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Ronsivalle V, Isola G, Lo Re G, Boato M, Leonardi R, Lo Giudice A. Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis. Prog Orthod 2023; 24:41. [PMID: 38072875 PMCID: PMC10710971 DOI: 10.1186/s40510-023-00494-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Previous evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12-18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments. RESULTS At T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05). LIMITATIONS The small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials. CONCLUSIONS Subjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Gianmarco Lo Re
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Mattia Boato
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
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Ronsivalle V, Nucci L, Bua N, Palazzo G, La Rosa S. Elastodontic Appliances for the Interception of Malocclusion in Children: A Systematic Narrative Hybrid Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1821. [PMID: 38002912 PMCID: PMC10670240 DOI: 10.3390/children10111821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Interceptive orthodontic treatment aims to eliminate factors that prevent the harmonious development of the maxillary and mandibular arches during childhood, and elastodontic appliances (EAs) represent a group of devices with an increasingly important role. This systematic narrative hybrid review (HR) aims to provide an overview of the clinical indications for the use of EAs according to the available evidence and to identify potential research areas for unexplored applications. MATERIALS AND METHODS To assess the available literature on the subject, selective database searches were performed between July 2023 and September 2023. With the assistance of a health sciences librarian, a search strategy that utilized terms related to elastodontic therapy was developed. Embase, Scopus, PubMed, and Web of Science were the databases used. RESULTS The current literature addressing the usability of EAs is scarce and mostly limited to case reports and case series. After 2168 citations were found through the searches, 13 studies were ultimately included. In this regard, information about the clinical use and effectiveness of EAs are reported in a narrative form, defining specific domains of the application that are clinically oriented, including sagittal and transversal discrepancies, atypical swallowing, teeth malposition, two-phase orthodontics and a lack of teeth retention. CONCLUSIONS Within the intrinsic quality limitation of the available literature, it seems that EAs may represent a promising treatment alternative for managing mild-to-moderate malocclusion in children as an adjuvant therapy to the interruption of spoiled habits.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
| | - Ludovica Nucci
- Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80100 Naples, Italy
| | - Nicolò Bua
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
| | - Giuseppe Palazzo
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
| | - Salvatore La Rosa
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
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Shen Y, Jiang X, Yu J. The combined orthodontic and restorative treatment for patients with malocclusion and dentition defects: A randomized controlled trial. Medicine (Baltimore) 2023; 102:e35025. [PMID: 37657034 PMCID: PMC10476711 DOI: 10.1097/md.0000000000035025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/09/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND To explore the effects of a combined orthodontic and restorative approach on chewing, swallowing, and language function in patients with malocclusion and dental defects. METHODS A total of 112 patients with malocclusion and dentition defects admitted to the Lianyungang Hospital of Traditional Chinese Medicine from June 2019 to June 2022 were prospectively selected. The patients were divided into study and control groups using a simple random number table method, with 56 patients in each group. The control group received routine restoration, whereas the study group received a combination of orthodontic and restorative treatments. The chewing function, swallowing and language function, and gingival periodontal condition before and after treatment in both groups were compared using t-test or Wilcoxon test, while treatment satisfaction were compared using chi-square test or Fisher exact test. RESULTS After treatment, maximum area frame bite force/max movie force in both groups increased compared to before treatment, while occlusion time, bite force distrbution balance, and standard deviation hue decreased compared to before treatment. Moreover, maximum area frame bite force/max movie force in the study group was higher than that in the control group, whereas occlusion time, bite force distrbution balance, and standard deviation hue were lower than those in the control group (P < .05). The swallowing and language function scores of the study group were higher than those of the control group (P < .05). After treatment, the bleeding index, plaque index, and probing depth of both groups decreased compared to before treatment, and the study group was lower than the control group (P < .05). The treatment satisfaction of the study group (94.64%) was higher than that of the control group (82.14%) (P < .05). CONCLUSION Adopting a combined orthodontic and restorative approach to intervene in patients with malocclusion and dentition defects is beneficial for improving their periodontal condition, effectively restoring chewing, swallowing, and language functions, and achieving high patient satisfaction.
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Affiliation(s)
- Yan Shen
- Department of Stomatology, Lianyungang Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Xiongying Jiang
- Department of Stomatology, Xiaoshan District Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Jing Yu
- Department of Stomatology, Xiaoshan District Hospital of Traditional Chinese Medicine, Hangzhou, China
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Hansson S, Josefsson E, Lindsten R, Magnuson A, Bazargani F. Pain and discomfort during the first week of maxillary expansion using two different expanders: patient-reported outcomes in a randomized controlled trial. Eur J Orthod 2023; 45:271-280. [PMID: 36331513 PMCID: PMC10230245 DOI: 10.1093/ejo/cjac067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Quad Helix (QH) is the appliance most preferred by orthodontists to correct unilateral posterior crossbite in the early mixed dentition while other orthodontists suggest rapid maxillary expansion (RME) on deciduous teeth in these patients. OBJECTIVES To evaluate and compare perceived pain intensity, discomfort, functional jaw impairment, and analgesic consumption during the first week of treatment with either RME or QH appliances. TRIAL DESIGN Two-arm parallel group, two-centre, randomized controlled trial. MATERIAL AND METHODS Seventy-two patients, mean age 9.5 (SD ±0.8) years, with unilateral posterior crossbite requiring maxillary expansion were randomly allocated to either the RME (22 boys, 14 girls) or QH (22 boys, 14 girls) group. Validated questionnaires were used to assess pain intensity, discomfort, jaw function impairment, and analgesic consumption, on the first, fourth, and seventh days after appliance insertion and activation. BLINDING Due to clinical limitations, only the outcome assessors were blinded to the groups to which the patients were allocated. RESULTS Seventy patients completed the questionnaires. Pain from the tongue and chafe from the appliance were significantly higher in the QH group on the first day of treatment (P = 0.003 and P = 0.000, respectively). On the fourth day, the chafe from the appliance was still significantly higher in the QH group (P = 0.007). Speech was affected in both groups on day 1; this impairment continued and was significantly higher in the RME group days 4 and 7. No significant difference in analgesic consumption was found between the groups at any time. The analgesic consumption was highest at day 1 of treatment. HARMS No harm was observed in any patient. LIMITATIONS Double blinding was not possible due to the clinical limitations. CONCLUSION During the initial 4 days of treatment, pain from the tongue and chafe from the appliance caused the most reported inconvenience in the patients in the QH group. A majority of reported visual analogue scale values were in the lower mid-range, suggesting low to moderate pain and discomfort in both groups. CLINICAL TRIAL REGISTRATION NCT04458506.
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Affiliation(s)
- Stina Hansson
- Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Eva Josefsson
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Rune Lindsten
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anders Magnuson
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Farhan Bazargani
- Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
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Alkadhi OH, Alotaibi LH, Alrashoud RR, Almutairi MH, Al Matar HA, Mallineni SK. Effect of Maxillary Expansion on the Maxillary Arch Width in Patients with Bilateral Cleft Palate: A Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:762. [PMID: 37238310 PMCID: PMC10217325 DOI: 10.3390/children10050762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/01/2023] [Accepted: 04/15/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To perform a comprehensive review of the literature to compare the effects of slow maxillary expansion (SME) and rapid maxillary expansion (RME) on maxillary arch width in patients with bilateral cleft palate. METHODS The databases include Medline, PubMed, Cochrane (CENTRAL) and (CDSR), OpenGrey, and ClinicalTrials.gov were searched for relevant studies that met the eligibility criteria published before or on 31 October 2022. The search was confined to the English language. The selection of eligible studies and collection of data were performed independently. Risk of bias assessment was conducted using the Cochrane Risk of Bias tool 2.0. RESULTS Two randomized controlled trials were available based on the search in the published literature. Both studies compared arch width between SME and RME in cleft palate patients and digitals casts and three-dimensional images used for the evaluation. A moderate risk of bias was evident in the available studies. CONCLUSIONS Both SME and RME can achieve similar amounts of maxillary expansion in patients with bilateral cleft palate.
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Affiliation(s)
- Omar H Alkadhi
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University (REU), Riyadh 13244, Saudi Arabia
| | - Lamis Hejab Alotaibi
- Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Rowaida R Alrashoud
- College of Dentistry, Riyadh Elm University (REU), Riyadh 13244, Saudi Arabia
| | - Mohammed Hamad Almutairi
- General Dentist, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia
| | | | - Sreekanth Kumar Mallineni
- Pediatric Dentistry, Dr. Sulaiman Al Habib Hospital, Ar Rayyan, Riyadh 14212, Saudi Arabia
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry Graduate School of Dentistry, Tohoku University, Sendai 980-8575, Japan
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6
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Al-Gumaei WS, Long H, Al-Attab R, Elayah SA, Alhammadi MS, Almagrami I, Al-Rokhami RK, Lai W, Zheng Y. Comparison of three-dimensional maxillary growth across spheno-occipital synchondrosis maturation stages. BMC Oral Health 2023; 23:100. [PMID: 36788563 PMCID: PMC9930258 DOI: 10.1186/s12903-023-02774-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND This study aimed to three-dimensionally compare the maxillary growth among the spheno-occipital synchondrosis (SOS) maturation stages in both genders. METHODS This is a cross-sectional study of a retrospective type in which cone-beam computed tomography (CBCT) images of 500 patients aged 6 to 25 years (226 males and 274 females) were analyzed. The SOS was evaluated using the four-stage scoring system; completely open, partially fused, semi-fused, or completely fused. The SOS scoring and three-dimensional cephalometric measurements were analyzed by Invivo 6.0.3 software. Descriptive and analytical statistics were performed and a P-value < 0.05 was considered statistically significant. RESULTS There was a statistically significant difference in maxillary measurements among SOS maturation stages in both genders (P < 0.05). The mean differences in the maxillary growth among the SOS maturation stages between SOS stages 2 and 3 were higher than those between stages 1and 2 and stages 3 and 4 for maxillary length and height in both genders. However, the mean difference in the maxillary width was higher between SOS stages 1 and 2 than those stages 2 and 3 and stages 3 and 4. On other hand, there may be lesser maxillary growth between SOS stages 3 and 4 for maxillary width, length (in males), and height. The growth curves showed high active growth of the maxilla as the SOS was still fusing (especially stage 2 and 3) than those of the fused (stage 4). Moreover, the acceleration of growth occurred earlier in females than males regarding chronological age but not for SOS maturation stages. CONCLUSIONS The SOS maturation stages are valid and reliable maxillary skeletal maturation indicators for three-dimensional maxillary growth in both genders.
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Affiliation(s)
- Waseem S. Al-Gumaei
- grid.32566.340000 0000 8571 0482Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, Lanzhou, China ,grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Reem Al-Attab
- grid.32566.340000 0000 8571 0482Department of Dental Implant, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Sadam A. Elayah
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Maged S. Alhammadi
- grid.411831.e0000 0004 0398 1027Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Ibtehal Almagrami
- grid.207374.50000 0001 2189 3846Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, Henan, China
| | - Remsh K. Al-Rokhami
- grid.412449.e0000 0000 9678 1884Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Yan Zheng
- Department of Orthodontics and Dentofacial Orthopedics, School of Stomatology, Lanzhou University, Lanzhou, China.
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Lim YN, Baharin F, Lin GSS, Hassan R, Tsai MH, Wei LC, Yeoh S, Ping MKX. Evaluation of the Changes of the Intercanine and Intermolar Widths Following Palatal Expansion in the Mixed Dentition Patients with Bilateral Posterior Crossbite: A Systematic Review. Dent J (Basel) 2023; 11:dj11020052. [PMID: 36826197 PMCID: PMC9955097 DOI: 10.3390/dj11020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
This systematic review aimed to identify the intercanine and intermolar width changes following palatal expansion in bilateral posterior crossbite (PXB) in mixed dentition. This review was registered in the PROSPERO database (CRD42021275833). All randomized controlled trials (RCT) and non-RCT articles between 1980 and August 2022 on the palatal expansion of bilateral PXB in mixed dentition were searched in seven online databases (Google Scholar, Ovid, Web of Science, Scopus, EBSCOHost, Cochrane Library and PubMed). The risk of bias (RoB) of the articles included was analyzed using the Joanna Briggs Institute (JBI) critical appraisal tool. Three non-RCT studies were included and showed a low risk of bias. Meta-analysis on the changes in intercanine and intermolar widths was not performed due to study design heterogeneity. One study reported an over-correction of the bilateral PXB. There is a need for more RCT studies with standardized landmark measurements, outcome assessment methods and retention periods to investigate the interdental changes following palatal expansion.
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Affiliation(s)
- Yen Nie Lim
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| | - Fadzlinda Baharin
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
- Correspondence: ; Tel.: +60-9-767-5853
| | - Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong 08100, Malaysia
| | - Rozita Hassan
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| | - Milton Hongli Tsai
- Discipline of Orthodontics, Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia
| | - Lim Chia Wei
- Taman Intan Dental Clinic, Ministry of Health Malaysia, Sungai Petani 08000, Malaysia
| | - Suzanne Yeoh
- Tudan Dental Clinic, Tudan Health Clinic, Ministry of Health Malaysia, Miri 98000, Malaysia
| | - Mark Ko Xiang Ping
- RTC Sibuti Dental Clinic, Bangunan RTC Sibuti, Ministry of Health Malaysia, Bekenu 98150, Malaysia
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Lo Giudice A, Ronsivalle V, Conforte C, Marzo G, Lucchese A, Leonardi R, Isola G. Palatal changes after treatment of functional posterior cross-bite using elastodontic appliances: a 3D imaging study using deviation analysis and surface-to-surface matching technique. BMC Oral Health 2023; 23:68. [PMID: 36732751 PMCID: PMC9894513 DOI: 10.1186/s12903-023-02731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The present study aimed to evaluate the changes in palate dimension and morphology after treatment of functional posterior crossbite (FPXB) with elastodontic devices (EAs). METHODS The treatment group (TG) consisted of 25 subjects (mean age 7.3 ± 0.9 years) who received treatment with EA for one year. The control group (CG) comprised 14 untreated subjects (mean age 6.8 ± 0.7 years). INCLUSION CRITERIA intra-oral scan registered before (T0) and after treatment (T1), FPXB with a mandibular shift towards the crossbite site of ≥ 2 mm, class I molar relationship. EXCLUSION CRITERIA missing teeth, anterior crossbite, temporomandibular disorders, previous orthodontic treatment, carious lesions, mobility of deciduous posterior teeth, craniofacial deformities. Digital models were analyzed to assess the inter-canine (ICW) and inter-molar widths (IMW) and the corresponding emi-lateral measurements (eICW and eIMW) using the median palatine plane as reference. According to a specific 3D imaging technology, the morphology and symmetry of the palate was investigated by analysing the 3D deviation between the two specular models of the palate. RESULTS At T0, both groups showed a significantly narrower dimension of eICW and eIMW at the crossbite side compared to the non-crossbite side (p < 0.05). Also, the 3D deviation analysis demonstrates a limited matching percentage of the original/mirrored models in both TG (81.12%) and CG (79.36%), confirming the asymmetry of the palate. The area of mis-matching was located at the alveolar bone level. At T1, subjects in the TG showed a significant increment of ICW and IMW (p < 0.05), a reduction of the differences of eICW and eIMW between both sides (p < 0.05) and an increment of the percentage matching (TG = 92.32%) (p < 0.05), suggesting a significant recovery of the palatal asymmetry. No significant changes were found between T0 and T1 in the CG (p > 0.05). CONCLUSIONS EAs could be successfully used to correct FPXB in mixed dentition and could restore the harmonious development of the palate in children.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy. .,Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Vincenzo Ronsivalle
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Cristina Conforte
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Giuseppe Marzo
- grid.158820.60000 0004 1757 2611Department of Health, Life and Environmental Science, University of L’Aquila, Piazza Salvatore Tommasi, 67100 L’Aquila, Italy
| | - Alessandra Lucchese
- grid.15496.3f0000 0001 0439 0892Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosalia Leonardi
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Gaetano Isola
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
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Muacevic A, Adler JR. Effects of Rapid Maxillary Expansion on Upper Airway Volume in Growing Children: A Three-Dimensional Cone-Beam Computed Tomography Study. Cureus 2023; 15:e34274. [PMID: 36855483 PMCID: PMC9968479 DOI: 10.7759/cureus.34274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/25/2023] [Indexed: 01/28/2023] Open
Abstract
Background: Rapid maxillary expansion (RME) is a common orthodontic procedure that widens the maxillary arch to treat moderate to mild overcrowding and transverse skeletal and dental abnormalities. Orthodontic equipment applies lateral tension on posterior maxilla teeth or palate mucosa to the mid-palatal suture. The maxilla may grow transversely when force is applied at right angles to the mid-palatal suture, which is usually inactive in children and adolescents. This study used cone-beam computed tomography (CBCT) and an authorized upper respiratory airway volume measurement approach to compare RME cohort pharyngeal airway volume changes to healthy controls. Materials and Methods: This retrospective analysis included 52 RME patients and 52 healthy controls. The RME category's expansion regimen entailed twisting the screw of expansion on a tooth-attached Hyrax-type expansion equipment by 0.25 mm daily for at least 14 days. After six months, a few RME participants used fixed orthodontic gear. The comparison group used fixed orthodontic appliances for minor malocclusions without extractions (without RME). CBCT scans from 1021 orthodontic patients who visited a dental hospital between 2012 and 2022 were examined. The registry comprised only anonymized photographs. Volume, minimum cross-sectional area (MCA), molar width, and inter-molar width were measured before and after therapy. Results: The control group had 12227.12 mm3 at T0 and 15805.54 mm3 at T1. The control group's T0-T1 volume difference was statistically significant (p = 0.007). The RME group has 12884.84 mm3 at T0 and 17471.08 mm3 at T1. The RME group had a significant volume difference at T0 and T1 (p = 0.002). The volume RME effect was ±1011.92 and statistically insignificant. (p > 0.05). MCA in the control group was 126.04 mm2 at T0 and 170.61 mm2 at T1. MCA at T0 and T1 in the control group was statistically significant (p = 0.041). RME group MCA was 126.53 mm3 at T0 and 164.69 mm2 at T1. The RME group had a significant volume difference at T0 and T1 (p = 0.002). The MCA, RME effect was 5.92 and statistically insignificant (p > 0.05). Both the control and RME groups had statistically significant volume and MCA differences at T0 and T1. However, the intergroup analysis showed no significant differences across the groups. Conclusion: Tooth-borne RME does not affect upper airway or MCA volume in children compared to controls. Upper airway changes were better with younger skeletal ages before treatment. The findings may aid RME for young children.
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Affiliation(s)
- Alexander Muacevic
- Orthodontics Department of Preventive Dental Sciences, Albaha University College of Dentistry, Albaha, SAU
| | - John R Adler
- Orthodontics Department of Preventive Dental Sciences, Albaha University College of Dentistry, Albaha, SAU
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Hoque T, Srinivasan D, Chakravarthi S, Kannan R. Evaluation and comparison of stresses and displacements generated by four different types of asymmetric maxillary expansion appliances in true unilateral crossbite using finite element method. Int Orthod 2022; 20:100668. [DOI: 10.1016/j.ortho.2022.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/03/2022] [Accepted: 07/10/2022] [Indexed: 11/28/2022]
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Rabah N, Al-Ibrahim HM, Hajeer MY, Ajaj MA, Mahmoud G. Assessment of Patient-Centered Outcomes When Treating Maxillary Constriction Using a Slow Removable Versus a Rapid Fixed Expansion Appliance in the Adolescence Period: A Randomized Controlled Trial. Cureus 2022; 14:e22793. [PMID: 35261839 PMCID: PMC8893008 DOI: 10.7759/cureus.22793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 12/18/2022] Open
Abstract
Objective This study aimed to evaluate and compare the levels of pain, discomfort, and functional impairments between slow and rapid maxillary expansion (RME) in treating skeletal maxillary constriction in the adolescence period (i.e., between 12 and 16 years). Materials and methods The study sample consisted of 52 patients (21 males and 31 females) with maxillary skeletal constriction in the posterior region. The patients were randomly distributed into either RME (26 patients, with a mean age of 13.87 (± 1.31) years) or slow maxillary expansion group (SME, 26 patients, with a mean age of 14.31 (± 1.19) years). The levels of pain, discomfort, and functional difficulties were assessed after 24 hours (T1), 7 days (T2), 15 days (T3), one month (T4), and four months (T5) following the onset of the expansion procedure. Results Patients in the RME group encountered significantly greater levels of pain and discomfort than those in the SME group at T1, T2, and T3 (p>0.001). Chewing and swallowing difficulties were significantly greater in the RME group at T1, T2, T3, and T4 (P≤0.001). The pressure on soft tissue was greater in the RME group at T2 and T3 (p>0.001). After four months (T5), the levels of pain and discomfort decreased to their lowest levels, as well as the difficulties of chewing and swallowing, and the pressure on soft tissue were almost non-existent in both groups. Conclusion Patients treated with the removable slow maxillary expander reported lower levels of pain and discomfort, fewer chewing and swallowing difficulties, and less pressure on soft tissues than those treated with the bonded rapid maxillary expander. These difficulties gradually decreased over time in both groups. The lower levels of pain and discomfort may make the SME an effective and comfortable treatment alternative for adolescents with skeletal maxillary constriction.
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Affiliation(s)
- Nancy Rabah
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Heba M Al-Ibrahim
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Mowaffak A Ajaj
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Ghiath Mahmoud
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
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