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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.
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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
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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.
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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
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Gül A, van der Tas JT, Ramdat Misier KRR, de Gijt JP, Strabbing EM, Tjoa STH, Wolvius EB, Koudstaal MJ. Three-dimensional dento-skeletal effects of mandibular midline distraction and surgically assisted rapid maxillary expansion: A retrospective study. J Craniomaxillofac Surg 2023:S1010-5182(23)00069-0. [PMID: 37355373 DOI: 10.1016/j.jcms.2023.04.007] [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: 04/27/2022] [Revised: 03/03/2023] [Accepted: 04/30/2023] [Indexed: 06/26/2023] Open
Abstract
It was the aim of the study to provide a three-dimensional evaluation of dento-skeletal effects following bone-borne vs tooth-borne mandibular midline distraction (MMD) and tooth-borne surgically assisted rapid maxillary expansion (SARME). A retrospective observational study was conducted. Cone beam computed tomography (CBCT) records were taken pre-operatively (T1), immediately post-distraction (T2) and 1 year post-operatively (T3). All included 30 patients had undergone MMD (20 bone-borne MMD; 10 tooth-borne MMD). A total of 20 bone-borne MMD and 8 tooth-borne MMD patients had simultaneously undergone tooth-borne SARME. At T1 vs T3, canine (p = 0.007; 26.0 ± 2.09 vs 29.2 ± 2.02) and first premolar (p = 0.005; 33.8 ± 2.70 vs 37.0 ± 2.43) showed significant expansion on the tip level for tooth-borne MMD. This was no significant on the apex level, indicating tipping. Bone-borne MMD showed a parallel distraction gap, whereas tooth-borne MMD showed a V-shape. There was a significant (p = 0.017; 138 ± 17.8 vs 141 ± 18.2) inter-condylar axes increase for bone-borne MMD. In conclusion, bone-borne vs tooth-borne MMD and tooth-borne SARME showed stable dento-skeletal effects at 1 year post-operatively. Bone-borne and tooth-borne MMD seemed not to be superior to each other. The choice of distractor type therefore depends more on anatomical and comfort factors.
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Affiliation(s)
- Atilla Gül
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Justin T van der Tas
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Karan R R Ramdat Misier
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Jan P de Gijt
- Department of Oral and Maxillofacial Surgery, Ikazia Hospital, Rotterdam, the Netherlands
| | - Elske M Strabbing
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Stephen T H Tjoa
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Eppo B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Maarten J Koudstaal
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands
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"Spin" in Plastic Surgery Randomized Controlled Trials with Statistically Nonsignificant Primary Outcomes: A Systematic Review. Plast Reconstr Surg 2023; 151:506e-519e. [PMID: 36442055 DOI: 10.1097/prs.0000000000009937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND "Spin" refers to a manipulation of language that implies benefit for an intervention when none may exist. Randomized controlled trials (RCTs) in other fields have been demonstrated to employ spin, which can mislead clinicians to use ineffective or unsafe interventions. This study's objective was to determine the strategies, severity, and extent of spin in plastic surgery RCTs with nonsignificant primary outcomes. METHODS A literature search of the top 15 plastic surgery journals using MEDLINE was performed (2000 through 2020). Parallel 1:1 RCTs with a clearly identified primary outcome showing statistically nonsignificant results ( P > 0.05) were included. Screening, data extraction, and spin analysis were performed by two independent reviewers. The spin analysis was then independently assessed in duplicate by two plastic surgery residents with graduate-level training in clinical epidemiology. RESULTS From 3497 studies identified, 92 RCTs were included in this study. Spin strategies were identified in 78 RCTs (85%), including 64 abstracts (70%) and 77 main texts (84%). Severity of spin was rated moderate or high in 43 abstract conclusions (47%) and 42 main text conclusions (46%). The most identified spin strategy in the abstract was claiming equivalence for statistically nonsignificant results (26%); in the main text, focusing on another objective (24%). CONCLUSIONS This study suggests that 85% of statistically nonsignificant RCTs in plastic surgery employ spin. Readers of plastic surgery research should be aware of strategies, whether intentional or unintentional, used to manipulate language in reports of statistically nonsignificant RCTs when applying research findings to clinical practice.
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Yi F, Liu OS, Lei L, Liu SL, Wang Y, Chu YH, Zhang LL, Li CR, Chen JJ, Lu YQ. Factors related to microimplant-assisted rapid palatal expansion in teenagers and young adults: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2022; 163:475-482. [PMID: 36564316 DOI: 10.1016/j.ajodo.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION For patients with maxillary transverse deficiency, selecting an appropriate therapeutic method is important for the treatment effect and prognosis. Our study aimed to explore factors related to microimplant-assisted rapid palatal expansion (MARPE) in teenagers and young adults using cone-beam computed tomography. METHODS Twenty-five patients who underwent MARPE were included in this retrospective study from February 2014 to June 2019. Midpalatal suture density (MPSD) ratio, midpalatal suture maturation (MPSM), bone effect, dentoalveolar effect, and dental effect in maxillary first molar were evaluated using cone-beam computed tomography. Spearman correlation analysis was used to analyze the correlation between the MPSD ratio, MPSM, age, and the expansion amount generated by MARPE. RESULTS Twenty-five patients (mean age, 19.84 ± 3.96 years; range, 15-29 years) with maxillary transverse deficiency were analyzed. Age was negatively correlated with bone expansion, alveolar expansion, and alveolar change (all P <0.05). There was a negative correlation between MPSM and nasal cavity variation, bone expansion, and alveolar change (all P <0.05). The bone expansion was negatively correlated with MPSD ratio 3 (r = -0.417; P <0.05) and MPSD ratio 4 (all P <0.05). CONCLUSIONS Age, MPSM, and MPSD ratio were significantly related to the MARPE effect. Age, MPSM, and MPSD ratio should be considered when choosing MARPE.
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Affiliation(s)
- Fang Yi
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Ou-Sheng Liu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Lei Lei
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Si-Ling Liu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yue Wang
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan-Hao Chu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Ling-Ling Zhang
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Cheng-Ri Li
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Jun-Jie Chen
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan-Qin Lu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China.
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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]
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Venezia P, Nucci L, Moschitto S, Malgioglio A, Isola G, Ronsivalle V, Venticinque V, Leonardi R, Lagraverè MO, Lo Giudice A. Short-Term and Long-Term Changes of Nasal Soft Tissue after Rapid Maxillary Expansion (RME) with Tooth-Borne and Bone-Borne Devices. A CBCT Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12040875. [PMID: 35453923 PMCID: PMC9031355 DOI: 10.3390/diagnostics12040875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/26/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023] Open
Abstract
The objective of the study was to assess the changes in nasal soft tissues after RME was performed with tooth-borne (TB) and bone-borne (BB) appliances. Methods. This study included 40 subjects with a diagnosis of posterior cross-bite who received tooth-borne RME (TB, average age: 11.75 ± 1.13 years) or bone-borne RME (BB, average age: 12.68 ± 1.31 years). Cone-beam computed tomography (CBCT) was taken before treatment (T0), after a 6-month retention period (T1), and one year after retention (T2). Specific linear measurements of the skeletal components and of the soft-tissue region of the nose were performed. All data were statistically analyzed. Results. Concerning skeletal measurements, the BB group showed a greater skeletal expansion of the anterior and posterior region of the nose compared to the TB group (p < 0.05) immediately after RME. Both TB and BB RME induce a small increment (>1 mm) of the alar base and alar width, without significant differences between the two expansion methods (p > 0.05). A high correlation was found between skeletal and soft-tissue expansion in the TB group; instead, a weaker correlation was found in the BB group. Conclusion. A similar slight increment of the alar width and alar base width was found in both TB and BB groups. However, the clinical relevance of these differences, in terms of facial appearance, remains questionable.
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Affiliation(s)
- Pietro Venezia
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 6, 80138 Naples, Italy;
| | - Serena Moschitto
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Alessia Malgioglio
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Gaetano Isola
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Vincenzo Ronsivalle
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Valeria Venticinque
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Rosalia Leonardi
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
| | - Manuel O. Lagraverè
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB T6G 2B7, Canada;
| | - Antonino Lo Giudice
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy; (P.V.); (S.M.); (A.M.); (G.I.); (V.R.); (V.V.); (R.L.)
- Correspondence:
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Skeletal, dentoalveolar, and buccal bone changes using hybrid and tooth-borne expanders for RME and SARME in different growth stages. AUSTRALASIAN ORTHODONTIC JOURNAL 2022. [DOI: 10.2478/aoj-2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective
To compare the skeletal, dentoalveolar and buccal bone thickness of tooth–bone-borne (Hybrid-H) and tooth-borne (TB) maxillary expanders used for rapid maxillary expansion (RME) in early and late adolescents and for surgically-assisted RME (SARME) in young adults.
Materials and methods:
This two-centre clinical study included initial and 6 months post-retention CBCT records of 60 patients (27 males, 33 females; mean age 15.7 ± 3.75 years). The cohort was divided into two groups according to the expander type (H or TB) and subdivided into a further three groups determined by cervical vertebrae maturation stages: early adolescents (EA), late adolescents (LA), and young adults (A). EA and LA patients underwent RME and young adults received a SARME.
Results:
The hybrid-designed appliance increased the internal skeletal maxillary width and nasal width more than the TB-designed appliance anteriorly in EA and posteriorly in SARME young adults. The TB expanders tipped and expanded the first premolars more than the Hybrid SARME expanders in young adults and caused a greater reduction in buccal alveolar bone thickness at the level of the first premolars and molars at the three growth stages.
Conclusion
The hybrid expanders, with relatively greater skeletal and nasal widening potential and fewer dentoalveolar side effects, were a favourable alternative to tooth-borne expanders for RME in the early and late adolescents, and for SARME in young adults.
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Minimally invasive surgical and miniscrew-assisted rapid palatal expansion (MISMARPE) in adult patients. J Craniomaxillofac Surg 2021; 50:211-217. [PMID: 34973887 DOI: 10.1016/j.jcms.2021.12.011] [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: 03/10/2021] [Revised: 10/08/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to evaluate maxillary expansion, operative time and pain associated with a new minimally invasive surgical technique to treat maxillary hypoplasia in adult patients. Consecutive patients were included and prospectively analyzed. The technique consists in miniscrew-assisted rapid palatal expansion (MARPE), minimally invasive approach to maxillary osteotomies, latency period and activation period until the desired expansion. The parameters evaluated included operative time, treatment-related pain by the visual analog scale (VAS), and transverse maxillary expansion. The Shapiro-Wilk test was used to assess the normality of data distribution. A paired t-test was used to compare the data between T0 (preoperative) and T1 (postoperative - end of activation). The significance level was set at 5%. Eleven patients were included. Mean operative time was 24.11 min (14.4-32 min) and overall postoperative VAS score was 2.81 (0-9). A comparative analysis showed significant increases in maxillary width at the skeletal, alveolar, and dental levels (p < 0.0001 for all), with a mean range of 1.8 (SD 0.3) mm to 4.7 (SD 0.5) mm. The present minimally invasive surgical MARPE (MISMARPE) technique appears to yield good skeletal outcomes with minimal trauma. It might have potential for clinical use, but larger comparative studies are needed to confirm the clinical relevance of the approach.
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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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Kapetanović A, Theodorou CI, Bergé SJ, Schols JGJH, Xi T. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. Eur J Orthod 2021; 43:313-323. [PMID: 33882127 PMCID: PMC8186837 DOI: 10.1093/ejo/cjab005] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its efficacy. Objectives This systematic review aims to evaluate the efficacy of MARPE in late adolescents and adults by assessing success rate and skeletal and dental transverse maxillary expansion, as well as treatment duration, dental and periodontal side effects and soft tissue effects. Search methods Seven electronic databases were searched (MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, ProQuest and ClinicalTrials.gov) without limitations in November 2020. Selection criteria Randomized and non-randomized clinical trials and observational studies on patients from the age of 16 onwards with transverse maxillary deficiency who were treated with MARPE and which included any of the predefined outcomes. Data collection and analysis Inclusion eligibility screening, data extraction and risk of bias assessment were performed independently in duplicate. When possible, exploratory meta-analyses of mean differences (MDs) with their 95% confidence intervals (CIs) were conducted, followed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis of the evidence quality. Results Eight articles were included: two prospective and six retrospective observational studies. One study had a moderate risk of bias, whereas seven studies had a serious risk of bias. GRADE quality of evidence was very low. MARPE showed a high success rate (mean: 92.5%; 95%CI: 88.7%–96.3%), resulting in a significant skeletal width increase (MD: 2.33 mm; 95%CI: 1.63 mm–3.03 mm) and dental intermolar width increase (MD: 6.55 mm; 95%CI: 5.50 mm–7.59 mm). A significant increase in dental tipping, a decrease in mean buccal bone thickness and buccal alveolar height, as well as nasal soft tissue change was present (P < 0.05). The mean duration of expansion ranged from 20 to 126 days. Limitations One of the main drawbacks was the lack of high-quality prospective studies in the literature. Conclusions and implications MARPE is a treatment modality that is associated with a high success rate in skeletal and dental maxillary expansion. MARPE can induce dental and periodontal side effects and affect peri-oral soft tissues. Given the serious risk of bias of the included studies, careful data interpretation is necessary and future research of higher quality is strongly recommended. Registration PROSPERO (CRD42020176618). Funding No grants or any other support funding were received.
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Affiliation(s)
- Aldin Kapetanović
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Orthodontics and Craniofacial Biology, Nijmegen, The Netherlands
| | | | - Stefaan J Bergé
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Oral and Maxillofacial Surgery, Nijmegen, The Netherlands
| | - Jan G J H Schols
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Orthodontics and Craniofacial Biology, Nijmegen, The Netherlands
| | - Tong Xi
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Oral and Maxillofacial Surgery, Nijmegen, The Netherlands
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