Expansion with vestibular shields: an experimental test of the periosteal-pull hypothesis

Clinical Effectiveness of Vestibular Shields in Orthodontic Treatment: A Scoping Review

This systematic literature search was performed to determine the clinical effectiveness of vestibular shields (VSs) in children undergoing orthodontic treatment. A comprehensive electronic search was performed in May 2022 using three databases (Medline via PubMed, the Cochrane Central Register of Controlled Trials, and Ovid). The initial screening of articles was based on titles and abstracts. Studies meeting the inclusion criteria were retrieved for the final quality assessment and the methodological qualities were assessed according to the Newcastle-Ottawa Scale and Cochrane risk of bias. The initial search identified 262 publications, of which 15 studies were potentially eligible, with excellent intra-examiner reliability (K = 0.88). A total of five studies were selected for the final analysis, including one randomized controlled trial, three clinical trials, and one cohort study. VS may have potential impacts on orthodontic treatment, lips and dental arches, but further high-quality studies are warranted.

Transverse skeletal base adaptations with Bionator therapy: a pilot implant study

The purpose of this randomized, controlled trial was to evaluate transverse skeletal base adaptations to Bionator therapy. The sample included 25 patients (15 male, 10 female) aged 6.9 to 11.2 years with Class II Division 1 malocclusion. The patients were randomly allocated to either a control (n = 11) or treatment (n = 14) group and followed longitudinally for approximately 12 months. Treatment consisted of a Bionator only, constructed to remain approximately 2 mm from the buccal dentition. Transverse maxillary and mandibular changes were evaluated cephalometrically according to 4 bilateral maxillary and 2 bilateral mandibular implants. Untreated Class II controls exhibited significant increases between posterior maxillary implants but no significant changes between the anterior maxillary or mandibular implants. There were no significant width differences between the control and treated groups before treatment. Posterior maxillary implant widths increased significantly (P < .05) in both groups, but the treated group showed significantly greater width increases than the control group. The treated group also showed greater increases between mandibular implants, but the differences were not statistically significant. These results suggest that transverse skeletal base adaptations occur as a result of Bionator therapy.