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André CB, Pasqua BDPM, Jacquier GDA, Nascimento FD. Miniscrew-assisted rapid palatal expansion (MARPE): Factors influencing planning. Dental Press J Orthod 2024; 29:e242439. [PMID: 39140568 DOI: 10.1590/2177-6709.29.3.e242439.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/08/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE This cross-sectional study evaluated the bone thickness on mini-implants insertion site, the factors that influence the digital planning of MARPE appliance (miniscrew-assisted rapid palatal expansion), and its different designs. METHODS A total of 135 plannings were assessed regarding the size of the expander screw used, the positioning and the type of the mini-implant rings, and their location in relation to the teeth. Bone thickness measurements were assessed in the region of the mini-implants' trajectory. Differences between the sexes was verified using the ANOVA test (5% significance). RESULTS 73 cases were planned with 4 mini-implants and 62 cases, with 6 mini-implants. In 90% of cases, teeth #16 and #26 were used as supports, and the most used expander screw was 13mm (64.1% of cases). The anterior mini-implants of conventional MARPE showed more pronounced insertion in bone in males (5.9 ± 2mm; p= 0.025). The extra mini-implants (anterior region) were inserted with greater bone thickness in males (11.1 ± 2.3mm) compared to females (9.9 ± 1.8mm; p=0.041). A greater bone thickness was observed in males (10.1 ± 2.1 mm) when using mini-implants in the paramedian region. CONCLUSION Additional rings allow more pronounced bone insertion. Male patients had greater bone thickness, which may be related to greater difficulty in opening the sutures. The alveolar process region seems to be a satisfactory site for mini-implants to those patients with reduced bone thickness in the paramedian posterior region. MARPE appliance must be customized for each patient, due to bone thickness and anatomical variations.
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Affiliation(s)
| | | | | | - Fabio Dupart Nascimento
- Federal University of São Paulo, Department of Biochemistry, Molecular Biology Division (São Paulo/SP, Brazil)
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Machado Pasqua BDP, Sendyk M, Barros André C, Batista de Paiva J, Wilmes B, Rino Neto J. Periodontal evaluation after maxillary expansion with a tooth-bone-borne expander in growing patients : A randomized clinical trial. J Orofac Orthop 2024:10.1007/s00056-024-00536-z. [PMID: 39102072 DOI: 10.1007/s00056-024-00536-z] [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: 09/04/2023] [Accepted: 05/21/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). MATERIALS AND METHODS Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). RESULTS Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). CONCLUSIONS RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.
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Affiliation(s)
| | - Michelle Sendyk
- School of Orthodontics, University of São Paulo, Professor Lineu Prestes Avenue 2227, 05508-000, São Paulo, Brazil
| | - Cristiane Barros André
- Technology Research Center, University of Mogi das Cruzes, Reverendo Henrique de Oliveira Camargo Street 374, 18090-170, Mogi das Cruzes, Brazil
| | - João Batista de Paiva
- School of Orthodontics, University of São Paulo, Professor Lineu Prestes Avenue 2227, 05508-000, São Paulo, Brazil
| | - Benedict Wilmes
- Department of Orthodontics, University of Düsseldorf, Düsseldorf, Germany
| | - José Rino Neto
- School of Orthodontics, University of São Paulo, Professor Lineu Prestes Avenue 2227, 05508-000, São Paulo, Brazil
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Barreneche-Calle LM, Marín-Arboleda RD, Gómez-Gómez SL, Agudelo-Suárez AA, Ramírez-Ossa DM. Dentoalveolar, periodontal and skeletal effects of maxillary expansion techniques assisted by temporary anchorage devices compared with conventional protocols in growing patients with transverse maxillary deficiency: A systematic review and meta-analysis. Int Orthod 2024; 22:100891. [PMID: 38865748 DOI: 10.1016/j.ortho.2024.100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared to conventional protocols. METHODS Five databases and grey literature were consulted, up to December 2023, focusing on intervention designs and excluding other type of studies. The quality assessment was conducted by using the adaptation for orthodontics of the CONSORT statement, the guidelines for reporting non-randomised studies, the RoB-2 tool, and the ROBINS-I tool. A descriptive summary and meta-analysis using RevMan 5.4 were performed. RESULTS Nine clinical trials were included (n=377 patients, mean age 13.2±0.6) with a diagnosis of transverse maxillary deficiency. The analysed studies showed qualitative dentoalveolar and periodontal changes after expansion, which were greater on the maxillary first premolars in tooth-borne appliances. Meta-analyses for some effects were included from two studies (n=64); patients who used tooth-borne appliances had greater effects of buccal intercoronal width between the premolars with statistically significant differences (Std Mean difference 2.34; 95% CI: 0.04-4.65 p=0.05). Conversely, those patients who used bone-borne or hybrid appliances had greater effects of buccal intercoronal width between molars with statistically significant differences (Std Mean difference -0.64; 95% CI: -1.38-0.10; p=0.09). CONCLUSIONS According to the studies analysed, all measurements increased in the intervention groups after expansion. Quantitative analyses show different findings at dentoalveolar level when tooth-borne, bone-borne or hybrid appliances are considered. Nevertheless, the results should be taken with caution due to the heterogeneity of the studies. The protocol was registered at PROSPERO (CRD42021283170), with no funding to report.
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Affiliation(s)
| | - Rober David Marín-Arboleda
- DDS, Posgraduate Orthodontic Program Student, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
| | - Sandra Liliana Gómez-Gómez
- DDS, Orthodontist, MSc in Epidemiology, Titular Professor and Department Chair, Department of Orthodontics, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
| | - Andrés A Agudelo-Suárez
- DDS, Public Health PhD, Titular Professor and Senior Researcher, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia
| | - Diana Milena Ramírez-Ossa
- DDS, Orthodontist, Professor, Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia.
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Ugolini A, Abate A, Donelli M, Gaffuri F, Bruni A, Maspero C, Lanteri V. Spontaneous Mandibular Dentoalveolar Changes after Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:501. [PMID: 38671718 PMCID: PMC11049362 DOI: 10.3390/children11040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. METHODS The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. RESULTS A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. CONCLUSIONS SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.
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Affiliation(s)
- Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Margherita Donelli
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Valentina Lanteri
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
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Bharti L, Daigavane P, Shrivastav S, Kamble R, Bharadwaj S, Shirbhate U, Bhargava A. Expanding Horizons: A Case Report of Cleft Expansion in the Mixed Dentition Stage. Cureus 2023; 15:e51091. [PMID: 38274940 PMCID: PMC10808886 DOI: 10.7759/cureus.51091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
A nine-year-old boy with a cleft lip and palate had midface retrusion as a result of maxillary complex growth inhibition. He sought treatment for total crossbite with a Class III skeletal pattern. The maxillary expansion widened the maxilla to improve the sagittal and transverse skeletal relationship. In skeletal Class III patients with a repaired cleft lip and palate, maxillary expansion and protraction usually provide effective improvement. The individual growth of the maxilla and mandible is crucial to the success of the orthopedic procedure.
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Affiliation(s)
- Lovely Bharti
- Orthodontics & Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pallavi Daigavane
- Orthodontics & Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunita Shrivastav
- Orthodontics & Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ranjit Kamble
- Orthodontics & Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shourya Bharadwaj
- Orthodontics and Dentofacial Orthopaedics, Jaipur Dental College and Hospital, Jaipur, IND
| | - Unnati Shirbhate
- Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aksha Bhargava
- Oral and Maxillofacial Surgery, Mahatma Gandhi Medical College and Research Institute, Jaipur, IND
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Pasqua BDPM, André CB, Paiva JBD, Rino Neto J. Short-term assessment of pain and discomfort during rapid maxillary expansion with tooth-bone-borne and tooth-borne appliances: randomized clinical trial. Dental Press J Orthod 2023; 28:e2322220. [PMID: 37729286 PMCID: PMC10508049 DOI: 10.1590/2177-6709.28.4.e2322220.oar] [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: 09/21/2022] [Accepted: 04/22/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE The aim of this randomized clinical trial was to evaluate and compare, during the first week of rapid maxillary expansion (RME), the impact caused by two types of appliances: Hyrax and Hybrid Hyrax. METHODS Forty-two patients who met the eligibility criteria (aged 11-14 years, with transverse maxillary deficiency, posterior crossbite, and presence of maxillary first premolars and first permanent molars) were selected and randomly divided into two groups: TBB GROUP (tooth-bone-borne expander), treated with Hybrid Hyrax (12 females and 9 males, mean age 13.3 ± 1.3 years), and TB GROUP (tooth-borne expander), treated with Hyrax (5 females and 16 males, mean age 13.3 ± 1.4 years). Pain and discomfort were assessed in two times: after the first day of activation (T1) and four days after, by means of the numerical rate scale and the instrument MFIQ (Mandibular Functional Impairment Questionnaire). Descriptive statistics and the Mann-Whitney test were used for comparison between groups and between sexes. A 5% significance level was adopted. RESULTS Both appliances had a negative impact, generating pain and discomfort, and reducing functional capacity. However, the scores obtained were of low intensity and no significant differences were observed between the groups. Considering sexes, there were statistically significant differences, with the female sex presenting higher scores for pain and functional limitation. CONCLUSIONS Despite causing impact in pain and increase in the functional limitation, these changes were of low intensity, with no statistical difference between the groups. Females were more sensitive to the impact caused by the RME.
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Affiliation(s)
| | | | | | - José Rino Neto
- University of São Paulo, Department for Orthodontics (São Paulo/SP, Brazil)
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Yoon A, Gozal D, Kushida C, Pelayo R, Liu S, Faldu J, Hong C. A roadmap of craniofacial growth modification for children with sleep-disordered breathing: a multidisciplinary proposal. Sleep 2023; 46:zsad095. [PMID: 37014012 PMCID: PMC10424160 DOI: 10.1093/sleep/zsad095] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/19/2023] [Indexed: 04/05/2023] Open
Abstract
Craniofacial modification by orthodontic techniques is increasingly incorporated into the multidisciplinary management of sleep-disordered breathing in children and adolescents. With increasing application of orthodontics to this clinical population it is important for healthcare providers, families, and patients to understand the wide range of available treatments. Orthodontists can guide craniofacial growth depending on age; therefore, it is important to work with other providers for a team-based approach to sleep-disordered breathing. From infancy to adulthood the dentition and craniofacial complex change with growth patterns that can be intercepted and targeted at critical time points. This article proposes a clinical guideline for application of multidisciplinary care with emphasis on dentofacial interventions that target variable growth patterns. We also highlight how these guidelines serve as a roadmap for the key questions that will influence future research directions. Ultimately the appropriate application of these orthodontic techniques will not only provide an important therapeutic option for children and adolescents with symptomatic sleep-disordered breathing but may help also mitigate or prevent its onset.
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Affiliation(s)
- Audrey Yoon
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry at the University of the Pacific, San Francisco, CA, USA
| | - David Gozal
- Department of Child Health, and Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Clete Kushida
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rafael Pelayo
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Stanley Liu
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - Jasmine Faldu
- Division of Orthodontics, Department of Orofacial Science, School of Dentistry, the University of California San Francisco, San Francisco, CA, USA
| | - Christine Hong
- Division of Orthodontics, Department of Orofacial Science, School of Dentistry, the University of California San Francisco, San Francisco, CA, USA
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Inchingolo AM, Patano A, De Santis M, Del Vecchio G, Ferrante L, Morolla R, Pezzolla C, Sardano R, Dongiovanni L, Inchingolo F, Bordea IR, Palermo A, Inchingolo AD, Dipalma G. Comparison of Different Types of Palatal Expanders: Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1258. [PMID: 37508755 PMCID: PMC10378123 DOI: 10.3390/children10071258] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the maxillary growth is unusually modest, are frequently treated with maxillary expansion. The purpose of this study is to compare the dental and skeletal effects of different types of expanders, particularly the Leaf Expander, rapid and slow dental-anchored or skeletal-anchored maxillary expanders. METHODS We chose studies that compared effects determined by palatal expansion using a rapid palatal expander, expander on palatal screws, and leaf expander. RESULTS Reports assessed for eligibility are 26 and the reports excluded were 11. A final number of 15 studies were included in the review for qualitative analysis. CONCLUSIONS Clinically and radiographically, the outcomes are similar to those obtained with RME and SME appliances; Therefore, it might be a useful treatment choice as an alternative to RME/SME equipment in cases of poor patient compliance or specific situations. Finally, all of the devices studied produce meaningful skeletal growth of the palate. The use of skeletally anchored devices does, without a doubt, promote larger and more successful growth in adolescent patients.
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Affiliation(s)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Matteo De Santis
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Roberta Morolla
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Carmela Pezzolla
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Roberta Sardano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Leonardo Dongiovanni
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | | | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
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Palatal shape covariation in extraction versus nonextraction borderline patients: A geometric morphometric study. Am J Orthod Dentofacial Orthop 2023; 163:e127-e136. [PMID: 36934057 DOI: 10.1016/j.ajodo.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 03/17/2023]
Abstract
INTRODUCTION This study aimed to evaluate changes in palatal shape after orthodontic treatment from a borderline sample of extraction and nonextraction patients with a Class I relationship. METHODS A borderline sample regarding premolar extractions was obtained through discriminant analysis and comprised 30 nonextraction and 23 extraction patients. The digital dental casts of these patients were digitized with 3 curves and 239 landmarks placed on the hard palate. Procrustes superimposition and principal component analysis were implemented to assess group shape variability patterns. RESULTS The success of the discriminant analysis in identifying a borderline sample regarding the extraction modality was validated using geometric morphometrics. Concerning palatal shape, no sexual dimorphism was found (P = 0.78). The first 6 principal components that were statistically significant accounted for 79.2% of the total shape variance. Palatal changes were 61% more pronounced in the extraction group, which exhibited a decrease in palatal length (P = 0.02; 10,000 permutations). In contrast, the nonextraction group showed an increase in the palatal width (P <0.001; 10,000 permutations). Intergroup comparisons indicated that the nonextraction group exhibited longer palates, whereas the extraction group exhibited higher palates (P = 0.02; 10,000 permutations). CONCLUSIONS Considerable changes in palatal shape were seen for the nonextraction and extraction treatment group, with the latter exhibiting more pronounced changes, mainly in terms of palatal length. Further investigations are needed to clarify the clinical significance of the palatal shape changes in borderline patients after extraction and nonextraction treatment.
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10
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Fleming PPS, Andrews DJ. Orthodontic Treatment: Getting the timing right. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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11
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Inchingolo AD, Ferrara I, Viapiano F, Netti A, Campanelli M, Buongiorno S, Latini G, Carpentiere V, Ciocia AM, Ceci S, Patano A, Piras F, Cardarelli F, Nemore D, Malcangi G, Di Noia A, Mancini A, Inchingolo AM, Marinelli G, Rapone B, Bordea IR, Scarano A, Lorusso F, Di Venere D, Inchingolo F, Dipalma G. Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report. CHILDREN 2022; 9:children9071046. [PMID: 35884030 PMCID: PMC9317392 DOI: 10.3390/children9071046] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Aim: In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. Methods: A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. Results: A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. Conclusions: From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Filippo Cardarelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angela Di Noia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
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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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