = 0.001). There was a positive correlation (63.6%) between the changes in skeletal and soft-tissue values. CONCLUSION The hybrid and TB devices led to similarly significant widening effects in nasal soft and hard tissues in both the short term and 6 months after SARME.
Collapse
Affiliation(s)
- Emre Kayalar
- Departments of Orthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey; Private Practice, Orthodontist (PhD), Istanbul, Turkey.
| | - Michael Schauseil
- Department of Orthodontics, University of Marburg, Marburg, Germany.
| | - Andreas Hellak
- Department of Orthodontics, University of Marburg, Marburg, Germany.
| | - Ufuk Emekli
- Department of Oral and Maxillofacial Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sönmez Fıratlı
- Departments of Orthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | | |
Collapse
|
15
|
Torun GS. Soft tissue changes in the orofacial region after rapid maxillary expansion : A cone beam computed tomography study. J Orofac Orthop 2018; 78:193-200. [PMID: 27957595 DOI: 10.1007/s00056-016-0074-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Rapid maxillary expansion (RME) is usually used for expanding the maxillary bony segments. Many studies have assessed the dental and skeletal effects of the expansion treatment but few studies evaluated soft tissue changes using cone beam computed tomography (CBCT) images. This study aims to compare soft tissue changes after RME in prepubertal and postpubertal subjects using CBCT images. The null hypothesis of this study is there is no difference between prepubertal and postpubertal patients in soft tissue changes after RME treatment. MATERIALS AND METHODS A total of 28 patients (10 males, 18 females) with a bonded type of rapid maxillary expander were included in this study. The patients were divided into two subgroups according to cervical vertebral maturation stage. Prepubertal and postpubertal groups were obtained. Following the selection of CBCT images from the archive, pretreatment (T0) and postretention measurements (T1) were performed. Nine linear and one angular measurement for a total of 10 measurements were evaluated on each CBCT image. The mean differences between T0 and T1 measurements were compared by using the paired-samples t test and significance was set at P < 0.05. RESULTS The largest median increase was found in cheek projection of the prepubertal group. Changes in soft tissue nasal base, philtrum width, upper lip length, columella width, columella height, and cheek projection were statistically significant (P < 0.001) in both groups. No significant differences were observed in soft tissue alar base, nostril width, nostril height, and nasolabial angle. CONCLUSION Some significant changes in facial soft tissues were observed after RME treatment but there were no significant differences between prepubertal and postpubertal subjects. The null hypothesis is accepted because there were no significant differences between the groups.
Collapse
Affiliation(s)
- Gülşilay Sayar Torun
- Department of Orthodontics, School of Dentistry, Istanbul Medipol University, Atatürk Bulvarı No:27, Unkapanı-Fatih, 34083, Istanbul, Turkey.
| |
Collapse
|
16
|
Aras I, Olmez S, Akay MC, Gunbay T, Aras A. The effects of maxillary expansion on the soft tissue facial profile. J Istanb Univ Fac Dent 2017; 51:1-10. [PMID: 29114424 PMCID: PMC5624139 DOI: 10.17096/jiufd.85884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 07/20/2016] [Indexed: 11/15/2022] Open
Abstract
Purpose The aims of this retrospective study were to evaluate the possible changes in soft tissue facial profile induced by orthopedic rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME), and to correlate them with the underlying hard tissue alterations. Materials and Methods 16 patients who received bone borne SARME and 25 patients who were subjected to RME using metal cast splint hyrax appliance were analyzed retrospectively. This research was conducted on lateral cephalometric radiographs taken on 2 occasions: before expansion (T1) and at the beginning of any further orthodontic treatment (T2). Investigated lateral cephalometric parameters consisted of Holdaway soft tissue measurements with some supplementary soft tissue, skeletal and dental assessments. Results The acquisition of T2 cephalograms which conforms to the initiation of further orthodontic treatment corresponded to 83.25±3.51 days for SARME and 85.68±4.37 days for RME after the expansion was completed. The only significant change in soft tissue profile of the SARME group was a decrease in upper lip thickness (p<0.05), whereas in the RME group, decrease in soft tissue facial profile angle and increase in H angle were found to be statistically significant (p<0.05 for each). For the RME group, the changes in soft tissue facial profile angle and H angle correlated only with the changes in SNB angle (p<0.05). Conclusion While bone-borne SARME did not seem to possess the potential to alter soft tissue profile, tooth-borne RME caused a more convex soft tissue profile related to a reduction in SNB.
Collapse
Affiliation(s)
- Isil Aras
- Department of Orthodontics, Faculty of Dentistry, Ege University Turkey
| | | | - Mehmet Cemal Akay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University Turkey
| | - Tayfun Gunbay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University Turkey
| | - Aynur Aras
- Department of Orthodontics, Faculty of Dentistry, Ege University Turkey
| |
Collapse
|
17
|
Xi T, Laskowska M, van de Voort N, Ghaeminia H, Pawlak W, Bergé S, Maal T. The effects of surgically assisted rapid maxillary expansion (SARME) on the dental show and chin projection. J Craniomaxillofac Surg 2017; 45:1835-1841. [PMID: 28935486 DOI: 10.1016/j.jcms.2017.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 07/18/2017] [Accepted: 08/21/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To quantify the postoperative changes of the dental show and chin projection following SARME using 3D CBCT imaging. MATERIAL AND METHODS 78 patients with transversal maxillary hypoplasia and mandibular hypoplasia who underwent SARME were enrolled into the study. A cone beam computed tomography (CBCT) scan was acquired preoperatively and at least 1 year postoperatively. 3D postoperative changes in the dental show and pogonion position were measured based on soft tissue and hard tissue landmarks. RESULTS 68 patients (87%) exhibited a postoperative increase in the dental show. The dental show was increased by a mean of 2.2 ± 2.0 mm (p < 0.01). The mean horizontal and vertical displacement of the chin (pogonion) following SARME was 1.6 ± 2.5 mm posteriorly and 1.6 ± 2.0 mm inferiorly (p < 0.01). An inferior displacement of the maxilla and maxillary tooth as well as a consequent clockwise pitch of the mandible seemed to play a role in inducing these postoperative changes. CONCLUSION An increase in dental show and a posterior and inferior displacement of the chin should be considered prior to SARME to prevent undesirable postoperative changes of the facial esthetics.
Collapse
Affiliation(s)
- Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
| | - Magdalena Laskowska
- Department of Oral and Maxillofacial Surgery, University Hospital of Wroclaw, Borowska 213, 50-556 Wroclaw, Poland.
| | - Neeltje van de Voort
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
| | - Hossein Ghaeminia
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
| | - Wojciech Pawlak
- Department of Oral and Maxillofacial Surgery, University Hospital of Wroclaw, Borowska 213, 50-556 Wroclaw, Poland.
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
| | - Thomas Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
| |
Collapse
|
18
|
Facial Mobility after Maxilla-Mandibular Advancement in Patients with Severe Obstructive Sleep Apnea Syndrome: A Three-Dimensional Study. Int J Dent 2017; 2017:1574304. [PMID: 28659977 PMCID: PMC5474255 DOI: 10.1155/2017/1574304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/04/2017] [Accepted: 05/14/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction. The functional results of surgery in terms of facial mobility are key elements in the treatment of patients. Little is actually known about changes in facial mobility following surgical treatment with maxillomandibular advancement (MMA). Objectives. The three-dimensional (3D) methods study of basic facial movements in typical OSAS patients treated with MMA was the topic of the present research. Materials and Methods. Ten patients affected by severe obstructive sleep apnea syndrome (OSAS) were engaged for the study. Their facial surface data was acquired using a 3D laser scanner one week before (T1) and 12 months after (T2) orthognathic surgery. The facial movements were frowning, grimace, smiling, and lip purse. They were described in terms of surface and landmark displacements (mm). The mean landmark displacement was calculated for right and left sides of the face, at T1 and at T2. Results. One year after surgery, facial movements were similar to presurgical registrations. No modifications of symmetry were present. Conclusions. Despite the skeletal maxilla-mandible expansion, orthognathic surgical treatment (MMA) of OSAS patients does not seem to modify facial mobility. Only an enhancement of amplitude in smiling and knitting brows was observed. These results could have reliable medical and surgical applications.
Collapse
|
19
|
Nasolabial changes after two different approaches for surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg 2017; 46:1088-1093. [PMID: 28499507 DOI: 10.1016/j.ijom.2017.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/21/2016] [Accepted: 04/18/2017] [Indexed: 11/23/2022]
Abstract
This retrospective study evaluated the nasolabial changes in patients who underwent surgically assisted rapid maxillary expansion (SARME) using two different approaches. Nineteen patients were included in the study, divided into two groups according to the kind of surgical approach performed: group 1 (n=9), SARME performed through the standard Le Fort I circumvestibular approach followed by the alar base cinch, and group 2 (n=10), SARME performed through a subtotal vestibular approach associated to a V-shaped incision at the maxillary midline in the labial frenulum region, without alar base cinch. Measurements of width, length, and nasal projection as well as upper lip length were taken from cone beam tomographic images obtained before surgery (T1) and 6 months postoperatively (T2). Both groups presented an increase in the alar base width postoperatively (P<0.05). The approach used in group 2 resulted in smaller changes in the alar base width as measured at the superior alar curvature (P<0.05). Nasal length and projection and upper lip length were not altered by SARME. The type of surgical approach influenced nasolabial changes, but did not eliminate increase in width of the alar base.
Collapse
|
20
|
Bianchi FA, Gerbino G, Corsico M, Schellino E, Barla N, Verzè L, Ramieri G. Soft, hard-tissues and pharyngeal airway volume changes following maxillomandibular transverse osteodistraction: Computed tomography and three-dimensional laser scanner evaluation. J Craniomaxillofac Surg 2017; 45:47-55. [DOI: 10.1016/j.jcms.2016.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 08/26/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022] Open
|
21
|
Lee KC, Perrino M. Alar width changes due to surgically-assisted rapid palatal expansion: A meta-analysis. J Orthod Sci 2017; 6:115-122. [PMID: 29119091 PMCID: PMC5655960 DOI: 10.4103/jos.jos_31_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A major objective of orthognatic surgery is the aesthetic outcome. Treatments only correcting for dentoskeletal deformities are not sufficient for optimal facial results because undesirable soft tissue changes may accompany skeletal manipulations. The primary objective of this study was to investigate alar base width (ABW) changes a minimum of 6 months following surgically-assisted rapid palatal expansion (SARPE). The following electronic databases and citation indices were searched: PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Virtual Health Library. The search included articles published until September 2015 without language restriction. The intervention was SARPE with maxillary vestibular incision from first molar to contralateral first molar, a modified LeFort I osteotomy with or without pterygomaxillary disjunction, and a V-Y closure. The primary outcome was the unstandardized mean difference between pre and postoperative ABW. A random effects meta-analysis was performed to combine study results, and included studies that were assessed for statistical heterogeneity using a Chi-square test for independence. The results of this meta-analysis (N = 41) showed a significant + 1.74 mm, 95% CI [0.14, 3.34] ABW increase in patients submitted to SARPE. There was no statistical heterogeneity among included studies (χ2 = 0.03; df = 2; P = 0.98). ABW increases were observed despite including cinched patients in the analysis. None of the three included studies were completely free of bias. The most prominent flaws were measurement bias, limited sample size, and patient recruitment.
Collapse
Affiliation(s)
- Kevin C Lee
- Division of Oral & Maxillofacial Surgery, Columbia University, College of Dental Medicine, New York, USA
| | - Michael Perrino
- Division of Oral & Maxillofacial Surgery, Columbia University, College of Dental Medicine, New York, USA
| |
Collapse
|
22
|
A systematic review on soft-to-hard tissue ratios in orthognathic surgery part I: Maxillary repositioning osteotomy. J Craniomaxillofac Surg 2014; 42:1341-51. [DOI: 10.1016/j.jcms.2014.03.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 01/16/2014] [Accepted: 03/20/2014] [Indexed: 11/23/2022] Open
|
23
|
Daif E. Segment tilting associated with surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg 2014; 43:311-5. [DOI: 10.1016/j.ijom.2013.06.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 05/02/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
|
24
|
Gerbino G, Bianchi FA, Verzé L, Ramieri G. Soft tissue changes after maxillo-mandibular advancement in OSAS patients: A three-dimensional study. J Craniomaxillofac Surg 2014; 42:66-72. [DOI: 10.1016/j.jcms.2013.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 02/19/2013] [Accepted: 02/19/2013] [Indexed: 11/25/2022] Open
|
25
|
Magnusson A, Bjerklin K, Kim H, Nilsson P, Marcusson A. Three-dimensional computed tomographic analysis of changes to the external features of the nose after surgically assisted rapid maxillary expansion and orthodontic treatment: a prospective longitudinal study. Am J Orthod Dentofacial Orthop 2013; 144:404-13. [PMID: 23992813 DOI: 10.1016/j.ajodo.2013.04.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 04/01/2013] [Accepted: 04/01/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this prospective, longitudinal study was to evaluate changes to the external shape and form of the nose after surgically assisted rapid maxillary expansion and orthodontic treatment. The changes were registered using a 3-dimensional computer tomography technique, based on superimposition on the anterior base of the skull. METHODS The subjects comprised 35 patients (mean age, 19.7 years; range, 16.1-43.9 years). Low-dose, helical computerized tomography images were taken at treatment start and after orthodontic treatment, about 18 months postsurgery. The 3-dimensional models were registered and superimposed on the anterior cranial base. RESULTS There were in general significant widening and overall anterior and inferior displacement of the nasal soft tissues. The changes varied in size and direction. No correlation was found between the initial and final widths of the nose, or between the initial and final widths of the nostrils. CONCLUSIONS After surgically assisted rapid maxillary expansion, the most obvious changes to the external features of the nose were at the most lateral alar bases. The difference in lateral displacement profoundly influenced the perception of a more rounded nose. Patients with narrow and constrained nostrils can benefit from these changes. The 3-dimensional superimposition applied in this study is a reliable method, circumventing projection and measurement errors.
Collapse
Affiliation(s)
- Anders Magnusson
- Department of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden.
| | | | | | | | | |
Collapse
|
26
|
de Assis D, Xavier T, Noritomi P, Gonçales A, Ferreira O, de Carvalho P, Gonçales E. Finite element analysis of stress distribution in anchor teeth in surgically assisted rapid palatal expansion. Int J Oral Maxillofac Surg 2013; 42:1093-9. [DOI: 10.1016/j.ijom.2013.03.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 03/12/2013] [Accepted: 03/14/2013] [Indexed: 11/30/2022]
|
27
|
Nada RM, van Loon B, Schols JGJH, Maal TJJ, de Koning MJ, Mostafa YA, Kuijpers-Jagtman AM. Volumetric changes of the nose and nasal airway 2 years after tooth-borne and bone-borne surgically assisted rapid maxillary expansion. Eur J Oral Sci 2013; 121:450-6. [DOI: 10.1111/eos.12068] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Jan G. J. H. Schols
- Department of Orthodontics and Craniofacial Biology; Radboud University Nijmegen Medical Centre; Nijmegen; the Netherlands
| | | | - Martien J. de Koning
- Department of Oral and Maxillofacial Surgery; Radboud University Nijmegen Medical Centre; Nijmegen; the Netherlands
| | - Yehya A. Mostafa
- Department of Orthodontics; Faculty of Oral and Dental Medicine; Cairo University; Cairo; Egypt
| | | |
Collapse
|
28
|
Three-dimensional evaluation of soft tissue changes in the orofacial region after tooth-borne and bone-borne surgically assisted rapid maxillary expansion. Clin Oral Investig 2013; 17:2017-24. [PMID: 23377777 DOI: 10.1007/s00784-013-0927-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study seeks to three-dimensionally assess soft tissue changes in the orofacial region following tooth-borne and bone-borne surgically assisted rapid maxillary expansion (SARME). MATERIALS AND METHODS This prospective cohort study included 40 skeletally mature patients with transverse maxillary hypoplasia. A tooth-borne distractor (Hyrax) was used for expansion in 25 patients. In the remaining 15, a bone-borne distractor (transpalatal distractor, TPD) was used. Cone beam computed tomography (CBCT) scans were acquired before treatment (T0) and 22 months later (T1). 3D models were constructed from CBCT data and superimposed using voxel-based matching. Distance maps between the superimposed 3D models were computed to evaluate the degree of skeletal and soft tissue changes in the maxillary region. RESULTS Distance maps showed negative distances (mean -1.25 (±1.5) mm) in the middle of the upper lip, indicating posterior repositioning of this area. The cheek region showed positive changes (mean 1.66 (±1.1) mm), reflecting the underlying increase in maxillary width. There was no significant difference between the two groups in all measured distances (p > 0.05). Retro-positioning of the upper lip accompanied skeletal remodeling in the anterior alveolar region at a mean ratio of 88 %, while the cheek region followed 32 % of the alveolar expansion. CONCLUSION Soft tissue changes following SARME include posterior repositioning of the upper lip and increased projection of the cheek area. These changes were comparable between bone-borne and tooth-borne appliances. CLINICAL RELEVANCE This study provides clinicians with more information over the expected orofacial soft tissue changes following SARME.
Collapse
|
29
|
Abstract
This article describes the authors' course, which takes facial plastic surgeons through specific exercises to demonstrate the esthetic impact of 3D manipulations of the nose and face. The course components are described, which include 3D assessment, exercises in manual dexterity, and improving imagination in sculpting facial and nasal features for the optimal esthetic result and match to a given facial shape. The overlap and relationship between a course in 3D sculpting in facial plastic surgery and current 3D tools for design and image analysis being used for facial plastic surgery are discussed.
Collapse
|
30
|
Lui D, Chou J, Carrasco L. Nasolabial Volumetric Symmetry Following SARPE. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Three-Dimensional Facial Asymmetry in Attractive and Normal People from Childhood to Young Adulthood. Symmetry (Basel) 2010. [DOI: 10.3390/sym2041925] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
32
|
Use of the dynamic volume spline method to predict facial soft tissue changes associated with orthognathic surgery. ACTA ACUST UNITED AC 2010; 110:e17-23. [DOI: 10.1016/j.tripleo.2010.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 06/05/2010] [Accepted: 06/14/2010] [Indexed: 11/16/2022]
|
33
|
Dik E, de Ruiter A, van der Bilt A, Koole R. Effect on the contour of bone and soft tissue one year after harvesting chin bone for alveolar cleft repair. Int J Oral Maxillofac Surg 2010; 39:962-7. [DOI: 10.1016/j.ijom.2010.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 05/04/2010] [Accepted: 06/02/2010] [Indexed: 11/25/2022]
|