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Benetti M, Montresor L, Cantarella D, Zerman N, Spinas E. Does Miniscrew-Assisted Rapid Palatal Expansion Influence Upper Airway in Adult Patients? A Scoping Review. Dent J (Basel) 2024; 12:60. [PMID: 38534284 DOI: 10.3390/dj12030060] [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: 12/19/2023] [Revised: 02/11/2024] [Accepted: 02/24/2024] [Indexed: 03/28/2024] Open
Abstract
(1) Objective: This scoping review evaluates the effects of miniscrew-assisted rapid palatal expansion (MARPE) on different regions of the upper airway in adult patients and investigates various methods of measurement. (2) Methods: The search encompassed Pubmed, Cochrane Library, Scopus and Web of Science. This review was conducted following the PRISMA_ScR guidelines, and the inclusion criteria for examined studies were chosen in accordance with the PICOS framework. (3) Results: Seven studies were included in this review, comprising four retrospective studies, one prospective and two case reports. All studies involved the use of Cone Beam Computed Tomography (CBCT) for measurements of the areas of interest. The percentage of increase in the volume of the nasal cavity varied between 31% and 9.9%, depending on the study. Volumetric variations in the nasopharynx were reported as increases between T0 (before expansion) and T1 (immediately after expansion) of 6.4%, 20.7% and 14.1%. All studies considered T0 before expansion and T1 immediately after expansion. Only one study evaluated remote follow-up to assess if the results were maintained after one year. (4) Conclusions: MARPE appears to lead to a statistically significant increase in the upper airway, especially in the nasal cavity and nasopharynx immediately after expansion. However, further prospective and retrospective trails with long-term controls are required to verify the effects of MARPE on the upper airway.
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Affiliation(s)
- Mariachiara Benetti
- Department of Surgical Science, Post Graduate School of Orthodontics, University of Cagliari, Via Ospedale, 01924 Cagliari, Italy
| | - Luca Montresor
- Department of Surgical Science, Post Graduate School of Orthodontics, University of Cagliari, Via Ospedale, 01924 Cagliari, Italy
| | - Daniele Cantarella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Commenda 10, 20122 Milan, Italy
| | - Nicoletta Zerman
- Department of Pediatric Dentistry and Dental Hygiene, University of Verona, Via San Marco 121, 37138 Verona, Italy
| | - Enrico Spinas
- Department of Surgical Science, Post Graduate School of Orthodontics, University of Cagliari, Via Ospedale, 01924 Cagliari, Italy
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Ok G, Sen Yilmaz B, Aksoy DO, Kucukkeles N. Maturity evaluation of orthodontically important anatomic structures with computed tomography. Eur J Orthod 2021; 43:8-14. [PMID: 32006443 DOI: 10.1093/ejo/cjaa009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES The success of the orthopaedic treatment is closely related to the patient's skeletal maturation. This study aimed to evaluate the midpalatal suture (MPS), the zygomaticomaxillary suture (ZMS) maturation, and the closure degree of the spheno-occipital synchondrosis (SOS) in patients of different age groups. The presence of a correlation between these parameters and the palatal dimensions was also verified. SUBJECTS/METHODS The study was based on computed tomography images of 314 patients between 7 and 30 years of age with no orthodontic treatment history. The images were retrieved from the archive of the Radiology Department of Bezmialem Vakif University Hospital and divided into six groups according to the patient's age: 7-10, 11-13, 14-16, 17-20, 21-25, and 26-30 years. The maturation scores of ZMS, SOS, and MPS were determined, and palatal thickness and length were recorded. The data were analysed by using Statistical Package for Social Sciences for Windows 22.0. RESULTS A positive relationship was found between SOS closure degree and MPS/ZMS maturation (MPS-ZMS: r = 0.816, MPS-SOS: r = 0.736, ZMS-SOS: r = 0.868, P = 0.000). The degrees of ZMS and MPS maturation were significantly increased as the SOS closure degree increased. The MPS maturation score was significantly lower in patients with a short and thick palate (MPS-palatal thickness: r = 0.405, MPS-palatal length: r = 0.387, P = 0.000). CONCLUSIONS A positive correlation indicated the simultaneous progress in the maturation of the SOS, MPS, and ZMS. Moreover, the ANS-PNS length increase was found to be correlated with the increase of the MPS, ZMS, and SOS maturation scores. In contrast, a negative correlation was observed between the palatal thickness and the maturation stage of these structures.
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Affiliation(s)
- Gokcen Ok
- Private Practice, Neo Golpark Villaları, Kocayusuf Cad., Bolluca, Istanbul, Turkey
| | - Berza Sen Yilmaz
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Direnc Ozlem Aksoy
- Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nazan Kucukkeles
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
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Angelieri F, Franchi L, Cevidanes LHS, Hino CT, Nguyen T, McNamara JA. Zygomaticomaxillary suture maturation: A predictor of maxillary protraction? Part I - A classification method. Orthod Craniofac Res 2018; 20:85-94. [PMID: 28414869 DOI: 10.1111/ocr.12143] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to present a method of classifying the maturational level of the zygomaticomaxillary sutures (ZMSs). METHODS Cone-beam CT (CBCT) images from 74 subjects (5.6-58.4 years) were examined to define the radiographic stages of ZMS maturation. Five stages of maturation of the ZMS were identified and defined: Stage A-uniform high-density sutural line, with no or little interdigitation; Stage B-scalloped appearance of the high-density sutural line; Stage C-two parallel, scalloped, high-density lines, separated in some areas by small low-density spaces; Stage D-fusion in the inferior portion of the suture; and Stage E-complete fusion. Intra- and inter-examiner agreements were evaluated by weighted kappa tests. RESULTS The intra- and inter-examiners reproducibility values demonstrated substantial to almost perfect agreement. No fusion of ZMSs was observed in patients up to 10 years of age. From 10 to 15 years, all maturational stages were identified. After 15 years of age, the majority of patients showed fusion of ZMSs. CONCLUSIONS The classification of ZMS maturation using CBCT is a reliable method that allows the assessment of the morphology of the ZMSs in the individual patient.
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Affiliation(s)
- F Angelieri
- Department of Orthodontics, Guarulhos University, Guarulhos, Brazil.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - L Franchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.,Department of Orthodontics, The University of Florence, Florence, Italy
| | - L H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - C T Hino
- Special Studies in Orthodontics, São Paulo Military Hospital, São Paulo, Brazil
| | - T Nguyen
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - J A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Ann Arbor, MI, USA.,Cell and Development Biology, School of Medicine, Ann Arbor, MI, USA.,Center of Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
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Haghanifar S, Mahmoudi S, Foroughi R, Mir APB, Mesgarani A, Bijani A. Assessment of midpalatal suture ossification using cone-beam computed tomography. Electron Physician 2017; 9:4035-4041. [PMID: 28461882 PMCID: PMC5407240 DOI: 10.19082/4035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/27/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The degree of ossification of the midpalatal suture is an important factor in the selection of treatment procedure, especially in young individuals. Considering the discrepancies in the results of studies on the exact time of the closure of this suture, the present study was undertaken to evaluate ossification and morphology of the suture with the use of CBCT. METHODS In the present cross-sectional study, the CBCT images of the maxilla in 144 Iranian subjects (72 males, 72 females) with an age range of 10 to 70 years, referring to a private radiology center in Sari, Iran, were evaluated. The CBCT images were evaluated in the axial cross-sectional slice at 1 mm intervals to determine morphology and the maturation stage of the suture and its degree of ossification. The six developmental stages that were observed were as follows: stage A, a direct line without disturbances; stage B, a scalloped appearance in the suture; stage C, two parallel lines with a scalloped appearance that were connected at some points; stage CD, the anterior portion was similar to stage C, and the posterior region was similar to stage D; stage D, ossification only in the palatine bone; stage E, complete ossification of the suture. The degree of ossification of the suture was calculated with the use of the ratio of the length of the ossified segment to the entire length of the suture. Data were analyzed with Spearman's correlation test, Chi-squared test, t-test, ANOVA, Mann-Whitney U, and Kruskal-Wallis test. Intra-observer agreement was calculated with the use of weighted kappa coefficient. Data were analyzed with SPSS 17. RESULTS There was a strong correlation between the age groups and the developmental stages of the midpalatal suture in both genders (r=0.681, p<0.001). The ossification process occurred in the posterior to anterior direction in 98% of the cases. There was a significant relationship between aging and the degree of ossification (p<0.001); however, the difference was not significant between the two genders (p=0.193). CONCLUSION Although the rate of suture closure increased with aging, age was not a reliable factor alone to determine the developmental stage of the suture. Use of CBCT is necessary in all the patients to determine the degree of ossification and morphology of the midpalatal suture.
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Affiliation(s)
- Sina Haghanifar
- DDS, MS, Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Sadaf Mahmoudi
- DDS, Dentist, Dental Faculty, Babol University of Medical Sciences, Babol, Iran
| | - Ramin Foroughi
- DDS, MS, Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Arash Poorsattar Bejeh Mir
- DDS, Researcher, Dental Materials Research Center, Dentistry School, Babol University of Medical Sciences, Babol, Iran
| | - Abas Mesgarani
- DDS, MS, Assistant Professor, Department of Endodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Bijani
- M.D, General Practitioner, Non Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran
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Angelieri F, Franchi L, Cevidanes LHS, Bueno-Silva B, McNamara JA. Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT. Dental Press J Orthod 2016; 21:115-125. [PMID: 28125147 PMCID: PMC5278941 DOI: 10.1590/2177-6709.21.6.115-125.sar] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022] Open
Abstract
Rapid maxillary expansion (RME) primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT) has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically.
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Affiliation(s)
- Fernanda Angelieri
- Assistant Professor, Guarulhos University, Guarulhos, Brazil; and Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI
| | - Lorenzo Franchi
- Research Associate, Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy; and Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI
| | - Lucia H. S. Cevidanes
- Assistant Professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry The University of Michigan, Ann Arbor, MI
| | | | - James A. McNamara
- Thomas M. and Doris Graber Endowed Professor Emeritus (Active), Department of Orthodontics and Pediatric Dentistry, School of Dentistry. Professor Emeritus of Cell and Development Biology, School of Medicine; and Research Professor Emeritus, Center of Human Growth and Development, The University of Michigan, Ann Arbor, MI
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Gueutier A, Paré A, Joly A, Laure B, de Pinieux G, Goga D. Rapid maxillary expansion in adults: Can multislice computed tomography help choose between orthopedic or surgical treatment? ACTA ACUST UNITED AC 2016; 117:327-334. [PMID: 27388783 DOI: 10.1016/j.revsto.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/13/2016] [Accepted: 06/10/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the accuracy of Multislice Computed Tomography (MSCT) in the detection resistance areas on the midpalatal suture (MPS) and thus to evaluate if MSCT could be a help in the kind of maxillary expansion to be used (pure orthodontic or surgically-aided) for the correction of transverse maxillary deficiencies in adults. METHODS Ten MSCT were obtained from 10 MPS removed from fresh corpses (mean age: 79.4; extreme: 70-86). Three standardized radiological regions of interest (ROI) were identified on each MPS and were classified into "open" (group 1) or "closed" (group 2) by 3 independent radiologists. The 30 ROI were then histologically analyzed according to 3 criteria: mean suture width (MSW), obliteration index (OI) and interdigitation index (Ii). RESULTS Nine ROI were classified in group 1 (closed) and 21 in group 2 (open). On the histological examination, the mean MSW was 396.9μm in group 1 and 227.1μm in group 2. OI was 3.098% and 9.309% and Ii was 1.25 and 1.34 respectively. Statistically significant difference between the 2 groups was only found for the MSW. We conclude that MSCT allows for the evaluation of the width of the MPS, but not for the evaluation of the other possible parameters of resistance we used. Therefore, it cannot predict precisely the amount of résistance in the MPS and is not suited for the choice between pure orthodontic or surgically-aided expansion.
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Affiliation(s)
- A Gueutier
- CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France.
| | - A Paré
- CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France
| | - A Joly
- CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France
| | - B Laure
- CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France
| | - G de Pinieux
- CHU Trousseau, University Francois-Rabelais, Department of Pathology, Tours, France
| | - D Goga
- CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France
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Midpalatal suture maturation: classification method for individual assessment before rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2014; 144:759-69. [PMID: 24182592 DOI: 10.1016/j.ajodo.2013.04.022] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 04/01/2013] [Accepted: 04/01/2013] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In this study, we present a novel classification method for individual assessment of midpalatal suture morphology. METHODS Cone-beam computed tomography images from 140 subjects (ages, 5.6-58.4 years) were examined to define the radiographic stages of midpalatal suture maturation. Five stages of maturation of the midpalatal suture were identified and defined: stage A, straight high-density sutural line, with no or little interdigitation; stage B, scalloped appearance of the high-density sutural line; stage C, 2 parallel, scalloped, high-density lines that were close to each other, separated in some areas by small low-density spaces; stage D, fusion completed in the palatine bone, with no evidence of a suture; and stage E, fusion anteriorly in the maxilla. Intraexaminer and interexaminer agreements were evaluated by weighted kappa tests. RESULTS Stages A and B typically were observed up to 13 years of age, whereas stage C was noted primarily from 11 to 17 years but occasionally in younger and older age groups. Fusion of the palatine (stage D) and maxillary (stage E) regions of the midpalatal suture was completed after 11 years only in girls. From 14 to 17 years, 3 of 13 (23%) boys showed fusion only in the palatine bone (stage D). CONCLUSIONS This new classification method has the potential to avoid the side effects of rapid maxillary expansion failure or unnecessary surgically assisted rapid maxillary expansion for late adolescents and young adults.
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Eskandarlou A, Poorolajal J, Talaeipour AR, Talebi S, Talaeipour M. Comparison between cone beam computed tomography and multislice computed tomography in diagnostic accuracy of maxillofacial fractures in dried human skull: anin vitrostudy. Dent Traumatol 2013; 30:162-8. [DOI: 10.1111/edt.12058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Amir Eskandarlou
- Department of Dentomaxillofacial Radiology; School of Dentistry, Hamadan University of Medical Sciences; Hamadan Iran
| | - Jalal Poorolajal
- Department of Epidemiology & Biostatistics; Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences; Hamadan Iran
| | - Ahmad Reza Talaeipour
- Department of Dentomaxillofacial Radiology; Dental Branch, Islamic Azad University; Tehran Iran
| | - Sahar Talebi
- Department of Dentomaxillofacial Radiology; School of Dentistry, Hamadan University of Medical Sciences; Hamadan Iran
| | - Maziar Talaeipour
- Department of periodontology; Dental Branch, Islamic Azad University; Tehran Iran
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Fricke-Zech S, Gruber RM, Dullin C, Zapf A, Kramer FJ, Kubein-Meesenburg D, Hahn W. Measurement of the midpalatal suture width. Angle Orthod 2011; 82:145-50. [PMID: 21812573 DOI: 10.2319/040311-238.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To conduct a pilot study to investigate the potentiality to determine the midpalatal sutural width radiographically with a flat-panel volume computed tomography (fpVCT) in a porcine model. MATERIALS AND METHODS Bone samples from the midpalatal suture of five young (16 weeks) and five old (200 weeks) sus scrofa domestica were gathered. The midpalatal suture width was measured via fpVCT and compared to respective histological preparations. Results with P < .05 were considered significant. RESULTS The data obtained by fpVCT and by histomorphometric analysis reveal a highly significant age dependency of the measured suture width (both P < .0001), with lower suture width values in older subjects compared to the younger group. The averaged suture widths measured in the fpVCT images shows a distinctively higher mean compared to the histomorphometric data with high statistical significance (P < .0001). The evaluated difference between both methods was almost constant. CONCLUSION fpVCT is a powerful tool for determining midpalatal sutural width.
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Affiliation(s)
- Susanne Fricke-Zech
- Department of Orthodontics, Georg-August-University of Goettingen, Goettingen, Germany.
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Sun Z, Hueni S, Tee BC, Kim H. Mechanical strain at alveolar bone and circummaxillary sutures during acute rapid palatal expansion. Am J Orthod Dentofacial Orthop 2011; 139:e219-28. [PMID: 21392665 DOI: 10.1016/j.ajodo.2009.12.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 12/01/2009] [Accepted: 12/01/2009] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Palatal expansion can potentially affect alveolar bone and circummaxillary sutures. In this study, we characterized their mechanical strain during acute expansion. METHODS Eight 3- and 6-month-old fresh pig heads received acute palatal expansion with hyrax expanders. Strain gauges were used to measure strain at the buccal alveolar bone of anchor and adjacent nonanchor teeth, and at maxillary-premaxillary, maxillary-zygomatic, and zygomatic-temporal sutures during expansion. Intermolar width changes were measured from dental casts. RESULTS Intermolar width increased less than expander activation, and the midpalatal sutures were only opened slightly. Alveolar bone strain increased linearly with expander activation and decayed by 20% to 30% during postactivation intervals. Compressive strain at anchor-tooth alveolar bone locations was directed occlusally and apically, related to tooth tipping, and significantly higher than that at nonanchor tooth locations. With expander activation, suture strains increased monotonically and tended to plateau. Suture strain magnitude was generally similar to physiologic (masticatory) strains reported in the literature. The dominant strain polarity was compression at the maxillary-zygomatic and zygomatic-temporal sutures, but there was tension at the maxillary-premaxillary suture. CONCLUSIONS In these pigs, palatal expansion can cause significant occlusal-apical compression at buccal alveolar bone and physiologic-level strains at circummaxillary sutures.
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Affiliation(s)
- Zongyang Sun
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio, USA.
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Effect of bone thickness on alveolar bone-height measurements from cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 2011; 139:e117-27. [PMID: 21300222 DOI: 10.1016/j.ajodo.2010.08.016] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Revised: 08/01/2010] [Accepted: 08/01/2010] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) has been used to assess alveolar bone changes after rapid palatal expansion. The purpose of this study was to investigate the accuracy of alveolar bone-height measurements from CBCT images with varied bone thicknesses and imaging resolutions. METHODS Eleven maxillary specimens from 6-month-old pigs were measured for alveolar bone height (distance between drilled reference holes and alveolar crests) at 6 locations with a digital caliper, followed by CBCT scanning at 0.4-mm and 0.25-mm voxel sizes. Buccal alveolar bone of these locations was then reduced approximately by 0.5 to 1.5 mm, followed by CBCT rescanning with the same voxel sizes. The CBCT images were measured by using 3-dimensional software to determine alveolar bone height and thickness in buccolingual slices by independent, blinded raters. The specimens were subsequently cut into buccolingual sections at reference-hole levels, and direct bone height and thickness were measured from these sections. Intrarater and interrater repeatability and the differences between CBCT and direct measurements were assessed. RESULTS Excellent intrarater (intraclass correlations, r = 0.89-0.98) and good interrater (r = 0.64-0.90) repeatability values were found for alveolar bone-height measurements from the CBCT images. Before alveolar bone reduction, the thickness was much greater than the CBCT voxel size (0.4 mm), and bone-height measurements from the CBCT images were 0.5 to 1 mm more than the direct measurements (paired t tests, P <0.017 at most locations). After bone reduction, the thickness at the subcrest 1-mm level was near or below the CBCT voxel size (0.4 mm), and bone-height measurements from the CBCT images were 0.9 to 1.2 mm less than the direct measurements (paired t tests, P <0.017 at most locations). These measurement inaccuracies were substantially improved by decreasing the CBCT voxel size to 0.25 mm. CONCLUSIONS Alveolar bone-height measurements from conventional clinical 0.4-mm voxel size CBCT images might overestimate alveolar bone-height loss associated with rapid palatal expansion.
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