1
|
Ugolini A, Abate A, Donelli M, Gaffuri F, Bruni A, Maspero C, Lanteri V. Spontaneous Mandibular Dentoalveolar Changes after Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:501. [PMID: 38671718 PMCID: PMC11049362 DOI: 10.3390/children11040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. METHODS The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. RESULTS A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. CONCLUSIONS SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.
Collapse
Affiliation(s)
- Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Margherita Donelli
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Valentina Lanteri
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
| |
Collapse
|
2
|
Bruni A, Abate A, Maspero C, Castroflorio T. Comparison of Mechanical Behavior of Clear Aligner and Rapid Palatal Expander on Transverse Plane: An In Vitro Study. Bioengineering (Basel) 2024; 11:103. [PMID: 38391589 PMCID: PMC10886082 DOI: 10.3390/bioengineering11020103] [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: 12/06/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: This study aims to investigate, within a controlled laboratory environment, the magnitude of the transversal load and the force decay over time produced by clear aligners in comparison to a Rapid Palatal Expander (RPE). (2) Methods: Resin models of a dental maxillary arch, additively manufactured from an intraoral scan, were inserted in a testing machine with uniaxial load cells to measure the force trend over time expressed by RPE and clear aligners. The mechanical load was recorded during a certain timeframe for both appliances. (3) Results: The force expressed by the RPE ranged from 30 to 50 N for each activation, decreasing with a nonlinear pattern over time. The force expressed by the clear aligner ranged from 3 to 5 N, decreasing with a linear pattern over time. In contrast, the force generated by the clear aligner fell within the range of 3 to 5 N, showing a linear reduction in force magnitude over the observed period of time. (4) Conclusions: The RPE exerted a force magnitude approximately ten times greater than that generated by clear aligners. Nevertheless, it is essential to acknowledge that the oral environment can significantly influence these results. These limitations underscore the need for caution when applying these findings to clinical settings.
Collapse
Affiliation(s)
- Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16126 Genova, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142 Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | |
Collapse
|
3
|
Gupta V, Rai P, Tripathi T, Kanase A. Stress distribution and displacement with four different types of MARPE on craniofacial complex: A three-dimensional finite element analysis. Int Orthod 2023; 21:100813. [PMID: 37776697 DOI: 10.1016/j.ortho.2023.100813] [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: 07/12/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Various designs of mini-implants assisted rapid palatal expander (MARPE) appliances can impact treatment effectiveness through their biomechanical effects. The purpose of the study was to study the stress distribution and displacement with four different designs of the MARPE appliance on the craniofacial complex. METHODS A 3D finite element model of the craniofacial complex was created from CBCT DICOM data, comprising four distinct groups. Each group consisted of one 4-hole expansion screw positioned between the second premolar and first molar in all models. Group 1 used four single-cortical mini-implants (1.5×8mm) engaging only the palatal cortex. Group 2 employed four mini-implants (1.5×11mm) engaging both the palatal and nasal cortices. Group 3 had monocortical implants on the palatal slopes, while Group 4 was similar to group 3 with implants in the acrylic wings. Comparisons between groups were made for anchorage (groups 1 and 2), mini-implant position (groups 1 and 3) and surface effect (groups 3 and 4). Von Mises stresses and displacements at various skeletal and dental points were evaluated using ANSYS software. RESULTS The highest stresses were observed in the maxillary, pterygoid and zygomatic bones, as well as in the mid- palatal suture in all four groups. Downward and forward rotation of the craniofacial complex was noted. Group 2 showed greater skeletal expansion than group 1. Among groups 1 and 3, group 3 showed a better stress distribution. Group 4 showed less dentoalveolar rotation than group 3. CONCLUSIONS The MARPE appliances had an impact on the craniofacial complex with stresses on the mid-palatal suture, maxillary bone, pterygoid bones and anterior teeth. Clockwise rotation of the maxilla, zygomatic bones and dentition was noted, while the pterygoid bones and pterygoid suture were displaced backwards. MARPE with bicortical anchorage produces better skeletal expansion. Placing implants on the palatal slopes with acrylic wings results in better skeletal expansion with less clockwise rotation of the dentition.
Collapse
Affiliation(s)
- Veenita Gupta
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, 110002 New Delhi, India
| | - Priyank Rai
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, 110002 New Delhi, India.
| | - Tulika Tripathi
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, 110002 New Delhi, India
| | - Anup Kanase
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, 110002 New Delhi, India
| |
Collapse
|
4
|
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
|
5
|
Tashayyodi N, Kajan ZD, Ostovarrad F, Khosravifard N. Relationship of the Fusion Stage of Spheno-Occipital Synchondrosis with Midpalatal and Zygomaticomaxillary Sutures on Cone-Beam Computed Tomography Scans of Patients Aged Between 7 and 21 Years. Turk J Orthod 2023; 36:186-193. [PMID: 37782008 PMCID: PMC10548058 DOI: 10.4274/turkjorthod.2022.2022.65] [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: 04/20/2022] [Accepted: 12/22/2022] [Indexed: 10/03/2023]
Abstract
Objective This study assessed the relationship of the fusion stage of spheno-occipital synchondrosis (SOS) with midpalatal (MPS) and zygomaticomaxillary (ZMS) sutures on cone-beam computed tomography (CBCT) scans of 7 to 21-year-old patients. Methods This cross-sectional study evaluated the CBCT scans of 176 patients between 7 and 21 years presenting to a maxillofacial radiology clinic. The fusion stage of SOS was determined using a five-stage classification system. The percentage of opening depth of MPS was measured on two middle coronal cuts in the anterior and posterior half of the palate. To assess ZMS, suture fusion was evaluated in four age groups in the axial cut visualizing its maximum length. Data were analyzed using the Kruskal-Wallis, Mann- Whitney U, and Bonferroni tests and regression models. Results The percentage of MPS opening significantly decreased in both the anterior and posterior halves with age (p<0.002). With an increase in SOS grade, the percentage of MPS opening in both the anterior and posterior halves significantly decreased (p<0.001). By an increase in the ZMS stage, the SOS grade significantly increased (r=0.565, p<0.001). Conclusion The MPS opening percentage in the anterior and posterior halves decreased with age, with a greater reduction in the posterior half. A significant inverse correlation exists between the SOS fusion stage and the percentage of MPS opening. In SOS grades I-III, the mean percentage of MPS opening was 100% in all age groups (with the highest frequency of ZMS stage I), indicating a higher chance of success for orthodontic treatments such as rapid maxillary expansion in these individuals.
Collapse
Affiliation(s)
- Niloufar Tashayyodi
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Dalili Kajan
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Farzane Ostovarrad
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
6
|
Serafin M, Fastuca R, Zecca PA, Lagravère M, Caprioglio A. 3D occlusal changes of upper first molars after rapid maxillary expansion on permanent versus deciduous teeth: a retrospective multicenter CBCT study. Prog Orthod 2023; 24:24. [PMID: 37518579 PMCID: PMC10387462 DOI: 10.1186/s40510-023-00476-1] [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: 06/27/2022] [Accepted: 05/19/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the three-dimensional dental changes for the maxillary first molars and the overall skeletal effects achieved after expansion between the rapid maxillary expansion (RME) appliance attached to two different anchor units, the maxillary deciduous molars and the maxillary permanent first molars. METHODS Patients were retrospectively selected according to the anchorage unit used for RME: deciduous upper second molars (RME-E group; 10 M, 10 F; mean age 8.4 ± 1.1 years) and first upper permanent molars (RME-6 group; 10 M, 10 F; mean age 12.6 ± 1.8 years). CBCT scans were obtained before treatment start (T1) and after retention and removal of the expander (T2). Images were analyzed using a new three-dimensional intra-hemi-maxillary reference system. 3D landmarks were marked to calculate all changes on maxillary first permanent molars; mesio-distal and buccal-lingual inclination and rotation, as well as intermolar and interforaminal distances were calculated. The Wilcoxon test was used to compare within-group changes, whereas the Mann-Whitney test was used to compare between-group differences, with the significance level set at 0.05. RESULTS In the RME-E group, significant distorotation and lingual inclination of the first permanent molars at T2 were observed (p < 0.01); in the RME-6 group, only the buccolingual inclination of the crossbite side after RME was resulted statistically significant (p < 0.01). In both groups, intermolar and interforaminal values increased significantly (p < 0.01). Intergroup analysis showed a significantly higher distorotation and reduced buccal inclination of maxillary first permanent molars in the RME-E group after RME (p < 0.01). CONCLUSIONS RME is effective in treating maxillary transverse hypoplasia; RME anchored too deciduous teeth spontaneously reduces buccal inclination and increases distorotation of maxillary first permanent molars, whereas anchorage to permanent molars is associated with increased buccal inclination, albeit with little clinical significance.
Collapse
Affiliation(s)
- Marco Serafin
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | - Piero Antonio Zecca
- Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy
| | - Manuel Lagravère
- Orthodontics Department, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Alberto Caprioglio
- Department of Biomedical, Surgical and Dental Sciences, Section of Orthodontics, University of Milan, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
7
|
Kinzinger GSM, Lisson JA, Buschhoff C, Hourfar J. Age-dependent effects on palate volume and morphology during orthodontic RME treatment. Clin Oral Investig 2023; 27:2641-2652. [PMID: 36602590 PMCID: PMC10264469 DOI: 10.1007/s00784-022-04831-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/18/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Rapid maxillary expansion (RME) shows different age-dependent effects. It has been shown that RME leads to a parallel expansion prior to the age of 10, while later and especially from the age of 12, a V-shaped expansion happens (transverse, anterior > posterior; horizontal, inferior > superior). However, it is not clear to what extent these effects influence palatal volume and morphology and eventually maxillary functional space. The aim of the present study was to examine possible age-related effects of treatment with a dental anchored RME appliance upon volume and width/height ratio of the anterior and posterior palate. MATERIALS AND METHODS Sixty children and adolescents with documented treatment histories after RME were divided into three equal groups according to age at treatment begin (PG 1, < 10 years, n=20; PG 2, 10 ≤ 12 years, n=20; PG 3, > 12 years, n=20). Maxillary dental casts before and after therapy were digitised. Changes in palatal volume were determined using 3D analyses. RESULTS In all patients, the palatal volume increases significantly after RME. Older patients experienced smaller increases in total and posterior volume in absolute and percentage terms. The anterior palate volume increases are almost equal in all patients. Since palatal width increases more markedly than palatal height, the width/height ratio always increases. Except for the posterior region in PG 3, its increase is significant in all groups, both anteriorly and posteriorly. After successful RME, the palatal morphology appears normal anteriorly in PG 1, PG 2 and PG 3 and rather steep posteriorly in PG 3. CONCLUSIONS RME treatment with identical force application causes different, age-dependent effects upon palate volume and morphology. Width changes have a greater influence on palate volume than height changes. CLINICAL RELEVANCE It is preferable to use an RME prior to the age of 10 if homogeneous changes of the anterior and posterior palate regarding maxillary symmetry and functional space are desired.
Collapse
Affiliation(s)
| | | | | | - Jan Hourfar
- Department of Orthodontics, Saarland University, Homburg, Saar, Germany
| |
Collapse
|
8
|
Laganà G, Paoloni V, Pavoni C, Palmacci D, Malara A. Tridimensional Changes in Mandibular Arch after Rapid Maxillary Expansion Therapy: A Clinical Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050775. [PMID: 37238323 DOI: 10.3390/children10050775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/08/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023]
Abstract
Aim: The upper jaw transverse deficit is certainly one of the most common clinical issues in the orthodontic field. It can be due to skeletal or dental factors, and its etiology may be both genetic and environmental. Rapid maxillary expanders (RMEs) are certainly the most effective appliance for upper transverse deficiency correction. The aim of this study was to evaluate the changes that occurred in the mandibular arch during treatment with RMEs in growing subjects by analyzing tridimensional lower digital casts. Materials and Methods: The study group (SG) consisted of 20 subjects (10 M, 10 F; mean age 9.4 ± 2.8 years old) randomly selected at the Department of Orthodontics at the University of Rome, "Tor Vergata". The inclusion criteria were negative posterior transverse interarch discrepancy ≥ 4 mm, mixed dentition phase with first permanent molars erupted, and prepubertal skeletal maturation stage (CS1-2), evaluated on a lateral radiograph through the Cervical Vertebral Maturation method. The SG was compared to an untreated control group (CG) of 20 subjects (10 M, 10 F, mean age 8.7 ± 2.3 years old) enrolled with the same inclusion criteria. The SG was treated by using RMEs. Dental casts of the lower arch were taken at two different times (T0-T1 = 6 months). All the dental casts were scanned with an OrthoXscan (Dentaurum 6mmbh E Co., Ispringen, Germany) and twenty points on the mandibular arch were digitized using Viewbox software. A Student t-test was used to compare the means of the quantitative variables associated with the effect of the device over time T0 and T1. Results: The results show a statistically significant increase (p < 0.05) in the intercanine and the intermolar diameters between the times T0 and T1 when compared to the CG. Conclusions: Rapid maxillary orthopedic expansion may achieve an increase in mandibular intercanine and intermolar diameter.
Collapse
Affiliation(s)
- Giuseppina Laganà
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Via S. Alessandro, 8, 00131 Rome, Italy
| | - Valeria Paoloni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy
| | - Chiara Pavoni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Via S. Alessandro, 8, 00131 Rome, Italy
| | - Daniel Palmacci
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy
| | - Arianna Malara
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford 81, 00133 Rome, Italy
| |
Collapse
|
9
|
Kobayashi S, Makino Y, Torimitsu S, Yamaguchi R, Chiba F, Tsuneya S, Iwase H. Age estimation by evaluating median palatine suture closure using postmortem CT. Int J Legal Med 2023:10.1007/s00414-023-02994-3. [PMID: 37074412 DOI: 10.1007/s00414-023-02994-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/14/2023] [Indexed: 04/20/2023]
Abstract
This study sought to develop an age-estimation formula to evaluate the extent of median palatine suture (MP) closure using postmortem computed tomographic (PMCT) images. The PMCT images of 634 Japanese subjects (mean age, 54.5 years; standard deviation [SD], 23.2 years) with known age and sex were examined. The degree of suture closure of the MP, anterior median palatine suture (AMP), and posterior median palatine suture (PMP) was measured and scored (suture closure score, SCS), and a single linear regression analysis was conducted with age at death. On the analysis, SCS of MP, AMP, and PMP showed a significant correlation with age (p < 0.001). The correlation coefficient of MP was higher (0.760, male; 0.803, female; and 0.779, total) than that of AMP (0.726, male; 0.745, female; and 0.735, total) or PMP (0.457, male; 0.630, female; and 0.549, total). The regression formula and standard error of estimation (SEE) of MP were calculated as Age = 100.95 × SCS + 20.51 (SEE 14.87 years) for male subjects, Age = 91.93 × SCS + 26.65 (SEE 14.12 years) for female subjects, and Age = 95.17 × SCS + 24.09 (SEE 14.59 years) for the total, respectively. In addition, another 50 Japanese subjects were randomly selected to validate the age-estimation formula. In this validation, the actual age of 36 subjects (72%) was within the estimated age ± SEE. This study showed that the age estimation formula using PMCT images of MPs was potentially useful for estimating the age of unidentified corpses.
Collapse
Affiliation(s)
- Susumu Kobayashi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Suguru Torimitsu
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Fumiko Chiba
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Shigeki Tsuneya
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
| |
Collapse
|
10
|
Georgiadis T, Angelopoulos C, Papadopoulos MA, Kolokitha OE. Three-Dimensional Cone-Beam Computed Tomography Evaluation of Changes in Naso-Maxillary Complex Associated with Rapid Palatal Expansion. Diagnostics (Basel) 2023; 13:diagnostics13071322. [PMID: 37046539 PMCID: PMC10093383 DOI: 10.3390/diagnostics13071322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
The introduction of Cone-Beam Computed Tomography (CBCT) in orthodontics has added a new tool to diagnosis and treatment planning. The aim of this prospective clinical trial was to investigate the changes in the dimensions of the naso-maxillary complex in growing patients after RPE using CBCT. A total of 16 growing children (8 females, 6 males) with a mean age of 11, 12 ± 1 and 86 years underwent RPE as part of their comprehensive orthodontic treatment. CBCT scans were obtained before RPE (T1), immediately after RPE (T2) and 6 months after RPE (T3). The dimensions of the nasal width, nasal floor and the aperture of the midpalatal suture were calculated in different coronal slices of CBCT. Evaluation of the mean value variance per measurement at the three time intervals were performed using the paired Wilcoxon signed-rank test. Differences between the three time intervals were assessed by performing Multiple Pairwise Comparisons. A statistically significant increase in all measurements was seen immediately after RPE expansion (T2–T1) and six months after expansion (T3–T1). Between the end of expansion and 6 months in retention (T3–T2), a decrease was observed for all measurements. RPE can cause expansion of the nasal cavity in growing patients. The expansion of the midpalatal suture follows a triangular pattern of opening.
Collapse
Affiliation(s)
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Moschos A. Papadopoulos
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Olga-Elpis Kolokitha
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| |
Collapse
|
11
|
Awni KM, Dewachi Z, Al-Hyani OH. Effect of Injectable platelet-rich fibrin (i-PRF) on new bone formation in surgical expansion with mini-screw assisted rapid palatal expander: A dog model study. J Orthod Sci 2023; 12:12. [PMID: 37351391 PMCID: PMC10282521 DOI: 10.4103/jos.jos_56_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES The objective of the study is to test whether the local injection of i-PRF may affect osteoblast, blood vessels and new bone formation in surgically expanded mid palatal suture using maxillary skeletal expander. MATERIALS AND METHODS Eighteen adult male local breed dogs were divided randomly into three groups: group I (control), includes the expansion with maxillary skeletal expander that was done without corticotomy and i-PRF. Group II, involves the expansion that was done with mid palatal corticotomy but without i-PRF injection. Group III, has the expansion that was done with mid palatal corticotomy and has injection with 2 ml of i-PRF. Each group consisted of 6 dogs which were subdivided into 3 dogs. Three dogs were sacrificed after 15 days and the other 3 dogs were sacrificed after 45 days. The number of osteoblast, blood vessels and new bone formation percentage were statistically analyzed using Sigma plot platform. Mean and standard error, ANOVA and Duncan were performed among the different groups. Values of P ≤ 0.05 were considered significant. RESULTS After expansion, the i-PRF group demonstrated a considerable increase in the amount of new bone in the mid-palatal suture at 15 and 45 days compared with other 2 groups which were indicated by highest percentages of new bone formation (29.30% of 15 days and 76.55% at 45 days) if compared to control group which were (7.72% at 15 days and 22.30% at 45 days). The corticotomy groups were in between, 15.33% and 46.84% respectively. Moreover the number of osteoblasts was higher in corticotomy with i-PRF group on 15 days and decreased on 45 days than the other two groups, while the blood vessels were highest in this group than the other two groups both on 15 and 45 days. CONCLUSION I-PRF enhanced the production of osteoblast, blood vessels, and new bone in the surgically expanded mid palatal suture.
Collapse
Affiliation(s)
- Khawla M. Awni
- Department of Orthodontics, College of Dentistry, College of Veterinary Medicine, University of Mosul, Iraq
| | - Zaid Dewachi
- Department of Orthodontics, College of Dentistry, College of Veterinary Medicine, University of Mosul, Iraq
| | - Osama Hazim Al-Hyani
- Department of Surgery and Obstetrics, College of Veterinary Medicine, University of Mosul, Iraq
| |
Collapse
|
12
|
Akyalcin S, Alev Y. Clinical advances in maxillary skeletal expansion and introduction of a new MARPE concept. J ESTHET RESTOR DENT 2023; 35:291-298. [PMID: 36478642 DOI: 10.1111/jerd.12994] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Transverse maxillary deficiency, typically characterized by the clinical manifestations of unilateral or bilateral crossbite, is a common orthodontic discrepancy. The primary goal of maxillary expansion should be to obtain a nearly maximum width increase in the basal bone of the constricted maxilla and to avoid the dental expansion of the anchor teeth. The introduction of miniscrew anchorage-supported rapid maxillary expansion (MARPE) devices has helped increase the feasibility of obtaining nonsurgical transverse correction in late adolescents and young adults with optimum orthopedic effects. However, the success rate of MARPE shows a negative correlation with age. Although MARPE offers an effective method for correcting a transverse skeletal deficiency, given the appliance cost and increased risk for complications, it could present challenges for adult patients and practitioners in daily practice. AIMS In this article, current advances in maxillary skeletal expansion are summarized, and a new MARPE concept is introduced. CONCLUSION The new MARPE design offers several advantages to other existing methods: (1) it can be installed directly to the patient in the clinical setting with no additional laboratory waiting times. (2) It is purely a bone-borne appliance. (3) The appliance is designed to be placed in the thickest part of the anterior palate to maximize the cortical and trabecular bone support. (4) Allows for bicortical placement of the miniscrews with no perforations in the nasal floor. Finally, (5) offers an esthetic and minimalistic approach to maxillary skeletal expansion in late adolescent and adult patients.
Collapse
Affiliation(s)
- Sercan Akyalcin
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | |
Collapse
|
13
|
Ronsivalle V, Carli E, Lo Giudice A, Lagravère M, Leonardi R, Venezia P. Nasal Septum Changes in Adolescents Treated with Tooth-Borne and Bone-Borne Rapid Maxillary Expansion: A CBCT Retrospective Study Using Skeletal Tortuosity Ratio and Deviation Analysis. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121853. [PMID: 36553296 PMCID: PMC9776818 DOI: 10.3390/children9121853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 11/30/2022]
Abstract
Background: Using three-dimensional (3D) images, this study evaluated the impact of Rapid Maxillary Expansion (RME) on changes in Nasal Septal Deviation (NSD). Methods: Cone-beam computed tomography (CBCT) scan of 40 children with transverse maxillary deficiency, who received tooth-borne (TB) RME or bone-borne (BB) RME, were included in this investigation. Two CBCT scans were performed: one before to appliance installation (T0) and one after a 6-month retention period (T1). The analysis was performed by dividing the actual length of the septum by the desired length in the mid-sagittal plane to measure NSD based on the tortuosity ratio (TR). Results: Subjects in the TB group showed a statistically significant reduction (p < 0.05) of the TR value from T0 to T1, according to the paired Student t test. Subjects in the BB group showed similar findings, with a statistically significant reduction (p < 0.05) of the TR value from T0. No statistically significant differences were found between the mean changes of TR between TB group and BB group. Conclusions: RME may have some effects in reducing the degree of NSD; however, no differences were found between RME performed with TB and BB anchorage systems.
Collapse
Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, Section of Orthodontics, University of Catania, Via S. Sofia 78, 95124 Catania, Italy
| | - Elisabetta Carli
- Department of Surgical Pathology, Molecular Medicine and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, Section of Orthodontics, University of Catania, Via S. Sofia 78, 95124 Catania, Italy
- Correspondence:
| | - Manuel Lagravère
- Division of Orthodontics, Faculty of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, Section of Orthodontics, University of Catania, Via S. Sofia 78, 95124 Catania, Italy
| | - Pietro Venezia
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, Section of Orthodontics, University of Catania, Via S. Sofia 78, 95124 Catania, Italy
| |
Collapse
|
14
|
Age-dependent interactions of maxillary sutures during RME and their effects on palatal morphology : CBCT and dental cast analysis. J Orofac Orthop 2022; 83:412-431. [PMID: 36205766 DOI: 10.1007/s00056-022-00429-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 10/10/2022]
Abstract
PURPOSE The effects of rapid maxillary expansion (RME) on the transverse palatine and midfacial sutures have been extensively scrutinized. Unlike the dentition stage, age-dependency was not yet regarded when investigating morphological changes of the tooth-bearing palate. Therefore, the first aim of the present study was to analyse age-dependent sutural and morphological changes of the palate in selected patients by cone-beam computed tomography (CBCT) and dental cast analysis. Secondly, age-dependent effects of RME on width, height, and depth of the palate in the region of the maxillary palatine processes were investigated by a comprehensive dental cast study, so that the combination of results could be used to provide a biomechanical explanation of the occurring changes. METHODS CBCT datasets of 9 patients (between 7.3 and 13.8 years) were measured around the median palatal suture and compared with the results of an individualised dental cast analysis. In addition, possible effects on other maxillary sutures were investigated. In the dental cast study, changes after RME in the tooth-bearing palate were analysed three-dimensionally in 60 children and adolescents. It was possible to divide those into three equally sized, age-dependant groups (PG1: < 10 years, n = 20; PG2: ≥ 10 < 12 years, n = 20; PG3: ≥ 12 years, n = 20). RESULTS The CBCT analysis reveals age-related differences in sutural responses. The opening width of the median palatine suture decreases cranially (frontal) and dorsally (horizontal). The opening mode thus changes from parallel to triangular in both planes. The transverse palatine suture completely opens in younger patients only (PG1 and PG2). The width increases are always significant in all patients. While in PG1 the width increase is greater posteriorly than anteriorly, this is always reversed in PG2 and PG3. The palatal height always increases significantly anteriorly, but posteriorly only in the youngest patients (PG 1) median and paramedian. In PG 2 and PG 3, the posterior height change is very small. That is the reason why the anteroposterior comparison reveals a much more pronounced height increase anteriorly than posteriorly. CONCLUSION The comparison of selected CBCT data with a dental cast analysis allows the conclusion that the maxillary expansion after RME in children up to 10 years is rather parallel, whereas it occurs V‑shaped (anterior > posterior transversal, inferior > superior vertical) with increasing age, especially in adolescents from the age of 12. In addition to an age-progressive rigidity of the pterygopalatomaxillary junction, morphological changes of the transverse palatine suture during growth seem to be causal. Thus, age-dependent effects of palatal expansion occur due to a positional change of maxillary centres of rotation and resistance. From dental cast measurements, especially at the skeletal-basal level, conclusions can be drawn about the median palatal suture opening mode.
Collapse
|
15
|
Long-term skeletal and dentoalveolar effects of hybrid rapid maxillary expansion and facemask treatment in growing skeletal Class III patients: a retrospective follow-up study. Prog Orthod 2022; 23:44. [PMID: 36178519 DOI: 10.1186/s40510-022-00429-0] [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: 03/08/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regardless of the treatment protocol, stability in Class III patients always represents a major concern. The aim of this study was to assess the short and long-term skeletal and dentoalveolar modifications in a group of class III patients treated with hybrid rapid maxillary expander (RME) and facemask (FM). Indeed, no long-term studies have been conducted yet with the objective of evaluating the effects of this kind of approach when applied to patients who have already gone thought their peak of growth. MATERIAL AND METHODS 27 patients with skeletal Class III malocclusion were treated using hybrid RME according to alternating rapid maxillary expansion and constriction (ALT-RAMEC) protocol, followed by 4 months of facemask therapy. After the orthopaedic phase, each patient underwent orthodontic treatment with fixed multibracket appliances. A mean follow-up of 7 years, 10 months was performed. Pre-treatment (TO), post-treatment (T1) and follow up (T2) cephalometric tracing were analysed, comparing dental and skeletal measurements. RESULTS Point A advanced by a mean of 3.5 mm with respect to VerT, then relapsed by 0.7 in the post-facemask period, thereby yielding of a mean advancement of 2.7 at T2. The sagittal relationship significantly changed after RME + facemask protraction (3.8° of ANB and 5.189 mm of Wits). Although both Wits and ANB values worsened over time, the improvement from T0 is still appreciable at T2. CONCLUSION Despite the physiological relapse due to mandibular growth, the long-term cephalometric follow-up confirms the maintenance of all positive outcomes of the previous orthopaedic treatment with hybrid RME and facemask.
Collapse
|
16
|
Balasubramanian S, Kalaskar R, Kalaskar A. Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing. Int J Clin Pediatr Dent 2022; 15:617-630. [PMID: 36865716 PMCID: PMC9973120 DOI: 10.5005/jp-journals-10005-2421] [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] [Indexed: 02/05/2023] Open
Abstract
Objective Rapid maxillary expansion (RME) has been extensively used in orthodontic practice for over a century, and it is claimed to benefit upper airway morphology. However, its effect in actually alleviating mouth breathing has remained unexplored. This systematic review was planned with an objective to provide a comprehensive synthesis of the effects of RME on upper airway volume and most importantly, its role in alleviating mouth breathing. Methods A literature search of electronic databases were done for the time period of 2000-2018. Randomized controlled trials (RCTs) and non-RCTs conducted on 8-15-year-old children who received bonded or banded RME and upper airway measured using three-dimensional (3D) imaging were included. Results Twelve studies (two RCTs, nine nonrandomized clinical trials, and one non-RCT) were included in this systematic review, and nine studies were included for meta-analysis. Among the evaluated parameters, nasal cavity volume showed a significant increase which was maintained even after the retention phase, whereas nasopharyngeal and oropharyngeal volume did not report a significant change. Conclusion Based on this systematic review, it can be concluded that RME causes a significant increase in nasal cavity volume, but its effect on nasopharyngeal and oropharyngeal volume is not statistically significant in majority of studies. This increase in volume may not be considered as an equivalent for enhancement of airway and function unless proven so. In order to establish its significance in the improvement of breathing, it is necessary to conduct more well-designed RCTs with samples actually comprising mouth breathers. How to cite this article Balasubramanian S, Kalaskar R, Kalaskar A. Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing. Int J Clin Pediatr Dent 2022;15(5):617-630.
Collapse
Affiliation(s)
- Shruti Balasubramanian
- Department of Pediatric & Preventive Dentistry, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Ritesh Kalaskar
- Department of Pediatric & Preventive Dentistry, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Ashita Kalaskar
- Department of Oral Medicine and Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| |
Collapse
|
17
|
Tavares A, Braga E, Neves FS. Influence of the palatal plane cant and skeletal patterns in the hard palate thickness? Orthod Craniofac Res 2022; 26:224-230. [PMID: 36047667 DOI: 10.1111/ocr.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/27/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of the present study was to evaluate the thickness of the hard palate at the different angles formed by the palatal plane and the Frankfort horizontal line using computed tomography in patients with different facial patterns for planning the installation of MARPE. MATERIALS AND METHODS The measurements were analysed in the hard palate of 106 patients. Four regions were selected passing through the mesial face, tangent at the level of the cemento-enamel junction of the premolars and molars. The bone thickness was measured from the floor of the nasal cavity to the cortical bone of the hard palate, 02 measurements with a distance of 05 mm between them (2.5 mm on each side starting from the midsagittal line) and 2 more with a distance of 7 mm between measurements (3.5 mm on each side starting from the midsagittal line). The palatal plane cant was determined based on the palatal plane and the Frankfort horizontal plane. The sagittal skeletal pattern was determined based on the ANB angle and the vertical skeletal pattern based on the SN.Go.Gn angle. RESULTS Palatal bone thickness was greater in males than in females. Regarding the sagittal skeletal pattern, patients with Class II were found to have a thinner hard palate than Class I and Class III patients. No difference in the vertical skeletal pattern was observed between groups. Regarding the palatal plane cant, bone thickness was greater in patients with clockwise rotation. CONCLUSIONS Careful planning should be considered in the case of female patients; patients with greater angles of the palatal plane cant and Class II patients have a smaller bone thickness.
Collapse
Affiliation(s)
- Alana Tavares
- Program in Dentistry and Health School of Dentistry, Federal University of Bahia, Ufba Salvador Brazil
- Avenida Alphaville, 635, apt 1103, Alphaville Salvador 1 Salvador /Bahia Brazil
| | - Emanuel Braga
- Department of Orthodontics School of Dentistry, Federal University of Bahia, Ufba Salvador Brazil
| | - Frederico Sampaio Neves
- Division of Dentomaxillofacial Radiology School of Dentistry, Federal University of Bahia, Ufba Salvador Brazil
| |
Collapse
|
18
|
Inchingolo AD, Ferrara I, Viapiano F, Netti A, Campanelli M, Buongiorno S, Latini G, Carpentiere V, Ciocia AM, Ceci S, Patano A, Piras F, Cardarelli F, Nemore D, Malcangi G, Di Noia A, Mancini A, Inchingolo AM, Marinelli G, Rapone B, Bordea IR, Scarano A, Lorusso F, Di Venere D, Inchingolo F, Dipalma G. Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report. CHILDREN 2022; 9:children9071046. [PMID: 35884030 PMCID: PMC9317392 DOI: 10.3390/children9071046] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Aim: In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. Methods: A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. Results: A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. Conclusions: From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.
Collapse
Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Filippo Cardarelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angela Di Noia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| |
Collapse
|
19
|
Hollander Z, Fraser A, Paredes N, Bui J, Chen Y, Moon W. Nonsurgical maxillary orthopedic protraction treatment for an adult patient with hyperdivergent facial morphology, Class III malocclusion, and bilateral crossbite. Am J Orthod Dentofacial Orthop 2022; 162:264-278. [DOI: 10.1016/j.ajodo.2021.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/02/2021] [Accepted: 02/11/2021] [Indexed: 11/01/2022]
|
20
|
Kinzinger GSM, Lisson JA, Buschhoff C, Hourfar J, Korbmacher-Steiner H. Impact of rapid maxillary expansion on palatal morphology at different dentition stages. Clin Oral Investig 2022; 26:4715-4725. [PMID: 35267098 PMCID: PMC9276570 DOI: 10.1007/s00784-022-04434-9] [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] [Received: 11/30/2021] [Accepted: 02/22/2022] [Indexed: 12/01/2022]
Abstract
Objective Rapid maxillary expansion (RME) is an established and frequently used procedure to overcome maxillary constriction. In-depth studies about morphological changes of the alveolar process and its immediate surroundings are missing. Therefore, the aim of the present study was to examine the treatment effects of a dentally anchored, rapid maxillary expander at different dentition stages upon palatal width, height and shape. Material and methods The dental casts of 114 patients—taken immediately before and after RME—were three-dimensionally analysed. Depending on the dentition stage, the patients were divided into two groups (each n = 57, group 1, early mixed dentition; group 2, late mixed or permanent dentition). Results The width increases were highly significant, both in the overall and in the individual groups (p < 0.001). While the width increase was greater in the posterior area than anteriorly in the early group, the widening in the late group happened significantly greater anteriorly than posteriorly. Palatal height increased anteriorly and posteriorly in both groups to a significant extent (p < 0.001). The height increase was more pronounced in the anterior region than in the posterior region in the late group. The palatine index according to Kim revealed a change in palatal morphology both anteriorly and posteriorly in the early group but only anteriorly in the late group. Conclusions Maxillary expansion occurs more parallel in early treatment compared to V-shaped opening in the later treatment approach. Clinical relevance RME is more advantageous in an early dentition.
Collapse
Affiliation(s)
| | | | | | - Jan Hourfar
- Department of Orthodontics, Saarland University, Homburg, Saar, Germany
| | - Heike Korbmacher-Steiner
- Department of Orthodontics, Philipps-University Medical Center Marburg, Philipps-University, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
| |
Collapse
|
21
|
Effectiveness of miniscrew-assisted rapid maxillary expansion: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:4509-4523. [PMID: 35211817 DOI: 10.1007/s00784-022-04415-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To compare the effectiveness and side effects of miniscrew-assisted rapid maxillary expansion (MARME) with conventional rapid maxillary expansion (RME) in the treatment of transverse maxillary deficiency. MATERIALS AND METHODS We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched in the MEDLINE, Embase, and Cochrane Central databases. The quality of included RCTs was evaluated using the Cochrane risk-of-bias tool. The primary outcome was the extent of dentoskeletal expansion achieved. Secondary outcomes were the dental and periodontal side effects. We calculated summary weighted mean differences (MD) with 95% confidence intervals (CI) using random-effects meta-analysis. RESULTS Six RCTs involving 287 participants met the inclusion criteria. Compared to conventional RME, MARME was associated with a greater palatal suture opening (mm) measured at the anterior nasal spine (MD = 1.21, 95% CI 0.75 to 1.66), first premolars (MD = 1.13, 95% CI 0.72 to 1.55), first molars (MD = 1.18, 95% CI 0.28 to 2.09), and posterior nasal spine (MD = 1.14, 95% CI 0.30 to 1.98), increased palatal width (mm) at the first molars (MD = 0.75, 95% CI 0.30 to 1.20), and reduced buccal inclination (degrees) of the first premolars (MD = - 6.06, 95% CI - 10.36 to - 1.76) and first molars (MD = - 3.17, 95% CI - 5.35 to - 0.99). CONCLUSIONS MARME is associated with the following advantages over traditional tooth-borne RME: increased palatal suture opening, increased palatal width, and reduced buccal tooth inclination. REGISTRATION This study is registered with PROSPERO, CRD42021256750. CLINICAL RELEVANCE MARME may be preferred over conventional RME in cases with fused mid-palatal sutures or where further buccal tooth inclination is undesirable.
Collapse
|
22
|
Comparison of changes in skeletal, dentoalveolar, periodontal, and nasal structures after tooth-borne or bone-borne rapid maxillary expansion: A parallel cohort study. Am J Orthod Dentofacial Orthop 2022; 161:e336-e344. [PMID: 34996663 DOI: 10.1016/j.ajodo.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This parallel cohort study aimed to assess the dentoalveolar, skeletal, periodontal, and airway effects of tooth-borne (hyrax) and computer-guided miniscrew-supported rapid palatal expansion appliances. METHODS Thirty-six subjects were randomly allocated into 2 groups. Eighteen subjects (mean age, 12.2 years; male-to-female ratio, 10:8) were assigned to receive treatment with the hyrax appliance (group A), and 18 subjects were treated with the computer-guided miniscrew-supported appliance (group B). The same type of expansion screw and expansion protocol was used in both groups. Linear and angular measurements of skeletal, dentoalveolar, periodontal, and nasal floor changes were performed on the pretreatment and posttreatment cone-beam computed tomography images (6-month follow-up). Descriptive statistics and the independent Student t test were used for the statistical analysis. Intraoperator reliability was evaluated using a 2 sample t test. The level of significance was P ≤0.05. RESULTS Ten subjects were censured because posttreatment cone-beam computed tomography imaging was not performed because of the coronavirus disease 2019 pandemic. In the remaining 26 subjects, increases in linear measurements were observed in both groups. The transversal skeletal increase was greater and statistically significant in the group treated with the bone-borne expander (P ≤0.05). The dentoalveolar transverse diameters were greater in the tooth-supported expander group, with no statistically significant difference between the groups. The buccal inclination of the maxillary first molar was observed in the group with the tooth-borne expander, with a statistically significant difference between the 2 groups. A slight reduction of buccal and palatal thicknesses at the level of the maxillary first molars was observed in both groups, smaller in the skeletal expander group, with a statistically significant difference between the 2 groups only on the right buccal cortical plate. The width of the nasal floor increased more in the group with skeletal expander with a statistically significant difference of 2 mm. CONCLUSIONS Computer-guided miniscrew-supported maxillary expanders allowed a greater transversal increase of the nasal-maxillary skeletal structures by reducing the dentoalveolar side effects of the tooth-supported devices.
Collapse
|
23
|
Losev FF, Arsenina OI, Shugaylov IA, Popova NV, Makhortova PI, Popova AV. [Algorithms for orthodontic treatment of patients with maxillary constriction based on the stages of formation of the palatal suture]. STOMATOLOGIIA 2022; 101:52-62. [PMID: 35362704 DOI: 10.17116/stomat202210102152] [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: 06/14/2023]
Abstract
THE AIM OF THE STUDY Improving the effectiveness of complex orthodontic treatment of patients with constriction and deformation of the upper jaw during the period of replacement and permanent bite based on the analysis of cone-beam computed tomography (CBCT) data. MATERIALS AND METHODS The results of complex treatment of 70 patients with constriction and deformation of the upper jaw during the period of temporary and permanent bite are presented. The patients were divided into groups according to the stage of formation of the midpalatal suture: 1st group - 40 patients with stage «A» and «B» (average age 11.5 years); 2nd group - 15 patients with stage «C» (average age 20.5 years); 3rd group - 15 patients with stage «D» and «E» (average age 24.5 years). Orthodontic treatment was carried out using palatine expanders with a dental and intraosseous type of fixation. The complex treatment consisted of: orthodontic treatment using a bracket system, transgingival laser corticotomy, piezocorticotomy, surgically assisted rapid palatal expansion, orthodontic appliances for the expansion of the upper jaw. After conducting a clinical X-ray examination of all patients and analyzing the data obtained, we developed algorithms for therapeutic measures. RESULTS As a result of the diagnosis and treatment planning, the expansion of the upper jaw was achieved both at the dental alveolar and skeletal levels. Detailed algorithms of complex treatment were developed based on the analysis of CBCT data, the stage of formation of the midpalatal suture individually for each patient. CONCLUSION It was found that the analysis of CBCT data makes it possible to choose the optimal treatment method for patients with skeletal deformities of the dentition complex, thereby increasing the effectiveness of orthodontic treatment.
Collapse
Affiliation(s)
- F F Losev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O I Arsenina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - I A Shugaylov
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - N V Popova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency Russia, Moscow, Russia
| | - P I Makhortova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency Russia, Moscow, Russia
| | - A V Popova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| |
Collapse
|
24
|
MARPE as an adjunct to orthodontic treatment. Dental Press J Orthod 2022; 27:e22bbo6. [PMID: 36995846 PMCID: PMC10042462 DOI: 10.1590/2177-6709.27.6.e22bbo6] [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: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 03/29/2023] Open
Abstract
Introduction: Miniscrew or microimplant-assisted rapid palatal expansion (MARPE) devices are used to achieve a skeletal expansion of the palate and to increase the arch perimeter. Objective: To describe the treatment of a 23-year-old woman with an Angle Class II, division 1 malocclusion with constricted maxillary and mandibular arches. Case report: The patient’s main complaint was mandibular anterior crowding. The treatment plan included expansion of the mandibular arch concurrent with maxillary expansion, using a MARPE appliance in combination with a full-fixed appliance to align and level the crowded mandibular teeth, along with miniscrews as anchorage for the maxillary teeth and for distalization of the molars and premolars. A successful non-extraction orthodontic treatment was accomplished after 28 months, and the occlusion and teeth alignment, as well as facial goals, were resolved in a clinically satisfactory manner. Conclusion: The treatment objectives were met, and the outcome of the expansion of the maxillary arch with a MARPE appliance as an adjunct to a fixed appliance was considered a success. An esthetic, functional, and stable result after a 1-year follow-up was achieved and was satisfactory to the patient.
Collapse
|
25
|
Jia H, Zhuang L, Zhang N, Bian Y, Li S. Age-dependent effects of transverse maxillary deficiency treated by microimplant-assisted rapid palatal expansion: A prospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2021; 161:557-573. [PMID: 34903419 DOI: 10.1016/j.ajodo.2020.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study investigated the results of maxillary discrepancy treated by microimplant-assisted rapid palatal expansion (MARPE) at different ages. METHODS Sixty patients (aged 11.0-34.1 years; 23 male and 37 female) were treated by MARPE. Cone-beam computed tomography scans and dental casts were taken before and after expansion. The data were compared among 4 age groups: early adolescents (aged 11-14 years), late adolescents (aged 15-19 years), young adults (aged 20-24 years), and old adults (aged 25-34.1 years). RESULTS The success rates of midpalatal suture separation were 100%, 100%, 88.2%, and 85.7% for early adolescents, late adolescents, young adults, and old adults, respectively. Palatal sutures at the level of the first molar were expanded by 4.02 mm, 3.48 mm, 2.63 mm, and 2.10 mm, corresponding to 66.7%, 58.1%, 42.0%, and 37.9% of the total dental expansion. Significant differences were found in the amounts of palatal suture expansion and the ratio of skeletal dental expansion between patients aged <20 years and patients aged ≥20 years (P <0.05). Skeletal expansion constituted 69.4%, 51.3%, 39.0%, and 29.8% of the total screw expansion. Except for the comparison between young adults and old adults, there were significant differences between groups for the ratio of skeletal screw expansion (P <0.05). CONCLUSIONS The midpalatal suture can be expanded by MARPE more easily in patients <20 years of age than in patients ≥20 years of age. The ratio of skeletal screw expansion decreases as age increases.
Collapse
Affiliation(s)
- Haichao Jia
- Department of Orthodontics, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China.
| | - Li Zhuang
- Department of Orthodontics, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Nan Zhang
- Department of Orthodontics, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Yuanyuan Bian
- Department of Orthodontics, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China
| | - Song Li
- Department of Orthodontics, Beijing Stomatological Hospital and School of Stomatology, Capital Medical University, Beijing, China.
| |
Collapse
|
26
|
Vidalón JA, Loú-Gómez I, Quiñe A, Diaz KT, Liñan Duran C, Lagravère MO. Periodontal effects of maxillary expansion in adults using non-surgical expanders with skeletal anchorage vs. surgically assisted maxillary expansion: a systematic review. Head Face Med 2021; 17:47. [PMID: 34753493 PMCID: PMC8579525 DOI: 10.1186/s13005-021-00299-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Describe and compare harmful periodontal effects as a consequence of maxillary expansion in adult patients with different types of anchorage devices in non-surgical expanders with skeletal anchorage and surgically assisted maxillary expansion. MATERIALS AND METHODS An exhaustive search was carried out on the electronic databases PubMed (MEDLINE), Embase, Cochrane and LILACS. Additionally, journal references and grey literature were searched without any restrictions. After the selection and extraction process; risk of bias was assessed by the ROB-1 Cochrane tool and Newcastle-Ottawa Scale (NOS) for randomized trials and cohort studies, respectively. RESULTS Of 621 studies retrieved from the searches, six were finally included in this review. One of them presented a low risk bias, while five were excellent respective to selection, comparability and outcomes. Results showed that maxillary expansion in adults using non-surgical expanders (bone-borne or tooth-bone-borne with bicortical skeletal anchorage) produce less harmful periodontal effects, such as: alveolar bending with an average range from 0.92° to 2.32°, compared to surgically assisted maxillary expansion (tooth-borne) of 6.4°; dental inclination with an average range from 0.07° to 2.4°, compared to surgically assisted maxillary expansion (tooth-borne) with a range from 2.01° to 5.56°. CONCLUSIONS Although limited, the current evidence seems to show that the bone-borne or tooth-bone-borne with bicortical skeletal anchorage produces fewer undesirable periodontal effects.
Collapse
Affiliation(s)
- José Antonio Vidalón
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ismael Loú-Gómez
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Aldo Quiñe
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Karla T Diaz
- Stomatology Second Speciality, Universidad Privada San Juan Bautista, Lima, Peru
| | - Carlos Liñan Duran
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuel O Lagravère
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Orthodontic Graduate Program, ECHA 5-524, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada.
| |
Collapse
|
27
|
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
|
28
|
Three-dimensional zygomatic changes after rapid maxillary expansion in growing patients. J Orofac Orthop 2021; 84:147-156. [PMID: 34542641 DOI: 10.1007/s00056-021-00348-5] [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: 03/30/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the effects of rapid maxillary expansion (RME) treatment on the zygomatic bone complex (ZBC). METHODS In this single-center retrospective study, pre- and posttreatment cone-beam computed tomography (CBCT) images of 38 patients treated with RME were analyzed to investigate changes in the coordinates of the ZBC landmarks. At the start of treatment (T0), the patients' mean age was 11.1 ± 3.8 years (range 8.3-14.9 years). Cohen's d test was used to evaluate statistical differences. RESULTS There were statistically significant differences between T0 and T1 (P < 0.01) in the measurement values for the maxillary transverse width (ΔT: 3.18 ± 2.58, d: 1.23), frontozygomatic sutures (ΔT: 1.09 ± 0.56, d: 0.43), lowest point of the zygomaticomaxillary sutures (ΔT: 3.16 ± 1.78, d: 0.78), frontomaxillary angular parameter (right side ΔT: 2.81 ± 1.63, d: 1.73; left side ΔT: 2.52 ± 1.20, d: 2.10), frontozygomatic angular parameter (right side ΔT: 2.81 ± 1.63 d: 1.07; left side ΔT: 2.21 ± 2.79, d: 0.61), anterior intermaxillary distance (ΔT: 2.11 ± 1.42, d: 0.99), interzygomaticotemporal distance (ΔT: 2.00 ± 2.42, d: 0.99), and zygomatic angular parameter (right side ΔT: 2.06 ± 1.29, d: 1.6; left side ΔT: 2.02 ± 1.86, d: 1.09). CONCLUSIONS After RME in growing patients, the zygomatic bone showed pyramidal expansion in the coronal plane and parallel palatal expansion in the axial plane. In addition, significant lateral relocation of the zygomatic bone occurred. The zygomatic bone tended to rotate outward in conjunction with the maxilla, with a typical center of rotation close to the superior side of the frontozygomatic suture. These results shed light on the patterns of skeletal expansion in the zygomatic bone associated with RME in growing patients.
Collapse
|
29
|
Seubert BJ, Gaalaas L, Larson BE, Grünheid T. Evaluation of transverse maxillary growth on cone-beam computed tomography images. Sci Rep 2021; 11:17462. [PMID: 34465855 PMCID: PMC8408260 DOI: 10.1038/s41598-021-97082-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/19/2021] [Indexed: 11/09/2022] Open
Abstract
This study aimed at quantifying the annual transverse growth of the maxilla using skeletal landmarks in three different regions on cone-beam computed tomography (CBCT) scans. CBCT scans taken before and after orthodontic treatment of 100 child and adolescent patients (50 male, 50 female) without maxillary transverse deficiencies were used to determine the transverse linear distances between the greater palatine foramina (GPFd), the lateral walls of the nasal cavity (NCd), and the infraorbital foramina (IOFd). We found that all distances increased significantly with growth in both genders (p < 0.001). The overall average annual change was 0.5 mm for GPFd, 0.3 mm for NCd, and 0.7 mm for IOFd. Males generally had greater annual changes than females for GPFd and IOFd, but not NCd. There were weak, statistically not significant (p > 0.05) correlations between patient age and the annual changes in GPFd, NCd, and IOFd. These results suggest that the positions of the greater palatine foramina, the lateral walls of the nasal cavity, and the infraorbital foramina change consistently with maxillary transverse growth. Clinicians can use the growth rates as population averages to more confidently estimate the amount of skeletal transverse deficiency or evaluate the long-term effects of maxillary expansion treatment.
Collapse
Affiliation(s)
| | - Laurence Gaalaas
- Division of Oral Medicine, Diagnosis and Radiology, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Brent E Larson
- Division of Orthodontics, School of Dentistry, University of Minnesota, 6-320 Moos Health Science Tower, 515 Delaware Street S.E., Minneapolis, MN, 55455, USA
| | - Thorsten Grünheid
- Division of Orthodontics, School of Dentistry, University of Minnesota, 6-320 Moos Health Science Tower, 515 Delaware Street S.E., Minneapolis, MN, 55455, USA.
| |
Collapse
|
30
|
Perceived Pain during Rapid Maxillary Expansion (RME): Trends, Anatomical Distinctions, and Age and Gender Correlations. Pain Res Manag 2021; 2021:7396466. [PMID: 34336069 PMCID: PMC8295004 DOI: 10.1155/2021/7396466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/08/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022]
Abstract
Objectives To investigate pain trends and characteristics of different facial districts in patients undergoing rapid maxillary expansion (RME) and its possible correlations with age and gender. Materials and Methods 85 subjects (45 males and 40 females) undergoing RME were selected and analyzed during first two weeks of treatment. Patients rated daily two types of pain perception: the general perceived pain (GPP), i.e., the pain overall perceived in the face, and the local perceived pain (LPP), i.e., the pain perceived locally in the following anatomical areas: anterior palate (APA), posterior palate (PPA), nasal (NA), joint (JA), and zygomatic (ZA). Patients were provided the Numeric Rating Scale (NRS) and Wong–Baker Faces Pain Rating Scale (FPS) to correctly assess their GPP and LPP. Pearson correlation coefficient and analysis of variance (ANOVA) were, respectively, used to define the linear relationship between all the variables considered and to verify whether the response variables (gender and age) were significantly different (α < 0.05). Results Sample's mean age was 10.11 years. Average pain values of GPP and LPP progressively rise from day 1 to days 2-3 (pain peak) and tended to decrease until day 14, with a linear decrease for GPP and a not linear decrease for LPP. PPA and APA resulted the most painful areas, followed, respectively, by JA, ZA, and NA. Statistically significant differences resulted in average pain values according to patients' age and gender, both in GPP and LPP. Conclusion RME causes perception of pain in several maxillofacial areas. Pain reported during RME resulted positively correlated with age and gender of patients.
Collapse
|
31
|
CBCT Comparison of Dentoskeletal Effects of Haas-Type and Hyrax-Type Expanders Using Deciduous Teeth as Anchorage: A Randomized Clinical Trial. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11157110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim of this study was to compare the three-dimensional dentoskeletal effects of Haas-type and Hyrax-type expanders using primary teeth as anchorage for rapid palatal expansion (RPE). Thirty-four subjects in mixed dentition were divided according to their expander’s type: Hyrax (n = 16; 6F, 10M; mean age 8 ± 3 years) or Haas (n = 18; 14F, 4M; mean age 8 ± 2 years). Each patient underwent CBCTs before (T0) and after RPE (T1). Dentoskeletal changes were collected. A paired sample t-test and independent t-test were used to compare each variable within the same group and between groups, respectively, with a 5% significance. The Hyrax group showed an increase in all dentoskeletal parameters; skeletal expansion was significantly increased anteriorly (1.76 mm) and posteriorly (1.93 mm). The greatest dental expansion was observed in the anchorage unit (6.47 mm), about twice as much as permanent molars (3.42 mm). The same statistical significance of Haas group measurements was observed; anteriorly skeletal expansion (2.97 mm) was greater than posteriorly (1.93 mm) and dental expansion was greater on anchored teeth (6.80 mm) than non-anchored teeth (4.57 mm). No statistical significance was observed between Hyrax and Hass groups. CBCT analysis showed that, in RPE, the dental expansion was greater than skeletal expansion. No significant or clinical changes were observed between Hyrax and Haas appliances anchored to primary teeth.
Collapse
|
32
|
Oliveira RDS, de Oliveira CJM, Panzarella FK, Cintra Junqueira JL. Maturation stages of the sutures in the median palatine evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 160:567-572. [PMID: 34274199 DOI: 10.1016/j.ajodo.2020.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to evaluate the influence of age, sex, and facial growth patterns on the maturation stage of midpalatal sutures. METHODS We selected 90 total skull cone-beam computed tomography scans and divided them into the following 3 groups: brachyfacial (n = 30), mesofacial (n = 30), and dolichofacial (n = 30). These groups were determined using Ricketts VERT 3-dimensional cephalometric analysis. All patients were aged ≥18 years and were divided into those aged ≥30 years and >30 years. The maturational stage of the median palatine sutures was determined by evaluating the central transverse axial dimension in the maxillary-mandibular palate. Maturational stages were classified as A, B, C, D, and E. RESULTS Of the 90 images reviewed, 55 (61.1%) were female patients, and 35 were male patients (38.9%). The age of patients ranged from 18 to 59 years, with 55 patients aged <30 years (61.1%) and 35 aged ≥30 years (38.9%). Regarding the maturational stages, 3.3% of brachyfacial, 6.7% of mesiofacial, and 16.7% of dolichofacial subjects (P = 0.032) were classified as stages B and C. CONCLUSIONS The patients' facial patterns were found to be a significant signal for the maturation stage of midpalatal sutures. Adult dolichofacial patients are the most likely to have stage B and C.
Collapse
Affiliation(s)
- Rudyard Dos Santos Oliveira
- Department of Dentistry, Postgraduate Program in Orthodontics, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil.
| | | | - Francine Kühl Panzarella
- Department of Dentistry, Postgraduate Program in Imaging and Oral Radiology, São Leopoldo Mandic College, Campinas, São Paulo, Brazil
| | - José Luiz Cintra Junqueira
- Department of Dentistry, Postgraduate Program in Imaging and Oral Radiology, São Leopoldo Mandic College, Campinas, São Paulo, Brazil
| |
Collapse
|
33
|
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] [Key Words] [MESH Headings] [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
|
34
|
Van de Velde AS, De Boodt L, Cadenas de Llano-Pérula M, Laenen A, Willems G. Short term effects of interceptive expansion treatment: a prospective study. Eur J Orthod 2021; 43:324-331. [PMID: 33830217 DOI: 10.1093/ejo/cjab006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This prospective cohort study investigated the short term effects of interceptive orthodontic treatment with a removable expansion plate, evaluating the changes in occlusion in all its dimensions: transversal, sagittal and vertical. SUBJECTS AND METHODS A total of 226 patients treated with a removable expansion plate (slow maxillary expansion, SME) by orthodontic residents at the Department of Orthodontics, University Hospitals Leuven, Belgium were included. The patients had a mean age of 8.5 years at the start of the treatment. The mean treatment time was 6.9 months. Transversal measurements (intercanine and intermolar width) and occlusal characteristics (molar occlusion, overjet, overbite and functional shift) were collected before (T0) and after active treatment (T1). Statistical analysis was performed using the Wilcoxon signed rank test, Sign test and McNemar test for assessing changes between T0 and T1. Linear models were used to assess the associations between patient factors and the amount of expansion. RESULTS A significant increase in transversal width at different occlusal landmarks was found. Correction of unilateral, bilateral and frontal crossbites was successful in 99.0%, 95.2% and 93.6% of the cases respectively. Changes in sagittal molar occlusion were significant: 64.9% (right side) and 62.6% (left side) remained stable, 28.4% (right) and 29.3% (left) improved and 6.7% (right) and 8.1% (left) deteriorated. Overbite changes were found to be statistically significant, though clinically irrelevant. Overjet changes were non-significant. CONCLUSIONS A removable expansion plate is successful in improving the transversal dental dimensions of the maxilla. Statistically significant sagittal effects on molar occlusion were found. Long-term follow-up is needed to evaluate the long-term stability of this treatment.
Collapse
Affiliation(s)
- A-S Van de Velde
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - L De Boodt
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - M Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - A Laenen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Belgium
| | - G Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
35
|
Juvenile/Adolescent Idiopatic Scoliosis and Rapid Palatal Expansion. A Pilot Study. CHILDREN-BASEL 2021; 8:children8050362. [PMID: 33946317 PMCID: PMC8146753 DOI: 10.3390/children8050362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/28/2022]
Abstract
The question of whether orthodontic therapy by means of rapid palatal expansion (RPE) affects the spine during development is important in clinical practice. RPE is an expansive, fixed therapy conducted with heavy forces to separate the midpalatal suture at a rate of 0.2–0.5 mm/day. The aim of the study was to evaluate the influence of RPE on the curves of the spine of juvenile/adolescent idiopathic scoliosis patients. Eighteen patients under orthopedic supervision for juvenile/adolescent idiopathic scoliosis and independently treated with RPE for orthodontic reasons were included in the study: Group A, 10 subjects (10.4 ± 1.3 years), first spinal radiograph before the application of the RPE, second one during the orthodontic therapy with RPE; Group B, 8 patients (11.3 ± 1.6 years), first radiograph during the use of RPE second one after the removal. Group A showed a significant worsening of the Cobb angle (p ≤ 0.005) at the second radiograph after RPE. Group B showed a significant improvement of the Cobb angle (p = 0.01) at the second radiograph after removal of RPE. Based on the results, the use of RPE during adolescence might influence the spinal curves of patients with idiopathic scoliosis.
Collapse
|
36
|
Lo Giudice A, Leonardi R, Ronsivalle V, Allegrini S, Lagravère M, Marzo G, Isola G. Evaluation of pulp cavity/chamber changes after tooth-borne and bone-borne rapid maxillary expansions: a CBCT study using surface-based superimposition and deviation analysis. Clin Oral Investig 2021; 25:2237-2247. [PMID: 32860529 DOI: 10.1007/s00784-020-03539-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare volume and shape changes of pulp chamber of maxillary posterior teeth between tooth-borne and bone-borne maxillary expansions in adolescents. MATERIALS AND METHODS This study included 36 adolescents with bilateral maxillary crossbite who received tooth-borne rapid maxillary expansion (TB group, average age 14.4 years) or bone-borne rapid maxillary expansion (BB group, average age 14.7 years). Cone beam computed tomography (CBCT) was taken before treatment (T1) and after a 6-month retention period (T2). Volumetric and shape changes of pulp chamber of maxillary first molars and premolars were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student's t tests were used to (1) compare T1 and T2 volumes of pulp chambers in TB and BB groups and (2) assess differences between the two groups in the post-treatment volumetric changes and in the percentage of matching of 3D pulp models. RESULTS All investigated teeth showed a reduction of pulp volume, being this difference significant in both TB (p < 0.0001) and BB (p < 0.0001) groups. The volumetric reduction was greater in the TB group; also, subjects in the TB group showed a lower percentage of matching between T1 and T2 pulp models (p < 0.0001). The area most affected by shape change was that of pulp horns. CONCLUSIONS TB expander could induce a higher volumetric reduction of pulp chamber of posterior teeth compared with BB expander, in the short term. CLINICAL RELEVANCE The present findings add new information concerning the effects of RME protocols on pulp tissue.
Collapse
Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | | | - Manuel Lagravère
- Orthodontic Graduate Program, Edmonton Clinic Health Academy, University of Alberta, 5th Floor, 11405 - 87 Avenue NW, Edmonton, Alberta, Canada
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, V.le San Salvatore, 67100, L'Aquila, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| |
Collapse
|
37
|
Evaluation of the Soft Tissue Changes after Rapid Maxillary Expansion Using a Handheld Three-Dimensional Scanner: A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073379. [PMID: 33805172 PMCID: PMC8036493 DOI: 10.3390/ijerph18073379] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022]
Abstract
Facial soft tissue esthetics is a priority in orthodontic treatment, and emerging of the digital technologies can offer new methods to help the orthodontist toward an esthetic outcome. This prospective study aimed to assess the soft tissue changes of the face after six months of retention following Rapid Maxillary Expansion (RME). The sample consisted of 25 patients (13 females, 12 males, mean age: 11.6 years) who presented with unilateral or bilateral posterior crossbite requiring RME, which was performed with a Hyrax expander. 3D facial images were obtained before treatment (T0) and at the end of a six-month retention period after the treatment (T1) using a structured-light 3D handheld scanner. Linear and angular measurements were performed and 3D deviation analyses were done for six morphological regions of the face. Significant changes in various areas of the nasal and the upper lip regions were observed. Based on the results of the study and within the limitations of the study, RME with a Hyrax expander results in significant morphological changes of the face after a six-month retention period.
Collapse
|
38
|
Maxillary dentoskeletal outcomes of the expander with differential opening and the fan-type expander: a randomized controlled trial. Clin Oral Investig 2021; 25:5247-5256. [PMID: 33580351 DOI: 10.1007/s00784-021-03832-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/05/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of this study was to compare the maxillary dentoskeletal outcomes of the expander with differential opening (EDO) and the fan-type expander (FE). MATERIAL AND METHODS Forty-eight patients with maxillary arch constriction in the mixed dentition were randomly allocated into EDO and FE groups. Cone-beam computed tomography scans were acquired before and after expansion. Linear and angular three-dimensional changes were assessed after cranial base superimposition using the ITK-SNAP and the 3D Slicer software. T or Mann-Whitney U tests were used for intergroup comparisons (P<0.05). RESULTS The EDO group comprised 24 patients treated with the EDO (13 female, 11 male; 7.6 years). The FE group comprised 24 patients treated with the FE (14 female, 10 male; 7.8 years). Skeletal lateral displacements were greater in the EDO group with greater expansion in the orbital, nasal cavity, zygomatic bone, and palate regions (mean intergroup differences of 0.4, 0.8, 0.9, and 1.1 mm, respectively). Intercanine expansion and canine buccal inclination were greater in the FE group, while intermolar distance changes and molar buccal inclination were greater in the EDO group. Similar changes were observed for vertical and anteroposterior displacements and palatal plane rotation. CONCLUSIONS The EDO produced greater transverse skeletal expansion compared to the FE, with similar vertical and anteroposterior effects. Dental changes were greater in the molar region for patients treated with the EDO and in the canine region for patients treated with the FE. CLINICAL RELEVANCE The EDO and the FE are capable of producing skeletal changes in the mixed dentition. The decision between both expanders will depend on the amount of expansion required in the molar region and in the nasomaxillary complex. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov , under the identifier NCT03705871.
Collapse
|
39
|
Jia H, Zhuang L, Zhang N, Bian Y, Li S. Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage. Angle Orthod 2021; 91:36-45. [PMID: 33289835 DOI: 10.2319/041920-332.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage. MATERIALS AND METHODS Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 ± 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 ± 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests. RESULTS The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P < .01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P < .01). CONCLUSIONS MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage.
Collapse
|
40
|
Santana LG, Marques LS. Do adjunctive interventions in patients undergoing rapid maxillary expansion increase the treatment effectiveness? Angle Orthod 2021; 91:119-128. [PMID: 33289794 DOI: 10.2319/051320-431.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To evaluate the clinical effectiveness of adjunctive interventions in individuals undergoing rapid maxillary expansion (RME). MATERIALS AND METHODS MEDLINE, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar were searched without restrictions up to June 2020. Trials involving participants undergoing orthopedic or surgical RME, along with adjunctive interventions, were included. Risk-of-bias assessments were performed using the Cochrane tool for randomized trials-2. The certainty level of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Six randomized clinical trials, with low to high risk of bias, were included. Low certainty of the evidence suggested that low-level laser facilitated opening of the midpalatal suture during the active phase of RME. Likewise, moderate certainty demonstrated that low-level laser accelerated the healing process of the suture during the retention phase. The clinical impact of this outcome, that is, stability and retention time, was not evaluated. Very low evidence indicated that osteoperforations along the midpalatal suture increased maxillary transverse skeletal gains in young adults undergoing RME. Low evidence suggested that platelet-rich plasma therapy did not minimize the vertical and thickness bone loss after RME in the short term. CONCLUSIONS Based on currently available information, the use of low-level laser associated with maxillary expansion seems to provide a more efficient suture opening and bone healing. Limited evidence suggests that osteoperforations improve the skeletal effects of RME in non-growing individuals. There are no adjunctive interventions capable of reducing the periodontal side effects of RME.
Collapse
|
41
|
Dalili Kajan Z, Hadinezhad A, Khosravifard N, Gholinia F, Rafiei E, Ghandari F. Fusion patterns of the spheno-occipital synchondrosis in the age range of 9-22: A computed tomography analysis. Orthod Craniofac Res 2020; 24:405-413. [PMID: 33306265 DOI: 10.1111/ocr.12455] [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: 09/22/2020] [Revised: 10/25/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the fusion patterns of the spheno-occipital synchondrosis (SOS) in the age range of 9-22 using CT and CBCT images of an Iranian population. SETTING/SAMPLE POPULATION Spiral CT and CBCT scans of 763 subjects (459 males and 304 females) aged 9-22 were evaluated. The scans had to cover the cranial base area, and those with diseases affecting the bone density, cranial base masses and history of trauma were excluded. MATERIALS AND METHODS Two oral and maxillofacial radiologists scored the images with regard to the status of SOS fusion based on a 5-stage system. Mann-Whitney, Kruskal-Wallis and Fisher's exact tests were used for data analysis. Age and SOS fusion stages were evaluated through Spearman correlation and linear regression methods (α = 0.01). RESULTS The earliest age for onset of SOS fusion was 9 in both sexes. Open SOS could be observed until the age of 15 and 14 in males and females, respectively. The earliest age of complete fusion was 12 in males and 13 in females. Furthermore, there was a significant, positive correlation between age and the different stages of SOS fusion (P < .001). CONCLUSION A significant correlation exists between age and the fusion stages of SOS, rendering it an appropriate means of age estimation during growth periods. Fusion of SOS begins approximately 2 years earlier in females; however, it ends at the age of 17 in both sexes. The fusion scar can be detected up to the age of 12 and 13 in males and females, respectively.
Collapse
Affiliation(s)
- Zahra Dalili Kajan
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Hadinezhad
- School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Faegheh Gholinia
- Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Biostatistician, Vice-chancellor of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran
| | - Farnaz Ghandari
- School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
42
|
Persistent palatal hypertrophy associated with rapid maxillary expansion procedure: Report of a rare case. Biomedicine (Taipei) 2020; 10:49-51. [PMID: 33854935 PMCID: PMC7735976 DOI: 10.37796/2211-8039.1007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/13/2020] [Indexed: 11/17/2022] Open
Abstract
Maxillary transversal deficiency (MTD) is a common skeletal problem. If not treated on time, MTD evolve to a more complex malocclusion. This problem can affect facial growth and development. Rapid maxillary expansion (RME) procedure frequently used for the management. This technique is usually successful in young individuals but as the age advances and the articulations of the maxilla with surrounding facial bones get more rigid, it becomes ineffective. Undesirable side effects or results have been reported after use of RME in skeletally mature patients such as buccal tipping of posterior teeth, extrusion, periodontal tissue recession, fenestration of buccal cortex, necrosis of palatal tissue, failure in opening of midpalatal suture, pain, and relapse of expansion. Side effects of RME are often temporary and permanent damages are rarely seen. The aim of this report is to present the management of a permanent side effect of the RME procedure in a 13-year-old child.
Collapse
|
43
|
Altieri F, Cassetta M. The impact of tooth-borne vs computer-guided bone-borne rapid maxillary expansion on pain and oral health–related quality of life: A parallel cohort study. Am J Orthod Dentofacial Orthop 2020; 158:e83-e90. [PMID: 32978017 DOI: 10.1016/j.ajodo.2020.07.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 01/04/2023]
|
44
|
Nam HJ, Gianoni-Capenakas S, Major PW, Heo G, Lagravère MO. Comparison of Skeletal and Dental Changes Obtained from a Tooth-Borne Maxillary Expansion Appliance Compared to the Damon System Assessed through a Digital Volumetric Imaging: A Randomized Clinical Trial. J Clin Med 2020; 9:jcm9103167. [PMID: 33007851 PMCID: PMC7601060 DOI: 10.3390/jcm9103167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/19/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to evaluate and compare dental and skeletal changes associated with the Damon and Rapid Maxillary Expander (RME) expansion using Cone-Beam Computed Tomography (CBCT). Eighty-two patients, from The University of Alberta Orthodontic Clinic, were randomly allocated to either Group A or B. Patients in Group A received orthodontic treatment using the Damon brackets. Patients in Group B received treatment using the Hyrax (a type of RME) appliance. CBCT images were taken two times (baseline and after expansion). The AVIZO software was used to locate 18 landmarks (dental and skeletal) on sagittal, axial, and coronal slices of CBCT images. Comparison between two groups showed that transverse movement of maxillary first molars and premolars was much greater in the Hyrax group. The lateral movements of posterior teeth were associated with buccal tipping of crowns. No clinically significant difference in the vertical or anteroposterior direction between the two groups was noted. Alveolar bone next to root apex of maxillary first premolar and molar teeth showed clinically significant lateral movement in the Hyrax group only. The comparison between two groups showed significantly greater transverse expansion of the first molar and first premolars with buccal tipping in the RME group.
Collapse
|
45
|
Lo Giudice A, Rustico L, Ronsivalle V, Nicotra C, Lagravère M, Grippaudo C. Evaluation of the changes of orbital cavity volume and shape after tooth-borne and bone-borne rapid maxillary expansion (RME). Head Face Med 2020; 16:21. [PMID: 32900389 PMCID: PMC7487642 DOI: 10.1186/s13005-020-00235-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/01/2020] [Indexed: 12/26/2022] Open
Abstract
Objective To assess and compare volumetric and shape changes of the orbital cavity in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). Study design Forty adolescents with bilateral maxillary cross-bite received tooth-borne (TB group = 20; mean age 14.27 ± 1.36 years) or bone-borne (BB group = 20; mean age of 14.62 ± 1.45 years) maxillary expander. Cone-beam computed tomography (CBCT) were taken before treatment (T1) and 6-month after the expander activation (T2). Volumetric and shape changes of orbital cavities were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student’s t tests were used to 1) compare T1 and T2 volumes of orbital cavities in TB and BB groups, 2) compare volumetric changes and the percentage of matching of 3D orbital models (T1-T2) between the two groups. Results Both TB and BB groups showed a slight increase of the orbital volume (0.64 cm3 and 0.77 cm3) (p < 0.0001). This increment were significant between the two groups (p < 0.05) while no differences were found in the percentage of matching of T1/T2 orbital 3D models (p > 0.05). The areas of greater changes were detected in the proximity of the frontozygomatic and frontomaxillary sutures. Conclusion TB-RME and BB-RME would not seem to considerably affect the anatomy or the volume of the orbital cavity in adolescents.
Collapse
Affiliation(s)
- Antonino Lo Giudice
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | | | - Vincenzo Ronsivalle
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | - Carmelo Nicotra
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | - Manuel Lagravère
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Grippaudo
- Dental and Maxillofacial Institute, Head and Neck Department, Fondazione Policlinico Gemelli IRCCS, Catholic University of Sacred Heart, 00168, Rome, Italy
| |
Collapse
|
46
|
Lo Giudice A, Ronsivalle V, Lagravere M, Leonardi R, Martina S, Isola G. Transverse dentoalveolar response of mandibular arch after rapid maxillary expansion (RME) with tooth-borne and bone-borne appliances. Angle Orthod 2020; 90:680-687. [PMID: 33378488 PMCID: PMC8032272 DOI: 10.2319/042520-353.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/01/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess and compare spontaneous expansion of mandibular posterior teeth between tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). MATERIALS AND METHODS This study included 36 adolescents with bilateral maxillary crossbite receiving tooth-borne (average age: 14.4 ± 1.3 years) or bone-borne (average age: 14.7 ± 1.4 years) maxillary expansion. Cone beam computed tomography was acquired before expansion (T1) and after 6 months' retention (T2). Specific linear and angular measurements were performed in the coronal view to assess buccal inclinations and widths of mandibular posterior units. All data were statistically analyzed. RESULTS In both groups there was a significant increase in buccal-lingual inclination of mandibular posterior teeth ranging from 1.67° to 2.30° in the TB group and from 1.46° to 2.11° in BB group. Mandibular posterior widths showed an increase ranging from 0.80 mm to 1.33 mm in TB group and from 0.64 mm to 0.96 mm in the BB group. No differences between groups were found for linear or angular measurements. CONCLUSIONS A clinically significant gain of space in the mandibular arch should not be expected after RME.
Collapse
|
47
|
Caldas LD, Takeshita WM, Machado AW, Bittencourt MAV. Effect of rapid maxillary expansion on nasal cavity assessed with cone-beam computed tomography. Dental Press J Orthod 2020; 25:39-45. [PMID: 32844972 PMCID: PMC7437151 DOI: 10.1590/2177-6709.25.3.039-045.oar] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 03/09/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction: Rapid maxillary expansion (RME) is assumed as a well established procedure; although, some effects on facial complex are not yet fully understood. Objective: The aim of this research was to verify, using cone-beam computed tomography, the effect on linear dimensions of the nasal cavity. Methods: Sample consisted of twenty patients aged 7 to 16 years, with skeletal deformity that justified the use of CT scans, and who required the RME as part of the orthodontic treatment planning. Scans were taken before clinical procedures were performed (T0) and after stabilizing the expander screw (T1). Dolphin Imaging v. 11.5 3D software was used to measure six areas on nasal cavity: three at the anterior portion (upper, middle, and lower) and other three at the posterior portion (also upper, middle, and lower). Data were statistically treated using Shapiro-Wilk test to verify normality. Differences between T0 and T1 were calculated using the Spearman correlation and paired Student’s t-test, with a significance level of 5%. Results: All linear measurements presented a significant increase (p< 0.05) after RME, both in the anterior and posterior regions, suggesting some parallelism on the opening pattern, especially at the lower portion (p< 0.001). Conclusions: RME was able to significantly modify the internal dimensions of the nasal cavity.
Collapse
Affiliation(s)
| | - Wilton M Takeshita
- Departamento de Radiologia Oral, Faculdade de Odontologia, Universidade Federal do Sergipe, Aracaju, SE, Brazil
| | - André Wilson Machado
- Departamento de Ortodontia, Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | | |
Collapse
|
48
|
Fox GC, Jones TA, Wilson JM, Claro WI, Williams RA, Trojan TM, Al Dayeh A. Sutural loading in bone‐ versus dental‐borne rapid palatal expansion: An ex vivo study. Orthod Craniofac Res 2020; 23:419-426. [DOI: 10.1111/ocr.12384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/17/2020] [Accepted: 04/27/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Gavin C. Fox
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Thomas A. Jones
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - John M. Wilson
- College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Wanda I. Claro
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Richard A. Williams
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Terry M. Trojan
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Ayman Al Dayeh
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| |
Collapse
|
49
|
Oliva G, Huanca Ghislanzoni L, Dalessandri D, Silvestrini-Biavati A, Ugolini A. Palatal changes in crossbite patients treated with rapid maxillary expansion vs untreated ones: A geometric morphometric study. Orthod Craniofac Res 2020; 23:439-444. [PMID: 32390290 DOI: 10.1111/ocr.12387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The present study aimed to analyse palatal changes due to rapid maxillary expansion (RME) by using modern geometric morphometric analysis (GMA) on 3D models. SETTINGS AND SAMPLE POPULATION Forty children with posterior crossbite and maxillary deficiency were selected for this study. Twenty children were treated with RME (mean age 7.4 ± 0.8 years), whereas 20 children were not treated (mean age 7.2 ± 1.1 years). MATERIALS AND METHODS In the treated group, RME screw was activated until overcorrection was achieved and the RME appliance remained in place for 11 months. Digital dental casts were recorded before treatment and 1 year after the end of active treatment. GMA was performed to compare shape and dimensional variations among groups (between-group principal component analysis). RESULTS All children in the treated group achieved crossbite correction. None of the control group children achieved crossbite self-correction. No significant shape and dimensional changes were noted in the control group after 1 year. On the other hand, significant shape and dimensional changes were noted in the treated group after 1 year (P < .05). Most of the shape changes in the treated group were similar but more pronounced compared to those observed in the control group. All major changes in palatal morphology occurred on the lateral sides of the palatal vault (widening) and at the height (shortening). Some shape changes were observed in the treated group alone. CONCLUSIONS Application of GMA to evaluate the effects of RME in crossbite patients revealed significant changes in palatal morphology compared with the absence of changes in the control group.
Collapse
Affiliation(s)
- Giorgio Oliva
- Department of Orthodontics, University of Brescia, Brescia, Italy
| | | | | | | | - Alessandro Ugolini
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| |
Collapse
|
50
|
Milad SAA, Hussein FA, Mohammed AD, Hashem MI. Three-dimensional assessment of transverse dentoskeletal mandibular dimensions after utilizing two designs of fixed mandibular expansion appliance: A prospective clinical investigation. Saudi J Biol Sci 2020; 27:727-735. [PMID: 32256159 PMCID: PMC7110864 DOI: 10.1016/j.sjbs.2019.12.008] [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: 10/29/2019] [Revised: 12/07/2019] [Accepted: 12/08/2019] [Indexed: 12/05/2022] Open
Abstract
The aim of this clinical study was to evaluate and compare the dentoskeletal transverse mandibular arch dimensions following the use of two designs of fixed mandibular expanders using cone beam computed tomography (CBCT). Twenty orthodontic patients, 12 females and 8 males, with mean age of 13.4 ± 0.5 years were selected and randomly divided into two equivalent groups; group A consisted of 10 patients (4 boys, 6 girls) who were treated with modified Williams expander and group B consisted of 10 patients (4 boys, 6 girls) who were treated with a two-arm fixed expander. Consistent expansion instructions were given to all patients according to a standardized slow protocol of one quarter turn twice/week for both expanders. Routine orthodontic records as well as mandibular CBCTs were obtained before (T1) and immediately after expansion (T2) to estimate changes in dentoskeletal mandibular transverse dimensions. The data was statistically analyzed and the significance level was set at p ≤ 0.05. Mandibular intercanine, inter-premolar, intermolar widths; and arch perimeter were significantly increased (p ≤ 0.05) following expansion with both fixed expanders. However, the changes in inter-premolar width, intercanine width, and arch perimeter were significantly augmented in two-arm fixed expander group than modified Williams’s group. In contrast, their effects on the skeletal mandibular body width were non-significant (p > 0.05). Both expanders yielded significant and equivalent dentoalveolar effects that were more evident with two-arm fixed expander than the William one. Both fixed designs enhanced mandibular transverse dental dimensions; however, they were unsuccessful to create any considerable skeletal effects.
Collapse
Affiliation(s)
| | - Farouk Ahmed Hussein
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, Egypt
| | - Al-DanyAtwa Mohammed
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, Egypt
| | - Mohamed I Hashem
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Dental Biomaterials Department, College of Dentistry, Al Azhar University, Egypt
| |
Collapse
|