1
|
Lin TW, Zhang JL, Chen L, Chen Z, Ai H, Mai ZH. Impact of Invisalign® first system on molar width and incisor torque in malocclusion during the mixed dentition period. Medicine (Baltimore) 2024; 103:e38742. [PMID: 38968482 DOI: 10.1097/md.0000000000038742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2024] Open
Abstract
In orthodontic treatment of patients during the mixed dentition period, arch expansion and opening deep overbite are one of the objectives to achieve proper alignment of the teeth and correction of sagittal and vertical discrepancies. However, the expected outcomes of most therapeutic regimens are not clear, making it impossible to standardize early treatment effects. Therefore, this study was designed to evaluate the impact of the Invisalign® First System on the dental arch circumference and incisor inclination in patients during the mixed dentition period. A total of 21 children during the mixed dentition period (10 females and 11 males, with an average age of 8.76 years) were included in this study. The patients received non-extraction treatment through Invisalign® First System clear aligners, and no other auxiliary devices were used except Invisalign® accessories. Subsequently, the cooperation degree of patients during treatment and the oral measurement parameters at the beginning (T1) and the end (T2) of treatment were collected. All patients showed moderate/good cooperation degree during treatment. Besides, horizontal width of the maxillary first molar increased significantly; the designed arch expansion was 4.1 mm (±1.4 mm), while the actual arch expansion was 3.0 mm (±1.7 mm). Furthermore, the torque expression rate of upper anterior teeth reached 56.53%. Invisalign® First System clear aligners can effectively correct the teeth of patients during the mixed dentition period, widen the circumference of dental arch, and control the torque of incisors.
Collapse
Affiliation(s)
- Tian-Wei Lin
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University. Guangzhou, Guangdong, China
| | - Jing-Lan Zhang
- Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Southern Medical University. Guangzhou, Guangdong, China
| | - Lin Chen
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University. Guangzhou, Guangdong, China
| | - Zheng Chen
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University. Guangzhou, Guangdong, China
| | - Hong Ai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University. Guangzhou, Guangdong, China
| | - Zhi-Hui Mai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University. Guangzhou, Guangdong, China
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Willershausen I, Kopp M, Scholz M, Ströbel A, Seidel CL, Paulsen F, Uder M, Gölz L, May MS. Feasibility of 3 Tesla MRI for the assessment of mid-palatal suture maturation: a retrospective pilot study. Odontology 2024:10.1007/s10266-024-00950-0. [PMID: 38758257 DOI: 10.1007/s10266-024-00950-0] [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: 03/08/2024] [Accepted: 05/04/2024] [Indexed: 05/18/2024]
Abstract
The maxilla occupies a key position in dentofacial orthopaedics, since its transversal development can be directly influenced by orthodontic therapy. The maturation stages of the mid-palatal suture, which are obtained from cone-beam computed tomography images (CBCT), present an addition to clinical decision-making in transversal discrepancies of the upper jaw. In an endeavour to reduce ionizing radiation in adolescents and young adults, who are particularly susceptible to long term stochastic irradiation effects, we investigated the feasibility of 3 Tesla (3T) MRI in detecting the maturation stages of the mid-palatal suture. A collective of 30 patients aged 24-93 years with routine neck MRI at 3T, underwent an additional three-dimensional isotropic T1 weighted study sequence of the midface. Image evaluation was performed on axial, multi-planar formatted reconstructions of the dataset aligned to the midline axis of the palate, and curved reconstructions aligned to the concavity of the palate. Inverted images helped to achieve an image impression similar to the well-known CBCT appearance. All datasets were reviewed by three readers and mid-palatal maturation was scored twice according to Angelieri et al. Intra- and inter-rater agreement were evaluated to measure the robustness of the images for clinical evaluation. 3T MRI deemed reliable for the assessment of mid-palatal suture maturation and hence for the appraisal of the hard palate and its adjacent sutures. The data of this pilot study display the feasibility of non-ionizing cross-sectional MRI for the determination of sutural maturation stages. These findings underline the potential of MRI for orthodontic treatment planning, further contributing to the avoidance of unnecessary radiation doses.
Collapse
Affiliation(s)
- Ines Willershausen
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
| | - Markus Kopp
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Scholz
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Armin Ströbel
- Center for Clinical Studies (CCS), Medical Faculty, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Corinna Lesley Seidel
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias Stefan May
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| |
Collapse
|
4
|
Dominguez-Mompell R, Zhang B, Paredes N, Combs A, Elkenawy I, Sfogliano L, Fijany L, Colak O, Romero-Maroto M, Moon W. Breathing changes following mini-implant-supported maxillary skeletal expander treatment in late adolescent or adult patients : Assessment of objective and subjective functional breathing changes. J Orofac Orthop 2024:10.1007/s00056-024-00521-6. [PMID: 38466417 DOI: 10.1007/s00056-024-00521-6] [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: 11/09/2022] [Accepted: 01/16/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE The aim of this study was to assess objective and subjective breathing changes in adult patients who underwent maxillary skeletal expansion with the mini-implant-supported maxillary skeletal expander (MSE). METHODS Twenty-nine patients (mean age 18.1 ± 4.3 years) who underwent expansion using the MSE were compared pre- and posttreatment and with a control group (mean age 19.9 ± 2.6 years) to assess objective and subjective functional breathing changes. Objective measurements of the airway including peak nasal inspiratory flow (PNIF) and peak oral inspiratory flow (POIF) were measured utilizing the In-Check medical device (Clement Clarke, Harlow, United Kingdom). Patients reported subjective breathing assessment utilizing the visual analog scale (VAS). Intragroup comparisons were performed with Wilcoxon tests and intergroup comparison with Mann-Whitney U tests. Spearman correlation coefficients were calculated among the studied variables (P < 0.05). RESULTS Following MSE treatment, there were significantly higher values for PNIF total (P < 0.0001), PNIF right (P < 0.0001), PNIF left (P < 0.0001), and POIF (P < 0.01) compared to pretreatment and control group results. Also, patients reported a significant decrease in troubled breathing as measured by the VAS for breathing through the right nostril (P < 0.01), left nostril (P < 0.001), and both nostrils (P < 0.01). Comparing the objective and subjective variables for both the pre-MSE or post-MSE groups, the results indicated no significant correlation between total PNIF and total VAS. However, the values had significant correlations between PNIF and VAS on each side when the patients were asked to block one nostril. CONCLUSIONS Objective functional breathing measurements were increased immediately after treatment with MSE. Subjective functional breathing measurements changes were significantly higher after MSE treatment and compared with the control group. MSE presents a nonsurgical alternative to achieving orthopedic expansion in adult patients which may provide a benefit for patients with nasal airway obstruction.
Collapse
Affiliation(s)
| | - Boshi Zhang
- UCLA School of Dentistry, Section of Orthodontics, Center for Health Science, Room 63-082 CHS, 10833 Le Conte Ave, Box 951668, 90095-1668, Los Angeles, CA, USA
| | - Ney Paredes
- UCLA School of Dentistry, Section of Orthodontics, Center for Health Science, Room 63-082 CHS, 10833 Le Conte Ave, Box 951668, 90095-1668, Los Angeles, CA, USA.
| | - Andrew Combs
- UCLA School of Dentistry, Section of Orthodontics, Center for Health Science, Room 63-082 CHS, 10833 Le Conte Ave, Box 951668, 90095-1668, Los Angeles, CA, USA
| | - Islam Elkenawy
- UCLA School of Dentistry, Section of Orthodontics, Center for Health Science, Room 63-082 CHS, 10833 Le Conte Ave, Box 951668, 90095-1668, Los Angeles, CA, USA
| | - Luca Sfogliano
- UCLA School of Dentistry, Section of Orthodontics, Center for Health Science, Room 63-082 CHS, 10833 Le Conte Ave, Box 951668, 90095-1668, Los Angeles, CA, USA
| | - Layla Fijany
- UCLA School of Dentistry, Section of Orthodontics, Center for Health Science, Room 63-082 CHS, 10833 Le Conte Ave, Box 951668, 90095-1668, Los Angeles, CA, USA
| | - Ozge Colak
- Orthodontics Department, State University of New York, 320 Hayes Rd, 14215, Buffalo, NY, USA
| | | | - Won Moon
- Orthodontics and Craniofacial Development Research Forsyth Institute, 245 First Street, 02142, Cambridge, MA, USA.
- Orthodontics Department, AJOU University, Suwon, Korea (Republic of).
| |
Collapse
|
5
|
Combs A, Paredes N, Dominguez-Mompell R, Romero-Maroto M, Zhang B, Elkenawy I, Sfogliano L, Fijany L, Colak O, Wu B, Moon W. Long-term effects of maxillary skeletal expander treatment on functional breathing. Korean J Orthod 2024; 54:59-68. [PMID: 38268461 PMCID: PMC10811361 DOI: 10.4041/kjod23.090] [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: 04/21/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 01/26/2024] Open
Abstract
Objective : To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing. Methods Objective measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). Results : Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. Conclusions : Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.
Collapse
Affiliation(s)
- Andrew Combs
- Center for Health Science, Section of Orthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | | | | | | | - Boshi Zhang
- Center for Health Science, Section of Orthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Islam Elkenawy
- Center for Health Science, Section of Orthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Luca Sfogliano
- Center for Health Science, Section of Orthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Layla Fijany
- Center for Health Science, Section of Orthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Ozge Colak
- Department of Orthodontics, State University of New York, Buffalo, NY, USA
| | - Ben Wu
- Orthodontic and Craniofacial Development Research, Forsyth Institute, Cambridge, MA, USA
| | - Won Moon
- Orthodontic and Craniofacial Development Research, Forsyth Institute, Cambridge, MA, USA
- Department of Orthodontics, Ajou University, School of Medicine, Suwon, Korea
| |
Collapse
|
6
|
Marino Merlo M, Quiroga Souki B, Nieri M, Bonanno A, Giuntini V, McNamara JA, Franchi L. Comparison of the effects on facial soft tissues produced by rapid and slow maxillary expansion using stereophotogrammetry: a randomized clinical trial. Prog Orthod 2024; 25:1. [PMID: 38168740 PMCID: PMC10761642 DOI: 10.1186/s40510-023-00498-9] [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: 03/30/2023] [Accepted: 09/28/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To compare the effects on facial soft tissues produced by maxillary expansion generated by rapid maxillary expansion (RME) versus slow maxillary expansion (SME). MATERIALS AND METHODS Patients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. A conventional RME screw was compared to a new expansion screw (Leaf expander) designed to produce SME. Both screws were incorporated in a fixed expander. The primary outcome was the difference of the facial tissue changes in the nasal area measured on facial 3D images captured immediately before application of the expander (T0) and after one year of retention, immediately after the expander removal (T1). Secondary outcomes were soft tissue changes of other facial regions (mouth, lips, and chin). Analysis of covariance was used for statistical analysis. RESULTS Fourteen patients were allocated to the RME group, and 14 patients were allocated to the SME group. There were no dropouts. Nasal width change showed a difference between the two groups (1.3 mm greater in the RME group, 95% CI from 0.4 to 2.2, P = 0.005). Also, intercanthal width showed a difference between treatments (0.7 mm greater in the RME group, 95% CI from 0.0 to 1.3, P = 0.044). Nasal columella width, mouth width, nasal tip angle, upper lip angle, and lower lip angle did not show any statistically significant differences. The Y-axis (anterior-posterior) components of the nasal landmark showed a statistically significant difference between the two groups (0.5 mm of forward displacement greater in the RME group, 95% CI from 0.0 to 1.2, P = 0.040). Also, Z-axis (superior-inferior) components of the lower lip landmark was statistically significant (0.9 mm of downward displacement in favor of the RME group, 95% CI from 0.1 to 1.7, P = 0.027). All the other comparisons of the three-dimensional assessments were not statistically significant. CONCLUSIONS RME produced significant facial soft tissue changes when compared to SME. RME induced greater increases in both nasal and intercanthal widths (1.3 mm and 0.7 mm, respectively). These findings, though statistically significant, probably are not clinically relevant. Trial registration ISRCTN, ISRCTN18263886. Registered 8 November 2016, https://www.isrctn.com/ISRCTN18263886?q=Franchi&filters=&sort=&offset=2&totalResults=2&page=1&pageSize=10.
Collapse
Affiliation(s)
- Matilde Marino Merlo
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy
| | - Agnese Bonanno
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor of Dentistry Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Professor Emeritus of Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy.
- Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, USA.
- Director of the Division of Dentistry, University Hospital of Careggi, Via del Ponte di Mezzo, 46-48, 50127, Florence, Italy.
| |
Collapse
|
7
|
Pan S, Gao X, Sun J, Yang Z, Hu B, Song J. Effects of novel microimplant-assisted rapid palatal expanders manufactured by 3-dimensional printing technology: A finite element study. Am J Orthod Dentofacial Orthop 2023; 164:700-711. [PMID: 37330728 DOI: 10.1016/j.ajodo.2023.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/01/2023] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The expansion effects of several new microimplant-assisted rapid palatal expanders (MARPEs) manufactured by 3-dimensional printing technology were evaluated by finite element analysis (FEA). The aim was to identify a novel MARPE suitable for treating maxillary transverse deficiency. METHODS The finite element model was established using MIMICS software (version 19.0; Materialise, Leuven, Belgium). First, the appropriate microimplant insertion characteristics were identified via FEA, and several MARPEs with the above insertion patterns were manufactured by 3-dimensional printing technology. Then, the stress distribution and displacement prediction of the 4 MARPEs and hyrax expander (model E) were evaluated via FEA: bone-borne (model A), bone-tooth-borne (model B), bone-mucous-borne (model C), bone-tooth-mucous-borne (model D). RESULTS Monocortical microimplants perpendicular to the cortical bone on the coronal plane resulted in better expansion effects. Compared with a conventional hyrax expander, the orthopedic expansion of each of the 4 MARPEs was far larger, the parallelism was greater, and the posterior teeth tipping rate was lower. Among them, the expansion effects of models C and D were the best; the von Mises peak values on the surfaces of the microimplants were smaller than those of models A and B. CONCLUSIONS This study may demonstrate that the 4 MARPEs obtained more advantageous orthopedic expansion effects than a hyrax expander. Models C and D obtained better biomechanical effects and had better primary stability. Overall, model D is the recommended expander for treating maxillary transverse deficiency because its structure acts like an implant guide and is beneficial for the accurate insertion of the microimplant.
Collapse
Affiliation(s)
- Shengyuan Pan
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiang Gao
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jicheng Sun
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zun Yang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Bo Hu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| |
Collapse
|
8
|
Teixeira R, Massaro C, Garib D. Comparison of nasal cavity changes between the expander with differential opening and the fan-type expander: a secondary data analysis from an RCT. Clin Oral Investig 2023; 27:5999-6006. [PMID: 37620440 DOI: 10.1007/s00784-023-05213-w] [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: 02/18/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The aim of this study was to compare the nasal cavity skeletal changes between the expander with differential opening (EDO) and the fan-type expander (FE). METHODS This study was a secondary analysis of a previous randomized clinical trial. Forty-eight patients with posterior crossbite were randomly allocated into two study groups. Twenty-four patients (11 male, 13 female) with a mean initial age of 7.6 ± 0.9 years were treated with rapid maxillary expansion (RME) using the EDO. Twenty-four patients (10 male, 14 female) with a mean initial age of 7.8 ± 0.9 years were treated with the FE. Cone-beam computed tomography (CBCT) was performed before treatment and 1 to 6 months after the active phase of RME. Using frontal CBCT slices passing at the level of maxillary permanent first molars and maxillary deciduous canines, the width of the nasal cavity was measured in the lower, middle and upper thirds. Nasal cavity height was also evaluated in both slices. Intergroup comparisons of interphase changes were performed using t or Mann-Whitney tests (P < 0.05). RESULTS The two groups were similar regarding baseline data. EDO showed a greater transverse increase in the lower third of the nasal cavity in both canine (P = 0.007) and molar regions (P < 0.001). No intergroup difference was observed for changes in middle and upper widths and height of the nasal cavity. CONCLUSIONS Both expanders are effective in promoting an increase of the nasal cavity skeletal dimensions. The expander with differential opening produced a greater transverse increase in the lower third of the nasal cavity compared to the fan-type expander, both at the anterior and posterior regions of the maxilla. CLINICAL RELEVANCE EDO might be more beneficial to pediatric patients with oral breathing and obstructive sleep apnea compared to FE.
Collapse
Affiliation(s)
- Rodrigo Teixeira
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-901, Brazil.
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-901, Brazil
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-901, Brazil
| |
Collapse
|
9
|
Liu B, Wang B, Wang Z, Meng Y, Li Y, Li L, Wang J, Zhai M, Liu R, Wei F. Near-Infrared Light-Controlled MicroRNA-21-Loaded Upconversion Nanoparticles to Promote Bone Formation in the Midpalatal Suture. ACS APPLIED MATERIALS & INTERFACES 2023; 15:43503-43514. [PMID: 37694956 DOI: 10.1021/acsami.3c08616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Rapid maxillary expansion (RME) is a common therapy for maxillary transverse deficiency. However, relapses after RME usually occur because of insufficient bone formation. MicroRNA-21 (miR-21) was reported as an important post-transcriptional modulator for osteogenesis. Herein, a photocontrolled miR-21 (PC-miR-21)-loaded nanosystem using upconversion nanoparticles (UCNPs) modified with poly(ether imide) (PEI), i.e., UCNPs@PEI@PC-miR-21, was constructed to promote bone formation in the midpalatal suture. UCNPs@PEI was constructed as the light transducer and delivery carrier. The UCNPs@PEI@PC-miR-21 nanocomplexes have good aqueous dispersibility and biocompatibility. The in vitro cell experiment suggested that UCNPs@PEI could protect PC-miR-21 from biodegradation and release PC-miR-21 into the cytoplasm under near-infrared light (NIR) irradiation. Furthermore, UCNPs@PEI@PC-miR-21 upregulated the expression of the osteogenic key markers, ALP, RUNX2, and COL1A1, at the levels of both genes and proteins. Besides, the results of the in vivo RME mice models further corroborated that photocontrollable UCNPs@PEI@PC-miR-21 accelerated bone formation with upregulating osteogenic markers of ALP, RUNX2, and osteoprotegerin and inducing fewer osteoclasts formation. In conclusion, UCNPs@PEI@PC-miR-21 nanoparticles with a NIR light could facilitate the remote and precise delivery of exogenous miR-21 to the midpalatal suture to promote bone formation during RME. This work represents a cutting-edge approach of gene therapy to promote osteogenesis in the midpalatal suture during RME and provides a frontier scientific basis for later clinical treatment.
Collapse
Affiliation(s)
- Bohui Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
- Department of Stomatology, Qingdao West Coast New Area Central Hospital, Qingdao 266555, China
| | - Bing Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Ziyao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Yiling Meng
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Yixuan Li
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Lan Li
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Jixiao Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Mingrui Zhai
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Rui Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| | - Fulan Wei
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
| |
Collapse
|
10
|
Liu Y, Zhong Y, Zheng B, Liu Y. Extracellular vesicles derived from M1 macrophages enhance rat midpalatal suture expansion by promoting initial bone turnover and inflammation. Prog Orthod 2023; 24:34. [PMID: 37661233 PMCID: PMC10475451 DOI: 10.1186/s40510-023-00477-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/18/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Midpalatal suture (MPS) expansion can be affected by many factors, and researchers have attempted to regulate the initial inflammatory stage of expansion to optimize clinical outcomes and their underlying mechanisms. This study aimed to investigate the potential effects and mechanisms of M1 macrophage small extracellular vesicles during rat MPS expansion. MATERIALS AND METHODS RAW264.7 cells were induced to M1 or M2 polarization and, small extracellular vesicles were isolated from the polarized macrophages. Male Sprague-Dawley rats (6-7 weeks) were administered 70 ± 5 g expansion force devices for 7 days. Rats with expanders without force served as controls. M1/M2 small extracellular vesicles were injected into the MPS region (50 µg/day) in the M1 and M2 small extracellular vesicle-assisted groups, while 0.9% saline was injected into the expansion-only group. Suture width, bone mass, and morphological changes in the region of interest (ROI) were examined. RESULTS The M1 small extracellular vesicle-assisted group showed a significantly increased MPS suture width in vivo (P < 0.001), and less bone mass was observed in the ROI (P < 0.05). Histological examination showed that the M1 small extracellular vesicle-assisted group exhibited a wider palatal area and obvious fibrous tissue rearrangement. The expression of RANKL and the number of osteoclasts were increased (P < 0.01) in the bony edges, and the p65 protein expression was significantly higher (P < 0.001). CONCLUSIONS M1 macrophage-derived small extracellular vesicles have a positive effect in MPS expansion and increase p65 protein content and RANKL expression, thus promoting bone turnover. This study may contribute to the clinical application of small extracellular vesicles in the expansion of the palatal suture.
Collapse
Affiliation(s)
- Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, 110002, China
| | - Yuan Zhong
- Department of Orthodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, 110002, China
| | - Bowen Zheng
- Department of Orthodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, 110002, China.
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Disease, China Medical University, Shenyang, 110002, China.
| |
Collapse
|
11
|
Abate A, Ugolini A, Maspero C, Silvestrini-Biavati F, Caprioglio A, Lanteri V. Comparison of the skeletal, dentoalveolar, and periodontal changes after Ni-Ti leaf spring expander and rapid maxillary expansion: a three-dimensional CBCT based evaluation. Clin Oral Investig 2023; 27:5249-5262. [PMID: 37466717 PMCID: PMC10492880 DOI: 10.1007/s00784-023-05144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND The aim of the present study was twofold:(1) three-dimensionally evaluate the quantitative skeletal and dentoalveolar changes after Ni-Ti leaf spring expander (leaf expander) and rapid maxillary expansion (RME) in mixed dentition patients;(2) analyze the modifications of the buccal alveolar bone plate of the maxillary first permanent molars. METHODS Patients who underwent CBCT scans before and after maxillary expansion were randomly selected from the records archived at the Department of Biomedical Surgical and Dental Sciences, University of Milan, Italy. Inclusion criteria were the following: no systemic disease or syndromes; maxillary transverse deficiencies (difference between the upper intermolar width and the lower intermolar width of at least 3 mm and/or clinical need based on radiographic evaluation), early mixed dentition with ages between 7 to 10 years old; cervical vertebra maturation stage (CVMS) 1 or 2; no pathologic periodontal status; skeletal class I or II; maxillary expander cemented on the upper second deciduous molars. Exclusion criteria were the following: patients with pubertal or post-pubertal stage of development (CVMS 3-6); late deciduous or late mixed dentition, impossibility to use the second primary molar as anchorage; skeletal class III malocclusion; craniofacial syndromes; patients unable to be followed during the treatment period. Twenty-three patients treated with Leaf Expander, 11 males (mean age 7.8 ± 0.6 years) and 12 females (mean age 8.1 ± 0.8 years), met the inclusion criteria and constituted the case group. Twenty-four (control group) treated with conventional RME, 12 males (mean age 8.4 ± 0.9 years) and 12 females (mean age 8.1 ± 0.7 years). The paired-sample T test was used for intra-group comparison to evaluate the difference between before (T1) and after (T2) maxillary expansion. Independent sample t-test was computed to perform between groups comparison of the skeletal, dentoalveolar, and periodontal changes. RESULTS The Leaf Expander and RME group showed a significant increase between T1 and T2 for most of the skeletal and dentoalveolar variables. Concerning the skeletal variables only the RME demonstrated a significant increase at the level of the posterior nasal (PNW) and apical base width (PABW) and maxillary mid-alveolar width (MMW). Despite this, when compare with the Leaf Expander, the RME group exhibited a statistically larger width increase for only two skeletal parameters: PNW (p = 0.03) and MMW (p = 0.02). No significant changes at the periodontal level were found in either group. CONCLUSIONS According to the current research, the authors confirm the effectiveness of the Leaf Expander and RME to produce similar skeletal and dentoalveolar effects in mixed dentition subjects. Moreover, the devices anchored to deciduous teeth did not reduce the thickness and height of the buccal bone at the level of the maxillary permanent first molars in either of the two groups.
Collapse
Affiliation(s)
- Andrea Abate
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, Genoa, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy.
| | | | - Alberto Caprioglio
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Valentina Lanteri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| |
Collapse
|
12
|
Barbosa DF, Bana LF, Michel MCB, Meira E Cruz M, Zancanella E, Machado Júnior AJ. Rapid maxillary expansion in pediatric patients with obstructive sleep apnea: an umbrella review. Braz J Otorhinolaryngol 2023; 89:494-502. [PMID: 36894478 DOI: 10.1016/j.bjorl.2023.02.004] [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: 08/28/2022] [Revised: 12/26/2022] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE To compare polysomnographic parameters with others from the literature in order to provide more accurate information about Rapid Maxillary Expansion (RME) for treating Obstructive Sleep Apnea (OSA) in children, through raising the question: Is RME a good option for treating OSA in children? Prevention of mouth breathing during children's growth remains a challenge with significant clinical consequences. In addition, OSA induces anatomofunctional changes during the critical period of craniofacial growth and development. METHODS The Medline, PubMed, EMBASE, CINAHL, Web of Science, SciELO and Scopus electronic databases were searched up to February 2021 for systematic reviews with meta-analysis in the English language. Among 40 studies on RME for treating OSA in children, we selected seven in which polysomnographic measurements of the Apnea-Hypopnea Index (AHI) had been made. Data were extracted and examined in order to clarify whether any consistent evidence exists for indicating RME as a treatment for OSA in children. RESULTS We found no consistent evidence favoring RME for long-term treatment of OSA in children. All the studies presented considerable heterogeneity due to variability of age and length of follow-up. CONCLUSION Through this umbrella review, the need for methodologically better studies on RME is supported. Moreover, it can be considered that RME is not recommended for treating OSA in children. Further studies and more evidence identifying early signs of OSA are necessary in order to achieve consistent healthcare practice.
Collapse
Affiliation(s)
- Denise Fernandes Barbosa
- Universidade de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Laura Fernandes Bana
- Universidade de Campinas (FOP-UNICAMP), Faculdade de Odontologia, Departamento de Morfologia, Piracicaba, SP, Brazil
| | | | - Miguel Meira E Cruz
- Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina da Universidade de Lisboa, Unidade de Sono, Lisboa, Portugal
| | - Edilson Zancanella
- Universidade de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
| | - Almiro José Machado Júnior
- Universidade de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| |
Collapse
|
13
|
Xie B, Zhang L, Lu Y. The role of rapid maxillary expansion in pediatric obstructive sleep apnea: Efficacy, mechanism and multidisciplinary collaboration. Sleep Med Rev 2023; 67:101733. [PMID: 36566679 DOI: 10.1016/j.smrv.2022.101733] [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: 09/03/2022] [Revised: 11/17/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
This review aims to provide current knowledge about the efficacy, mechanism, and multidisciplinary collaboration of rapid maxillary expansion (RME) treatment in pediatric obstructive sleep apnea (OSA). OSA is a chronic disease characterized by progressively increasing upper airway resistance, with various symptoms and signs. Increasingly the evidence indicates that RME is a non-invasive and effective therapy option for children with OSA. Besides, the therapeutic mechanism of RME includes increasing upper airway volume, reducing nasal resistance, and changing tongue posture. Recent clinical researches and case reports also show that a multidisciplinary approach improves sleep-disordered breathing in children. Applied with adenotonsillectomy, mandibular advancement, continuous positive airway pressure, and comprehensive orthodontic treatment, RME can be more effective in recurrent or residual OSA.
Collapse
Affiliation(s)
- Bintao Xie
- Hunan Key Laboratory of Oral Health Research, China; Hunan Clinical Research Center of Oral Major Diseases and Oral Health, China; Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Lingling Zhang
- Hunan Key Laboratory of Oral Health Research, China; Hunan Clinical Research Center of Oral Major Diseases and Oral Health, China; Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Yanqin Lu
- Hunan Key Laboratory of Oral Health Research, China; Hunan Clinical Research Center of Oral Major Diseases and Oral Health, China; Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China.
| |
Collapse
|
14
|
Filonenko VV, Kaniura OА, Kopchak AV, Kryshchuk MG. STUDY OF THE STRESS-STRAIN STATE OF THE MAXILLA DURING ORTHODONTIC TREATMENT OF DENTOGNATHIC DEFORMATIONS IN CHILDREN WITH CONGENITAL CLEFT LIP AND PALATE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:2648-2656. [PMID: 38290029 DOI: 10.36740/wlek202312114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE The aim: To create a three-dimensional simulation mechanical-mathematical model of the biomechanical system "Orthodontic appliance-maxilla", to study peculiarities of the stress-strained state of the maxilla. PATIENTS AND METHODS Materials and methods: A simulation model of the biomechanical system "Orthodontic appliance-maxilla" was created using computed tomography (CBCT) data. Mathematical modeling was used to determine the stress-strain state of the simulation model. RESULTS Results: The patterns of changes in the stress state were determined and the values of deformation displacements in the structural elements of the biome-chanical system "Orthodontic appliance-maxilla" were determined under a force stress of the orthodontic device with an amplitude of 50 N. CONCLUSION Conclusions: Simulation computer modeling of the stress-strain state of the "Orthodontic appliance-maxilla" system showed that activation of the kinematic mechanism of the appliance with a force of 50 N causes the emergence of a complex stress-strain state of bones. When the orthodontic appliance is activated, there is an asymmetry in the distribution of stresses by Mises between the right and left sides both for the appliance itself and for the maxillary bone tissue.
Collapse
Affiliation(s)
| | | | | | - Mykola G Kryshchuk
- NATIONAL TECHNICAL UNIVERSITY OF UKRAINE «IGOR SIKORSKY KYIV POLYTECHNIC INSTITUTE», KYIV, UKRAINE
| |
Collapse
|
15
|
Lione R, Cretella Lombardo E, Paoloni V, Meuli S, Pavoni C, Cozza P. Upper arch dimensional changes with clear aligners in the early mixed dentition : A prospective study. J Orofac Orthop 2023; 84:33-40. [PMID: 34477905 DOI: 10.1007/s00056-021-00332-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/04/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND One goal of orthodontic treatment in mixed dentition is to expand the maxillary arch to allow proper tooth alignment and a correction of sagittal and vertical malocclusions. However, for most treatment protocols, expected outcome is not really clear to allow for a standardization of phase I orthodontic treatments. This lack of information makes it difficult for clinicians to predict tooth movements, including transverse expansion efficacy with Invisalign® (Align Technology, Santa Clara, CA, USA) in children. Therefore, the aim of the present study was to evaluate the transverse maxillary arch development with the Invisalign First System® in growing subjects. METHODS The study group included 23 subjects (9 females, 14 males, mean age 9.4 ± 1.2 years). Patients were treated nonextraction with Invisalign First System® clear aligners with no auxiliaries other than Invisalign® attachments. Transverse interdental widths were measured only in the upper arch on each model at the start (T1) and at the end (T2) of treatment. A paired t‑test was chosen to compare T2-T1 changes. The level of significance was set at 5%. RESULTS The greatest increase of maxillary width was detected at the level of the upper first deciduous molars (+3.7 ± 1.4 mm; P < 0.001), followed by the level of the second deciduous molars (+3.4 ± 1.6 mm; P < 0.001) and by the deciduous canine (+2.6 ± 2.0 mm; P < 0.001). Upper first molars showed a greater expansion in the intermolar mesial width (+3.2 ± 1.2 mm; P < 0.001) than in the intermolar distal (+1.7 ± 1.2 mm; P < 0.001) and transpalatal width (+1.2 ± 1.2 mm; P < 0.01). CONCLUSIONS The Invisalign First System® can be considered effective in growing patients who require maxillary arch development. The greatest net increase was detected at the level of upper first deciduous molars, whereas the upper first molars showed a greater expansion in the intermolar mesial width due to a rotation that occurs around its palatal root.
Collapse
Affiliation(s)
- Roberta Lione
- Department of Dentistry, UNSBC, Tirana, Albania
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | | | - Valeria Paoloni
- Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Simonetta Meuli
- Department of Aging, Neurological, Orthopedic and Head-Neck, Catholic University of Sacred Heart, Rome, Italy
| | - Chiara Pavoni
- Department of Dentistry, UNSBC, Tirana, Albania
- Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Paola Cozza
- Department of Dentistry, UNSBC, Tirana, Albania
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
- Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
16
|
Investigation of the role of midpalatal and circummaxillary sutures in bone-anchored rapid maxillary expansion using a verified finite-element model. Am J Orthod Dentofacial Orthop 2022. [DOI: 10.1016/j.ajodo.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
Lione R, Gazzani F, Moretti S, Danesi C, Cretella Lombardo E, Pavoni C. Gingival Margins' Modifications during Orthodontic Treatment with Invisalign First ®: A Preliminary Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1423. [PMID: 36291359 PMCID: PMC9600055 DOI: 10.3390/children9101423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
The aim of the study was to assess modifications of gingival morphology at the end of Phase I treatment with Invisalign First. Eighteen subjects (ten females, eight males, mean age nine years) treated with Invisalign First were selected. The following parameters were measured on intraoral photographs before treatment (T0) and after the first set of aligners (T1) at level of permanent incisors, deciduous canines and molars: gingival margin height (GMH) and deciduous canine inclination (DCI). A paired t-test was used to evaluate T1-T0 changes. The level of significance was established at 5%. Deciduous canines' GMH showed a major reduction between T1 and T0 accounting for 0.87 mm and 0.86 mm, respectively on the right and left sides. DCI increased for all patients in the interval T0-T1 on both sides, +7.11° on the right and +7.5° on the left. Tooth movement during Invisalign First induced significant modifications of gingival contour resulting in a more harmonious smile.
Collapse
Affiliation(s)
- Roberta Lione
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
- Department of Medicine and Surgery, UniCamillus International Medical University, 00133 Rome, Italy
- Department of Dentistry, UNSBC, 1000 Tirana, Albania
| | - Francesca Gazzani
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
| | - Sofia Moretti
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
| | | | | | - Chiara Pavoni
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy
- Department of Medicine and Surgery, UniCamillus International Medical University, 00133 Rome, Italy
- Department of Dentistry, UNSBC, 1000 Tirana, Albania
| |
Collapse
|
18
|
Tepedino M, Esposito R, Montaruli G, Monaco A, Chimenti C, Ciavarella D. Changes in hyoid bone and tongue position in Class I subjects after orthodontic treatment with rapid palatal expander. Cranio 2022:1-10. [PMID: 36101967 DOI: 10.1080/08869634.2022.2121015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To evaluate the effects of the rapid palatal expander (RPE) on the hyoid bone and tongue position in skeletal Class I patients, compared to control groups. METHODS Eighty-four Class I subjects, aged 6-14, were selected. Among these, 28 patients were treated with RPE, 28 with function-generating bite (FGB) appliance, and 28 were untreated. Lateral cephalograms taken before (T0) and after (T1) treatment were retrieved. Changes in the hyoid bone and tongue position were evaluated, and the area above the tongue was measured. RESULTS No significant difference in the hyoid and tongue posture was observed across the groups. However, there were significant differences for HC3 (distance from H-point to the third cervical vertebrae), H2H (distance from H-point to SN plane), and TT-Eb (tongue length) between T0 and T1 in all groups. CONCLUSION The results suggest that hyoid bone and tongue position changes were related to growth rather than treatment.
Collapse
Affiliation(s)
- Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rosa Esposito
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Graziano Montaruli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Annalisa Monaco
- Department of Health, Science and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| |
Collapse
|
19
|
Nucci L, Rotolo RP, Pellegrino T, Menichelli M, Perillo L, Apuzzo F, Grassia V. Dental Arch Changes with Two Different Trans-Palatal Arch. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Rapid maxillary expansion (RME) is a dentofacial orthopedic treatment often used to treat patients with narrow palate and transverse maxillary growth deficiency.
Introduction:
This treatment leads to correction of posterior dental crossbites, coordination of the upper and lower arches and gaining arch perimeter in patients with tooth size/arch size discrepancies. To stabilize the results obtained with RME and to limit or avoid the relapse, the use of Transpalatal Arch (TPA) would be recommended.
Objectives:
The aim of this study is to evaluate short-term maxillary changes in patients treated with RME followed by TPA with and without palatal arms.
Materials and Methods:
30 patients, 16 females and 14 males (mean age of 9.7 yrs ranging between 9 and 12), were treated by expansion with palatal Hyrax-type expander. After this period, it was removed and one of the two different types of TPA was used.
The two different TPA were a 0.036-inch stainless steel wire with a loop directed mesially in the middle, one maintained the original design (TPA), the second one presented arms extended to canines (TPAa). Dental casts were collected for each patient for each treatment step; before (T0), after expansion (T1) and after TPA or TPAa (T2). To assess differences in dental arches after the two treatment phases, three-dimensional (3D) dental casts were used to make more predictable measurements compared with caliper measurements that presented intra-examiner and inter-examiner measurements errors.
Results:
In TPAa group, differences between the value at the end of the retention period and at the end of expansion showed no statistical significance. Instead in TPA group, the same measurements suggested a reduction of value in almost all dental transverse diameters. Statistically significant differences in dental measurements were found between TPAa and TPA.
Conclusion:
Results confirm the hypothesis that TPAa can allow to better maintain dental transverse dimensions.
Collapse
|
20
|
Damian A, Gozal D. Innovations in the Treatment of Pediatric Obstructive Sleep Apnea. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1384:339-350. [PMID: 36217094 DOI: 10.1007/978-3-031-06413-5_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Obstructive sleep apnea affects a large proportion of otherwise healthy children in the context of interactions between craniofacial elements, adenotonsillar hypertrophy and other anatomical factors, and neuromuscular reflexes of the upper airway. In light of the adverse consequences of sleep apnea, it is important not only to proceed with early diagnosis but also to implement adequate treatment that is guided by the pathophysiological determinants of the disease in each child. Here, we will describe the current standard of care approaches to the treatment of pediatric obstructive sleep apnea, and will also explore novel management strategies that should enable more personalized therapy in the near future.
Collapse
Affiliation(s)
- Allan Damian
- Department of Neurology, University of Missouri School of Medicine, Columbia, MO, USA
- Comprehensive Sleep Medicine Program, University of Missouri School of Medicine, Columbia, MO, USA
| | - David Gozal
- Comprehensive Sleep Medicine Program, University of Missouri School of Medicine, Columbia, MO, USA.
- Department of Child Health and the Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA.
| |
Collapse
|
21
|
Abate A, Cavagnetto D, Fama A, Matarese M, Lucarelli D, Assandri F. Short term effects of rapid maxillary expansion on breathing function assessed with spirometry: A case-control study. Saudi Dent J 2021; 33:538-545. [PMID: 34803298 PMCID: PMC8589571 DOI: 10.1016/j.sdentj.2020.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The aim of this work is to evaluate changes following rapid maxillary expansion (RME) on breathing function in two groups of patients: mouth breathers and nasal breathers. MATERIALS AND METHODS Twenty-five oral breather patients (12 male, 13 female, mean age 15.2 ± 1.3), and 25 nasal breather patients (14 male, 11 female, mean age 15.3 ± 1.6) were treated with RME. Breathing function was evaluated by computerized spirometry. Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), Tiffenau index (FEV1/ FVC ratio, IT%), forced expiratory flow at 25-75% of vital capacity (FEF 25-75%), and Tidal volume (TV) were assessed. Breathing function analysis was performed before RME and 6 and 12 months after RME during follow-up appointments. The Shapiro-Wilk test was used to assess whether data were normally distributed. As data were not normally distributed, Mann-Whitney U and Friedman tests were used to perform comparisons between treatment groups and within group comparisons, respectively. RESULTS Oral breathers and nasal breathers showed statistically significant differences in FVC, FEF 25-75%, and TV at T0. They did not present any statistically significant difference in FEV1 and IT% at the same time point.Statistically significant differences were noticed for all indices in the oral breather group after maxillary expansion, while the nasal breather group showed statistically significant differences only in FCV, FEF 25-75%, and TV after treatment.There were no statistically significant differences in all indices 12 months after maxillary expansion between the oral breather and nasal breather groups. CONCLUSIONS RME appeared to improve breathing function in both groups. Forced vital capacity (FVC), forced expiratory flow at 25-75% of vital capacity (FEF 25-75), and Tidal volume (TV) reached similar values in both groups after treatment with RME.
Collapse
Affiliation(s)
- Andrea Abate
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Davide Cavagnetto
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Andrea Fama
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Marco Matarese
- Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, School of Dentistry, Via Consolare Valeria 1, University of Messina, 98125 Messina, Italy
| | - Danilo Lucarelli
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Fausto Assandri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| |
Collapse
|
22
|
Requena Pérez M, Zubizarreta-Macho Á, Colino Gallardo P, Albaladejo Martínez A, Garcovich D, Alvarado-Lorenzo A. Novel Digital Measurement Technique to Analyze the Palatine Suture Expansion after Palatine Rapid Maxillary Expansion Technique. J Pers Med 2021; 11:jpm11100962. [PMID: 34683103 PMCID: PMC8538160 DOI: 10.3390/jpm11100962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to validate a novel digital measurement method to quantify the volume of the midpalatal suture after rapid maxillary expansion (RME). Material and methods: Eight patients with maxillary skeletal transverse deficiency were submitted to palatine suture expansion using the McNamara orthodontic appliance during a period of nine months. After 30 days of treatment, all patients were exposed postoperatively to a cone-beam computed tomography (CBCT) scan. Afterwards, the scans were uploaded into the three-dimensional orthodontic-planning software to allow the volumetric assessment of the palatine suture expansion through palatine rapid maxillary expansion using a McNamara appliance. The repeatability was analyzed by repeating twice the measures by a single operator and reproducibility was analyzed by repeating three times the measures by two operators, and Gage R&R statistical analysis was performed. Results: The expansion of the midpalatal suture by means of the rapid maxillary expansion technique, in terms of digital volume measurement, showed a repeatability value of 0.09% and between the two operators a reproducibility value of 0.00% was shown. Conclusions: The novel measurement technique demonstrated a high repeatability and reproducibility rate for volume assessment of the palatine suture expansion through palatine rapid maxillary expansion technique.
Collapse
Affiliation(s)
- Mariano Requena Pérez
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain;
| | - Álvaro Zubizarreta-Macho
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); (A.A.-L.)
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
- Correspondence:
| | - Pedro Colino Gallardo
- Department of Orthodontics, Faculty of Faculty of Health Sciences, European University Miguel de Cervantes, 47012 Valladolid, Spain;
| | - Alberto Albaladejo Martínez
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); (A.A.-L.)
| | - Daniele Garcovich
- Department of Dentistry, European University of Valencia, Passeig de lÁlbereda 7, 46010 Valencia, Spain;
| | - Alfonso Alvarado-Lorenzo
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); (A.A.-L.)
| |
Collapse
|
23
|
de Medeiros Alves AC, de Medeiros Padilha H, de Andrade Barbalho AL, Gonçalves Tomaz AF, Gomes Pereira HS, Rabelo Caldas SGF. Influence of rapid maxillary expansion on nocturnal enuresis in children. Angle Orthod 2021; 91:680-691. [PMID: 33978712 DOI: 10.2319/042520-355.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 02/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the influence of rapid maxillary expansion (RME) on nocturnal enuresis (NE) in children to discuss whether RME can be indicated as an alternative treatment for NE in those patients. MATERIALS AND METHODS An electronic search was performed in the following databases: PubMed/MEDLINE, Cochrane Library, Scopus, Science Direct, Google Scholar and LILACS. The literature review was blindly performed by two reviewers. References of each selected study were manually searched to identify articles that were not found by the electronic search. Kappa statistics were used to analyze interexaminer agreement after the selection of the articles. After reading the selected full-text articles, the studies that met the inclusion criteria were assessed qualitatively using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) and the Revised Cochrane risk-of-bias tool for randomized controlled trials-2 (RoB 2). The certainty level of evidence was assessed through the Grading of Recommendations, Assessment, Development and Evaluation tool. Kappa tests were used to analyze the interexaminer concordance level after the quality assessment of the studies. RESULTS A total of 488 articles were found; however, after applying the inclusion and exclusion criteria, only 8 studies were selected for the systematic review. A low certainty level of evidence suggested that RME seems to promote a variable reduction in frequency or a remission of NE in children in both the short (4, 6, and 8 months) and long term (13, 36, 48, and 120 months). CONCLUSIONS Based on currently available information, RME seems to promote an improvement in NE in children. However, the low quality of the existing evidence weakens the recommendation.
Collapse
|
24
|
Christovam IO, Lisboa CDO, Vilani GNL, Brandão RCB, Visconti MAPG, Mattos CT, Ruellas ACDO. Tomographic analysis of midpalatal suture prior to rapid maxillary expansion. Dental Press J Orthod 2021; 26:e2119300. [PMID: 34231834 PMCID: PMC8279114 DOI: 10.1590/2177-6709.26.3.e2119300.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 03/04/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. In this study, individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). DESCRIPTION Twenty-six patients submitted to RME with a tooth-supported appliance (Hyrax) were evaluated. The inclusion criteria were: minimum age of 14 years, presenting all posterior teeth, diagnosed with transverse maxillary discrepancy, and with a clinical indication for maxillary expansion. The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. RESULTS The maturation stages present were C, D or E; the density ranged from 0.6 to 1, and lower density (MSD < 0.75) and higher density (MSD ≥ 0.75) groups were determined. Individuals with higher MSD presented smaller sagittal area, compared to the lower density group. Individuals in D and E MSM stages presented smaller sagittal area and intermediate thickness, compared to stage C. CONCLUSIONS Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MSM.
Collapse
Affiliation(s)
- Ilana Oliveira Christovam
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Ortodontia (Rio de Janeiro/RJ, Brazil)
| | | | | | | | | | - Claudia Trindade Mattos
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Ortodontia (Niterói/RJ,Brazil)
| | | |
Collapse
|
25
|
Paoloni V, Giuntini V, Lione R, Nieri M, Barone V, Merlo MM, Mazza F, Passaleva S, Cozza P, Franchi L. Comparison of the dento-skeletal effects produced by Leaf expander versus rapid maxillary expander in prepubertal patients: a two-center randomized controlled trial. Eur J Orthod 2021; 44:163-169. [PMID: 34114608 DOI: 10.1093/ejo/cjab035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to compare the skeletal and dentoalveolar effects produced by slow maxillary expansion (SME) with the Leaf expander versus the conventional rapid maxillary expansion (RME) on digital dental casts, lateral and postero-anterior cephalometric radiographs. TRIAL DESIGN This is a superiority, two-center, two arms parallel balanced randomization trial. METHODS Patients in the mixed dentition were included with a transverse interarch discrepancy of at least 3 mm. An expansion screw using moderate continuous forces (Leaf group) was compared to a conventional RME screw (RME group). The primary response variable was the difference in maxillary intermolar width (U6-U6) measured at baseline (T0) and one-year follow-up (T1) on the digital dental casts. Other dento-skeletal variables were also measured on digital dental casts and cephalograms. Computer-generated block randomization was used with allocation concealed in sequentially numbered opaque sealed envelopes. The examiner was blinded on the type of expander used. Linear models were used for statistical analysis. RESULTS Twenty-eight patients in the Leaf group and 28 patients in the RME group were randomized and included in the study. There were no dropouts. U6-U6 did not show a statistically significant difference between the two groups (-0.4 mm in favor of the RME group, 95% CI from -1.2 to 0.5, P = 0.365). As for the other secondary variables no statistically significant differences were found between the two groups except maxillary intercanine width (U3-U3, -0.9 mm in favor of the RME group, 95%CI from -1.5 to -0.3, P = 0.005) and maxillary skeletal width (Mx-Mx, -1.4 mm in favor of the RME group, 95%CI from -2.4 to -0.3, P = 0.013). CONCLUSIONS No significant differences between the RME and Leaf groups were detected for any of the analyzed dento-skeletal variables except the T1-T0 differences in U3-U3 and Mx-Mx that were significantly greater in the RME group. REGISTRATION The study was registered in the ISRCTN register on 08/11/2016 with the number ISRCTN18263886. FUNDING No funding or conflict of interest to be declared.
Collapse
Affiliation(s)
- Valeria Paoloni
- Department of Systems Medicine, University of Rome, Tor Vergata, Italy
| | - Veronica Giuntini
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Roberta Lione
- Department of Systems Medicine, University of Rome, Tor Vergata, Italy.,UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | | | - Matilde Marino Merlo
- Postgraduate Program in Orthodontics, The University of Florence, Florence, Italy
| | - Francesca Mazza
- SOC Odontostomatologia, AUSL Toscana centro, Florence, Italy
| | | | - Paola Cozza
- Department of Systems Medicine, University of Rome, Tor Vergata, Italy.,UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy.,Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
26
|
Pediatric Obstructive Sleep Apnea Syndrome: Emerging Evidence and Treatment Approach. ScientificWorldJournal 2021; 2021:5591251. [PMID: 33981185 PMCID: PMC8088382 DOI: 10.1155/2021/5591251] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 04/17/2021] [Indexed: 11/17/2022] Open
Abstract
OSA pediatric subjects suffer from episodes of upper airway obstruction that can be partial or complete, with atypical sleep patterns and blood-gas level alteration. If poor treated and/or diagnosed, it can cause cardiovascular disease, learning difficulties, behavioural issues, and retardation of growth. In the literature, there are conflicting evidence about OSA assessment and treatment in pediatric age, so the aim of this paper is to highlight the multidisciplinary approach in the management of sleep disorders, stressing the role of the pediatric dentist in both diagnosing and treating the OSAS in children, according to the current evidence of the treatment options effectiveness of the syndrome itself. Conclusions. Scientific evidence shows that OSAS management requires a multidisciplinary approach in order to make an early diagnosis and a correct treatment plan. The orthodontic treatment approach includes orthopedic maxillary expansion and mandibular advancement using intraoral appliances. Hence, the orthodontist and the pediatric dentist play an important role not only in early diagnosis but also in the treatment of pediatric OSAS.
Collapse
|
27
|
Abate A, Cavagnetto D, Rusconi FME, Cressoni P, Esposito L. Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:33. [PMID: 33430404 PMCID: PMC7827492 DOI: 10.3390/children8010033] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects and the safety of rapid maxillary expansion (RME) in growing patients affected by JIA. It was evaluated whether RME could be performed without complications on TMJs of JIA patients using DC/TMD protocol, and naso-maxillary transversal parameters were compared with the ones obtained on healthy patients. METHODS Twenty-five patients affected by JIA that ceased to manifest TMJ (Temporo-Mandibular Joint) symptoms in the previous year were treated with RME to solve the maxillary transverse hypoplasia. Postero-anterior cephalometric tracings were collected before and after treatment; linear measurements were obtained to study maxillary and nasal cavity modifications. Data were compared to those of a similar group of twenty-five healthy patients. Paired t-test and Independent t-test were used to evaluate changes before and after treatment in each group and to perform a comparison between the groups. RESULTS All patients demonstrated a statistically significant increase in nasal cavity width, maxillary width and upper and lower intermolar width. No patients presented a worsening of their TMJs condition. Intragroup comparisons revealed significant changes of cephalometric measurements, but no difference was found when comparing JIA and healthy patients. CONCLUSIONS Growing patients with JIA that ceased to show signs of active TMJ involvement for at least one year could be safely treated with RME, expecting similar benefits to those of healthy patients. Dentists and rheumatologists should be informed of safety and potential benefits of palatal expansion in JIA patients in order to improve the outcome of orthodontic treatment and reduce the indication for more invasive procedures (i.e., Surgical Assisted Rapid Maxillary Expansion).
Collapse
Affiliation(s)
- Andrea Abate
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (A.A.); (D.C.); (F.M.E.R.); (P.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Davide Cavagnetto
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (A.A.); (D.C.); (F.M.E.R.); (P.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Francesca Maria Emilia Rusconi
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (A.A.); (D.C.); (F.M.E.R.); (P.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Paolo Cressoni
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (A.A.); (D.C.); (F.M.E.R.); (P.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Luca Esposito
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (A.A.); (D.C.); (F.M.E.R.); (P.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| |
Collapse
|
28
|
Lanteri V, Cavagnetto D, Abate A, Mainardi E, Gaffuri F, Ugolini A, Maspero C. Buccal Bone Changes Around First Permanent Molars and Second Primary Molars after Maxillary Expansion with a Low Compliance Ni-Ti Leaf Spring Expander. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9104. [PMID: 33291246 PMCID: PMC7730214 DOI: 10.3390/ijerph17239104] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 02/07/2023]
Abstract
Background: Vestibular bone thickness changes and dento-alveolar buccal tipping of second primary molars and of first molars after maxillary expansion performed with a slow maxillary expansion protocol was investigated. Methods: Twenty patients (mean age 7.3 ± 0.9 years old; 9 male and 11 female) were treated according to the Leaf Expander protocol. Buccal alveolar bone thickness (BT), buccal alveolar bone height (BH), inter-dental angle (TIP), and inter-molar width (IW) regarding first molars and second primary molars were calculated before and after expansion on cone beam computed tomography (CBCT) images. Descriptive statistics and paired t-tests were used to assess changes between the pre-treatment and post-treatment measurements. Results: Bone thickness vestibular to second primary molars and intermolar width of both teeth were the only variables that showed statistically significant changes. Conclusions: It appears that buccal bone thickness vestibular to first molars was not significantly reduced after maxillary expansion with the Leaf Expander. The clinical use of a slow maxillary expander with Ni-Ti springs appears efficient and safe in in the correction of maxillary hypoplasia during mixed dentition.
Collapse
Affiliation(s)
- Valentina Lanteri
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (D.C.); (A.A.); (E.M.); (F.G.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Davide Cavagnetto
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (D.C.); (A.A.); (E.M.); (F.G.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Andrea Abate
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (D.C.); (A.A.); (E.M.); (F.G.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Eleonora Mainardi
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (D.C.); (A.A.); (E.M.); (F.G.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (D.C.); (A.A.); (E.M.); (F.G.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16132 Genova, Italy;
| | - Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (D.C.); (A.A.); (E.M.); (F.G.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| |
Collapse
|
29
|
Fourneron M, Morant F, Boutin F, Frapier L. Is the Quad Helix more efficient to correct mandibular asymmetry before age 7? A retrospective comparative study. Int Orthod 2020; 18:443-450. [DOI: 10.1016/j.ortho.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 02/08/2023]
|
30
|
Niu X, Di Carlo G, Cornelis MA, Cattaneo PM. Three-dimensional analyses of short- and long-term effects of rapid maxillary expansion on nasal cavity and upper airway: A systematic review and meta-analysis. Orthod Craniofac Res 2020; 23:250-276. [PMID: 32248642 DOI: 10.1111/ocr.12378] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The purpose of this systematic review was to evaluate the three-dimensional (3D) changes occurring at short- and long-term follow-up after rapid maxillary expansion (RME) in nasal cavity (NC) and upper airway (UA) in growing patients. METHODS A literature search up to 1 July 2019 was performed. Randomized and non-randomized clinical trials and cohort studies comparing the effects of RME in a paediatric population using 3D analyses based on computed tomography (CT), cone-beam CT and MRI were included. The risks of bias of the included studies were assessed using the Cochrane Collaboration's risk of bias tool, the GRADE approach and a customized tool. The random-effects meta-analyses of the mean differences and 95% confidence intervals of NC and UA volume changes were carried out, followed by subgroup analyses. RESULTS Twenty-seven studies were included, with 18 selected for quantitative synthesis. Immediately after expansion, the nasopharynx and oropharynx increased significantly. After 3 months of retention, only the NC and nasopharynx showed a significant volume increase. Two studies mentioned the use of a sleep-disordered breathing questionnaire, and one study reported the difference before and after RME. None of the 27 articles included assessed the correlation between the skeletal widening and NC or UA volume changes after RME. CONCLUSIONS The existing evidence confirmed only the short-term positive effect of RME on expanding the volume of the NC and the upper part of the UA. However, long-term stability could not be sustained.
Collapse
Affiliation(s)
- Xiaowen Niu
- Section of Orthodontics, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
| | - Gabriele Di Carlo
- Section of Orthodontics, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark.,Department of Oral and Maxillofacial Sciences, Unit of Pediatric Dentistry, Sapienza University of Rome, Rome, Italy
| | - Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
| | - Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
31
|
Maspero C, Cavagnetto D, Abate A, Cressoni P, Farronato M. Effects on the Facial Growth of Rapid Palatal Expansion in Growing Patients Affected by Juvenile Idiopathic Arthritis with Monolateral Involvement of the Temporomandibular Joints: A Case-Control Study on Posteroanterior and Lateral Cephalograms. J Clin Med 2020; 9:E1159. [PMID: 32325675 PMCID: PMC7230922 DOI: 10.3390/jcm9041159] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) affecting temporomandibular joints (TMJ) in growing patients results in maxillofacial deformities, especially if only one condyle has been affected by the rheumatic disease. Mandibular hypoplasia is the most common issue and it may be associated with maxillary hypoplasia. The aim of this retrospective case-control study is to evaluate the effects of rapid maxillary expansion (RME) in these patients. METHODS 25 growing patients affected by maxillary hypoplasia, currently in a quiescent phase of JIA for at least one year and monolateral involvement of the TMJs, were treated with RME. Data gathered from posteroanterior and lateral cephalograms before and after 1 year from RME were compared to those of 25 non-JIA controls. RESULTS Nasal cavity width, maxillary width and upper and lower intermolar width statistically increased. Maxillary and mandibular symmetry indexes presented a statistically significant increase, so did the skeletal class. No signs or symptoms of TMJ activity of JIA occurred according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) criteria. No difference was found when comparing JIA and non-JIA patients apart from the better improvement of several mandibular symmetry indexes in the affected TMJ side of JIA patients. This event is allegedly due to a worse baseline asymmetry in JIA patients that underwent a bigger relative improvement after treatment. CONCLUSIONS Results suggest that solving maxillary hypoplasia and, therefore, premature contacts are likely to have allowed mandibular repositioning and condylar growth. RME is a safe and effective solution that can substantially improve maxillary and mandibular symmetry in growing patients affected by JIA with TMJ involvement.
Collapse
Affiliation(s)
- Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Davide Cavagnetto
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Andrea Abate
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Paolo Cressoni
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| |
Collapse
|
32
|
Fastuca R, Michelotti A, Nucera R, D’Antò V, Militi A, Logiudice A, Caprioglio A, Portelli M. Midpalatal Suture Density Evaluation after Rapid and Slow Maxillary Expansion with a Low-Dose CT Protocol: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E112. [PMID: 32150850 PMCID: PMC7143279 DOI: 10.3390/medicina56030112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/16/2022]
Abstract
Background and objectives: The aim of the present paper is to use low-dose computed tomography (CT) to evaluate the changes in the midpalatal suture density in patients treated with rapid maxillary expansion (RME) and slow maxillary expansion (SME). Materials and Methods: Thirty patients (mean age 10.2 ± 1.2 years) were retrospectively selected from the existing sample of a previous study. For each patient, a low-dose computed tomography examination was performed before appliance placement (T0) and at the end of retention (T1), seven months later. Using the collected images, the midpalatal suture density was evaluated in six regions of interest. Results: No significant differences were found between the timepoints in the rapid maxillary expansion group. Three out of six regions of interest showed significant decreases between the timepoints in the slow maxillary expansion group. No significant differences were found in comparisons between the two groups. Conclusions: The midpalatal suture density showed no significant differences when rapid maxillary expansion groups were compared to slow maxillary expansion groups, suggesting that a similar rate of suture reorganization occurs despite different expansion protocols.
Collapse
Affiliation(s)
- Rosamaria Fastuca
- Department of Medicine and Surgery, School of Medicine, University of Insubria, Via G. Piatti 10, 21100 Varese, Italy; (R.F.); (A.C.)
| | - Ambra Michelotti
- Section of Orthodontics, Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy;
| | - Riccardo Nucera
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy; (R.N.); (A.M.); (A.L.)
| | - Vincenzo D’Antò
- School of Orthodontics, University of Naples, 80131 Naples, Italy;
| | - Angela Militi
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy; (R.N.); (A.M.); (A.L.)
| | - Antonino Logiudice
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy; (R.N.); (A.M.); (A.L.)
| | - Alberto Caprioglio
- Department of Medicine and Surgery, School of Medicine, University of Insubria, Via G. Piatti 10, 21100 Varese, Italy; (R.F.); (A.C.)
| | - Marco Portelli
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy; (R.N.); (A.M.); (A.L.)
| |
Collapse
|
33
|
Cretella Lombardo E, Franchi L, Lione R, Chiavaroli A, Cozza P, Pavoni C. Evaluation of sagittal airway dimensions after face mask therapy with rapid maxillary expansion in Class III growing patients. Int J Pediatr Otorhinolaryngol 2020; 130:109794. [PMID: 31812840 DOI: 10.1016/j.ijporl.2019.109794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this investigation was to analyze the effects of RME and FM on the airway dimensions in Class III patients compared with untreated controls. METHODS A sample of 47 Class III patients treated with RME and FM was analyzed. The treated group was compared with 18 untreated controls. Lateral cephalograms for each patient at T1, T2, and T3 were digitized. RESULTS At long-term evaluation a significant increase in airway size and a significant decrease in adenoid size were found in the treated group as well as an improvement in the pharynx dimension. During active treatment the treated group showed a significant improvement in lower airway size and in lower pharynx dimension. A significant decrease in adenoid size was also found. CONCLUSION The treatment with RME and FM produced favorable stable changes in the airway dimensions in Class III subjects when compared with untreated controls.
Collapse
Affiliation(s)
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Alice Chiavaroli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy; Department of Orthodontics, University Zoja e Këshillit Të Mirë, Tirane, Albania
| | - Chiara Pavoni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| |
Collapse
|
34
|
Evangelista K, Ferrari-Piloni C, Barros LAN, Avelino MAG, Helena Soares Cevidanes L, Ruellas ACDO, Valladares-Neto J, Silva MAG. Three-dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study. Orthod Craniofac Res 2020; 23:300-312. [PMID: 32022986 DOI: 10.1111/ocr.12370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/13/2020] [Accepted: 02/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate craniofacial asymmetry in children with transverse maxillary deficiency, with or without functional unilateral posterior crossbite (UPC), before and after rapid maxillary expansion (RME). SETTING AND SAMPLE POPULATION A sample of 51 children with cone beam computed tomography scans obtained before RME (T1) and a year after RME (T2). MATERIAL AND METHODS This prospective study consisted of 2 groups: 25 children with functional UPC (6.77 ± 1.5 years) and 26 children without UPC (7.41 ± 1.31 years). Linear and angular measurements were obtained from zygomatic, maxilla, glenoid fossa and mandible, using original and mirrored 3D overlapped models. All right and left side comparisons in both groups and intergroups asymmetries were compared using MANOVA and t test for independent samples, respectively, statistically significant at P < .05. RESULTS The UPC group showed no side differences, but mandibular horizontal rotation at T1, and this asymmetry was improved in T2. The non-UPC group showed at baseline significant lateral asymmetry in orbitale, position of palatine foramen, respectively, in average 2.95 mm and 1.16 mm, and 0.49 mm of average asymmetry in condylar height. The glenoid fossa was symmetric in both groups at T1 and T2. CONCLUSIONS Children with transverse maxillary deficiency showed slight morphological asymmetry, located in the mandible position in cases of UPC, and in the orbital and maxillary regions in cases without UPC. One year after RME, patients improved their craniofacial asymmetry, with significant changes in the mandible and correction of the mandibular rotation in patients who presented UPC.
Collapse
|
35
|
Haffaf RA, Hasan AK, Tizini M. Mandibular Behavior after Rapid Maxillary Expansion: A Clinical Study. Open Dent J 2019. [DOI: 10.2174/1874210601913010537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Rapid Maxillary Expansion (RME) is a primary part of the contemporary orthodontic treatment plans. In addition to the maxilla, it is important to know its effect on the other dentofacial components. Some studies showed dentofacial changes after RME in the sagittal and vertical planes. The clinical importance of these changes is controversial.
Objective:
To investigate the mandibular changes after RME as the only treatment intervention in the sagittal and vertical planes.
Methods:
Twenty-eight growing patients aged 4-14 years were included in the current study. The bonded acrylic splint expander was used. Lateral cephalometric radiographs were taken at the beginning of the treatment (T1) and after a retention phase of six months (T2). The mandibular changes were assessed using vertical parameters (SN.MP, MMA, LAFH/TAFH, S.AR/AR.GO) and sagittal parameters (SNB, S.N.POG, N.A.POG). The changes between T1 and T2 were examined by paired samples T-test.
Results:
Two parameters showed a backward rotation in the vertical plane. The parameter S.AR/AR.GO showed a significant increase. The skeletal convexity increased with no clinical significance.
Conclusion:
There were statistically significant changes in the sagittal and vertical planes with no clinical importance. RME may affect the mandibular condyle position.
Collapse
|
36
|
Amat P. [Obstructive sleep disordered breathing and orthodontics: primum non nocere]. Orthod Fr 2019; 90:247-262. [PMID: 34643513 DOI: 10.1051/orthodfr/2019039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Obstructive sleep apnoea syndrome is a widespread and under-diagnosed condition, making it a major public health and safety issue. The objective of this article was to clarify some of the evidence-based elements of therapeutic decision-making and the information provided to the patient and family on the benefit-cost-security ratio of several of his therapeutic options. Published data on the effectiveness of oral appliances and functional orthopaedic appliances for obstructive sleep apnea (OSA) in children, the durability of their effects, the therapeutic possibilities of maxillary or bimaxillary expansion, and the interrelationships between permanent teeth extractions and obstructive sleep disordered breathing, were researched and analyzed. Based on available evidence, in growing patients with Class II malocclusion, treatment with functional orthopedic devices can increase the volume of the pharyngeal airway and thus hopefully reduce the risk of developing OSA. An improvement in the apnea-hypopnea index and lower oxygen saturation was observed in children treated with rapid maxillary expansion. Permanent teeth extractions prescribed for the treatment of teeth crowding in an orthodontic age patient do not result in any significant change in the upper airway. The role of the orthodontist in the multidisciplinary team in the screening and management of Obstructive Sleep Disordered Breathing (OSDB) is essential. By combining clinical experience with published data on various therapeutic approaches, the orthodontist helps the patient to benefit from better adapted care and a more sustainable outcome, while taking into account his or her preferences.
Collapse
Affiliation(s)
- Philippe Amat
- 19, Place des Comtes du Maine, 72000 Le Mans, France
| |
Collapse
|
37
|
Liu JL, Li HF, Yan H. [Comparing the effects of fast and slow expansion on nasal cavity and maxilla structure]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:533-536. [PMID: 31721503 DOI: 10.7518/hxkq.2019.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aims to compare the effects of fast and slow expansion on nasal cavity structure. METHODS A total of 40 patients were selected and randomly divided into two groups. Cone-beam computer tomography (CBCT) was obtained before and after surgery and used for comparing the changes in nasal structure before and after treatment. RESULTS Fast expansion had resulted in greater changes in the basilar and nasal bone arch extension structures than slow expansion. No significant difference at maxillary width and nasal parenchyma. CONCLUSIONS Rapid expansion therapy has more beneficial effects on nasal function.
Collapse
Affiliation(s)
| | - Hong-Fa Li
- Stomatological Hospital, Tianjin Medical University, Tianjin 300000, China
| | - Hui Yan
- Tianjin Nankai Hospital, Tianjin 300000, China
| |
Collapse
|
38
|
Oh H, Park J, Lagravere-Vich MO. Comparison of traditional RPE with two types of micro-implant assisted RPE: CBCT study. Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
39
|
Garcez AS, Suzuki SS, Storto CJ, Cusmanich KG, Elkenawy I, Moon W. Effects of maxillary skeletal expansion on respiratory function and sport performance in a para-athlete – A case report. Phys Ther Sport 2019; 36:70-77. [DOI: 10.1016/j.ptsp.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/10/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
|
40
|
Helal N, Basri O, Gadi LS, Alhameed AF, Grady JM. Parents’ Perceptions of Breathing Pattern Changes, Sleep Quality, and Fatigue in Children after Rapid Maxillary Expansion: A Survey and Case Series Study. Open Dent J 2019. [DOI: 10.2174/1874210601913010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Rapid Maxillary Expansion (RME) aims to re-establish balance between the widths of the jaws. It is mainly utilized to treat skeletal and dental manifestations associated with transverse maxillary constriction and to improve facial structures involving the nasal cavity.
Objectives:
This study aimed to investigate parents’ perceptions of breathing pattern changes after their child had undergone RME and the associated effects on sleep quality and fatigue. We also evaluated nasal cavity changes in three dimensions in six randomly selected patients.
Methods:
Ninety-one children aged 5-13 years with transverse maxillary deficiency and no major systemic diseases or syndromes were recruited. Their parents completed a 16-item questionnaire pre-treatment and 6 months post-treatment. The questionnaire included items pertaining to changes in (1) sleep apnea and breathing patterns, (2) sleep quality and fatigue, and (3) behavior. The cone beam computed tomography scans from six randomly chosen patients were also subjected to stereolithographic reconstruction of the midface pre-RME and post-RME.
Results:
Responses in the three domains exhibited good reliability. Significant improvements were observed in 59% of the items post vs. pre-RME. The overall rates of dry mouth in the morning, snoring half of the time, and heavy breathing decreased by ≥30%. The percentage change in headache in the morning, snoring loudly, and snoring half of the time was >80%. In addition, in the series of six cases, the mean difference in nasal cavity area post-RME was 4.1 mm2.
Conclusion:
Post-RME, parents perceived that their children exhibited improved behavior and were less fatigued during the day. Enhanced sleep quality and breathing patterns were also observed, but to a lesser extent.
Collapse
|
41
|
Corticopuncture Facilitated Microimplant-Assisted Rapid Palatal Expansion. Case Rep Dent 2019; 2018:1392895. [PMID: 30627452 PMCID: PMC6305058 DOI: 10.1155/2018/1392895] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/10/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Microimplant-assisted rapid palatal expansion (MARPE) has been considered an alternative to avoid extensive surgical procedures. In order to obtain skeletal results of MARPE, force should be enough to overcome areas of resistance and the first one that is required to be disrupted is the midpalatal suture, which becomes increasingly interdigitated after adolescence. Objective The present study aimed at providing a novel approach using a minimally invasive method called corticopuncture (CP) in association with MARPE illustrated by a case report of a 35-year-old Brazilian female Caucasian patient presenting maxillary transverse deficiency. Method Treatment plan started with an orthopedic correction of the transverse problem using a MARPE device. After many unsuccessful attempts to activate MARPE, corticopunctures were performed along the midpalatal suture. CP procedure at the midpalatal suture included 8 perforations (2 mm apart), performed after previous predrilling followed by miniscrew insertion (5 mm thread length and 1.8 mm diameter). Results After CP and new activation protocol, the opening of the midpalatal suture was observed by CBCT images, showing skeletal results, suture split of 3.14 mm (premolar area) and 2.06 (molar area), an increase of 4.3 mm (premolar) and 3.03 mm (molar) in basal bone width, 4.43 mm (premolar) and 3.1 mm (molar) in cortical bone width, and minimal dental effects (mean of 1.2° of tooth tipping). Conclusion The combination of MARPE and corticopuncture method was proved to be a nonsurgical treatment option to correct maxillary transverse deficiency in an adult patient. CP was able to weaken suture interdigitation thus facilitating the split.
Collapse
|
42
|
Cossellu G, Lanteri V, Lione R, Ugolini A, Gaffuri F, Cozza P, Farronato M. Efficacy of ketoprofen lysine salt and paracetamol/acetaminophen to reduce pain during rapid maxillary expansion: A randomized controlled clinical trial. Int J Paediatr Dent 2019; 29:58-65. [PMID: 30298560 DOI: 10.1111/ipd.12428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/31/2018] [Accepted: 09/06/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Rapid maxillary expansion (RME) is an orthopaedic procedure indicated for a wide variety of clinical conditions. AIM The aim of the study was to compare the effects of ketoprofen lysine salt (KLS) vs paracetamol/acetaminophen (P) on pain perception during RME. DESIGN One hundred and fifty-one subjects (mean age 8.6 year) were enrolled in this prospective controlled clinical trial according to inclusion criteria: prepuberal stage of development, negative posterior transverse interarch discrepancy, non-concurrent use of other drugs. First phase: n.40 allocated to Group 1 used 40 mg of KLS, n.40 to Group 2 used 250 mg of P, n.36 to Group 3 as control group. Second phase: n.35 allocated to Group 4 used 40 mg ketoprofen lysine salt once a day for the first 3 days of activation. Pain experience was reported on a numeric rating scale (0-4) and a 100-mm visual analogue scale. Pain perception was tested with the Mann-Whitney test (P < 0.05). RESULTS Pain perception was higher during the first 3 days of activation and it was described as mild to moderate. Group 1 experienced significantly less pain during the fourth, fifth, and sixth day (P < 0.05) compared with Group 2. Patients of the Group 4 reported significantly lower pain during the whole period of RME activation (P < 0.05). CONCLUSIONS The perceived higher pain was reported during the second and third day of expansion. The analgesic effect of KLS is more effective than P during the fourth, fifth, and sixth day. The use of KLS during the first 3 days of activation seems to be able reducing pain during the whole active phase.
Collapse
Affiliation(s)
- Gianguido Cossellu
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Valentina Lanteri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Francesca Gaffuri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Farronato
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| |
Collapse
|
43
|
PIMENTEL DJB, MAGRI LV, MELCHIOR MDO, MARAÑÓN-VÁSQUEZ GA, MATSUMOTO MAN, MAZZETTO MO. Rapid maxillary expansion in the treatment of the functional posterior crossbite: joint noise and electromyographic activity analysis. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.03819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction The rapid maxillary expansion (RME) reduces the risk of developing structural and functional disorders in the stomatognathic system. Objective To examine the effects of the RME as a treatment for the posterior crossbite, related with the electromyographic activity of the masticatory muscles and the TMJ noises in a population of children. Material and method 13 girls and 7 boys, regardless of the type of malocclusion, with a mean age of 9 years old (± 3), were treated with RME. The electrovibratography analyzed the TMJ noise, and the electromyography analyzed the masticatory muscles before treatment (T0) and after three months of a short-term follow-up (T1). The comparisons of the affected and unaffected sides by the crossbite were performed using Mann-Whitney’s test, and to compare data before and after treatment the Wilcoxon’s test was used (level of significance: 5%). Result No significant differences were found in the parameters of joint noise in comparison to the sides affected and unaffected by the crossbite, in both T0 and T1 (p>0.05); only the side without the crossbite observed decrease in the peak amplitude of the joint noises after treatment. In the static electromyographic analysis, inter-side differences were observed before and after treatment, since the deliberate unilateral chewing showed greater asymmetry activity in T0 for both sides, which has been corrected after treatment, improving the functional chewing. Conclusion The proposed treatment did not lead to the occurrence of joint noises and improved the functional pattern of electromyographic activity during chewing at the end of treatment.
Collapse
|
44
|
Stark TR, Pozo-Alonso M, Daniels R, Camacho M. Pediatric Considerations for Dental Sleep Medicine. Sleep Med Clin 2018; 13:531-548. [DOI: 10.1016/j.jsmc.2018.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
45
|
Mitteilungen DGKFO. J Orofac Orthop 2018. [DOI: 10.1007/s00056-018-0152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
46
|
Giuliani A, Mazzoni S, Mangano C, Zecca PA, Caprioglio A, Vercellini N, Raspanti M, Mangano F, Piattelli A, Iezzi G, Fastuca R. Osteo-regeneration personalized for children by rapid maxillary expansion: an imaging study based on synchrotron radiation microtomography. BMC Oral Health 2018; 18:125. [PMID: 30045728 PMCID: PMC6060467 DOI: 10.1186/s12903-018-0590-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/12/2018] [Indexed: 11/11/2022] Open
Abstract
Background Personalized maxillary expansion procedure has been proposed to correct maxillary transversal deficiency; different protocols of stem cell activation have been suggested and rapid maxillary expansion (RME) is the most commonly used among clinicians. The present study aimed to quantify in three-dimensions (3D) the osteo-regeneration of the midpalatal suture in children submitted to RME. Methods Three patients (mean age 8.3 ± 0.9 years) were enrolled in the study to preform biopsy of midpalatal suture. Two patients (subjects 1 and 2) were subjected to RME before biopsy. The third patient did not need maxillary expansion treatment and was enrolled as control (subject 3). Midpalatal suture samples were harvested 7 days after RME in subject 1, and 30 days after RME in subject 2. The samples were harvested with the clinical aim to remove bone for the supernumerary tooth extraction. When possible, maxillary suture and bone margins were both included in the sample. All the biopsies were evaluated by complementary imaging techniques, namely Synchrotron Radiation-based X-ray microtomography (microCT) and comparative light and electron microscopy. Results In agreement with microscopy, it was detected by microCT a relevant amount of newly formed bone both 7 days and 30 days after RME, with bone growth and a progressive mineralization, even if still immature respect to the control, also 30 days after RME. Interestingly, the microCT showed that the new bone was strongly connected and cross-linked, without a preferential orientation perpendicular to the suture’s long axis (previously hypothesized by histology), but with well-organized and rather isotropic 3D trabeculae. Conclusions The microCT imaging revealed, for the first time to the authors’ knowledge, the 3D bone regeneration in children submitted to RME. Electronic supplementary material The online version of this article (10.1186/s12903-018-0590-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alessandra Giuliani
- Sezione di Biochimica, Biologia e Fisica Applicata, Department of Clinical Sciences, Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy.
| | - Serena Mazzoni
- Sezione di Biochimica, Biologia e Fisica Applicata, Department of Clinical Sciences, Università Politecnica delle Marche, Via Brecce Bianche 1, 60131, Ancona, Italy
| | | | - Piero Antonio Zecca
- Department of Medicine and Surgery, University of Insubria, Via Guicciardini 9, Varese, Italy
| | - Alberto Caprioglio
- Department of Medicine and Surgery, University of Insubria, Via Guicciardini 9, Varese, Italy
| | - Nicolò Vercellini
- Department of Medicine and Surgery, University of Insubria, Via Guicciardini 9, Varese, Italy
| | - Mario Raspanti
- Department of Medicine and Surgery, University of Insubria, Via Guicciardini 9, Varese, Italy
| | | | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti Scalo, CH, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti Scalo, CH, Italy
| | - Rosamaria Fastuca
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Messina, Italy
| |
Collapse
|
47
|
Machado AJ, Crespo AN, Pauna HF. Rapid maxillary expansion in pediatric patients with obstructive sleep apnea: current and future perspectives. Sleep Med 2018; 51:7-8. [PMID: 30077017 DOI: 10.1016/j.sleep.2018.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 06/14/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Almiro J Machado
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
| | - Agrício N Crespo
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Henrique F Pauna
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| |
Collapse
|
48
|
Abstract
No agreement exists on the most appropriate timing of orthodontic treatment in patients with cleft lip and palate. The aim of this study is to investigate the effect of early orthodontic treatment on development of the dental arches and alveolar bone.A dental casts analysis was performed on 28 children with cleft lip and palate before orthodontic treatment (T0; mean age, 6.5 ± 1.7) and at the end of active treatment (T1; mean age, 9.2 ± 2.1 years). The considered variables were: intercanine and intermolar distances; dental arch relationships, evaluated according to the modified Huddart/Bodenham system.The study group was divided into 2 samples according to the age at T0: Group A (age < 6 years) and Group B (age ≥ 6 years). A statistical comparison of the treatment effects between the 2 samples was performed.Patients in Group A exhibited a greater increase of intercanine distance (8 mm versus 2.7 mm; P<0.001), intermolar distance (7.2 mm versus 5 mm; P = 0.06), and Huddart/Bodenham score (7.1 versus 3; P < 0.05) when compared with patients in Group B.Early orthodontic treatment strongly improved the dental arch relationship, since subjects starting the therapy before the age of 6 had a better response in terms of anterior maxillary expansion.
Collapse
|
49
|
Costa JG, Galindo TM, Mattos CT, Cury-Saramago ADA. Retention period after treatment of posterior crossbite with maxillary expansion: a systematic review. Dental Press J Orthod 2018; 22:35-44. [PMID: 28658354 PMCID: PMC5484268 DOI: 10.1590/2177-6709.22.2.035-044.oar] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/12/2016] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE: The aim of this systematic review was to evaluate the duration of the retention period in growing patients undergoing maxillary expansion and its relation with posterior crossbite stability. METHODS: Search strategies were executed for electronic databases Cochrane Library, Web of Science, PubMed and Scopus, which were completed on January 15, 2016. The inclusion criteria included randomized, prospective or retrospective controlled trials in growing subjects with posterior crossbite; treated with maxillary expanders; retention phase after expansion; post-retention phase of at least 6 months. The exclusion criteria were anterior crossbite, craniofacial anomalies, surgery or another orthodontic intervention; case reports; author’s opinions articles, thesis, literature reviews and systematic reviews. The risk of bias of selected articles was assessed with Cochrane risk of bias tool for RCTs and Downs and Black checklist for non-RCTs. RESULTS: A total of 156 titles/abstracts was retrieved, 44 full-texts were examined, and 6 articles were selected and assessed for their methodological quality. The retention period after maxillary expansion ranged between 4 weeks and 16 months. Fixed (acrylic plate, Haas, Hyrax and quad-helix) or removable (Hawley and Hawley expander) appliances were used for retention. CONCLUSIONS: Six months of retention with either fixed or removable appliances seem to be enough to avoid relapse or to guarantee minimal changes in a short-term follow-up.
Collapse
Affiliation(s)
- Julia Garcia Costa
- Orthodontics department, Universidade Federal Fluminense, Niterói, Brazil
| | | | - Claudia Trindade Mattos
- Professor of Orthodontics, Dental Clinic department, Universidade Federal Fluminense, Niterói, Brazil
| | | |
Collapse
|
50
|
Brunetto DP, Sant'Anna EF, Machado AW, Moon W. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE). Dental Press J Orthod 2018; 22:110-125. [PMID: 28444019 PMCID: PMC5398849 DOI: 10.1590/2177-6709.22.1.110-125.sar] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/10/2016] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). OBJECTIVE The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA). METHODS All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained. CONCLUSION It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.
Collapse
Affiliation(s)
- Daniel Paludo Brunetto
- Department of Restorative Dentistry, Dental School, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Eduardo Franzzotti Sant'Anna
- Department of Pediatric Dentistry and Orthodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andre Wilson Machado
- Department of Orthodontics, Dental School, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Won Moon
- Dental School, University of California, Los Angeles, CA, USA
| |
Collapse
|