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Sader LHB, Siécola G, Marin Ramirez CM, Otazu A, Torres DM, Cotrin P, Valarelli FP, Pinzan-Vercelino CRM, Freitas KMS. Comparison of maxillary transversal changes between auxiliary beta-titanium expansion arch and miniscrew-assisted rapid palatal expansion. Orthod Craniofac Res 2024; 27:421-428. [PMID: 38124269 DOI: 10.1111/ocr.12745] [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] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE(S) This study compared buccal bone thickness, dental inclinations and maxillary transverse width dimensions changes between auxiliary beta-titanium expansion arch (AEA) and miniscrew-assisted rapid palatal expansion (MARPE). MATERIALS AND METHODS The sample consisted of 29 patients, aged between 18 and 40 years, with transverse maxillary deficiency and treated without extractions, divided into two groups: group AEA: comprised 13 individuals (initial mean age: 29.23 ± 9.13 years) treated using auxiliary beta-titanium expansion arch; group MARPE: comprised 16 patients (initial mean age: 24.92 ± 7.60 years) treated with miniscrew-assisted rapid palatal expansion. Buccal bone thickness, dental inclinations and transverse width dimensions (dental, nasal base and jugular) were measured in cone-bean computed tomographies at pre- and post-treatment stages. The variables were compared using the independent t-test. RESULTS The buccal bone thickness was similar for both groups at the post-treatment stage. The second premolars were significantly more buccal inclined in the AEA group and the right maxillary first molars in the MARPE group. The intercanine and intermolar distances were statistically significantly greater in the MARPE group. Changes in dental arch transverse dimensions were significantly greater for the MARPE group. CONCLUSION Both treatment protocols corrected the maxillary transverse discrepancy; however, MARPE provided greater correction.
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Affiliation(s)
| | - Gustavo Siécola
- Department of Orthodontics and Public Health, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | | | - Aldo Otazu
- Department of Orthodontics and Public Health, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Dino Marcelo Torres
- Department of Orthodontics, Institute of Advanced Dentistry, Asunción, Paraguay
| | - Paula Cotrin
- Department of Orthodontics, Ingá University Center UNINGÁ, Maringá, Brazil
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Jiang T, Tang XY, Su H, Chen JY, Qin YQ, Qin YC, Ouyang NJ, Tang GH. Neutrophils are involved in early bone formation during midpalatal expansion. Oral Dis 2023. [PMID: 38135895 DOI: 10.1111/odi.14849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE Midpalatal expansion (MPE) is routinely employed to treat transverse maxillary arch deficiency. Neutrophils are indispensable for recruiting bone marrow stromal cells (BMSCs) at the initial stage of bone regeneration. This study aimed to explore whether neutrophils participate in MPE and how they function during bone formation under mechanical stretching. MATERIALS AND METHODS The presence and phenotype of neutrophils in the midpalatal suture during expansion were detected by flow cytometry and immunofluorescence staining. The possible mechanism of neutrophil recruitment and polarization was explored in vitro by exposing vascular endothelial cells (VECs) to cyclic tensile strain. RESULTS The number of neutrophils in the distracted suture peaked on Day 3, and N2-type neutrophils significantly increased on Day 5 after force application. The depletion of circulatory neutrophils reduced bone volume by 43.6% after 7-day expansion. The stretched VECs recruited neutrophils via a CXCR2 mechanism in vitro, which then promoted BMSC osteogenic differentiation through the VEGFA/VEGFR2 axis. Consistently, these neutrophils showed higher expression of canonical N2 phenotype genes, including CD206 and Arg1. CONCLUSIONS These results suggested that neutrophils participated in early bone formation during MPE. Based on these findings, we propose that stretched VECs recruited and polarized neutrophils, which, in turn, induced BMSC osteogenic differentiation.
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Affiliation(s)
- Ting Jiang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xin-Yue Tang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Han Su
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jia-Yi Chen
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yu-Qi Qin
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yu-Chen Qin
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ning-Juan Ouyang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Guo-Hua Tang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Wang C, Liu C, Mao Q, Zhou L, Xiang X. Skeletal and dentoalveolar modifications in adults with different sagittal facial patterns after personalized miniscrew-assisted rapid palatal expansion: A prospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2023; 164:843-854. [PMID: 37632488 DOI: 10.1016/j.ajodo.2023.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION This study aimed to compare the skeletal and dental modifications in adults with different sagittal facial patterns by a personalized miniscrew-assisted rapid palatal expander (pMARPE). METHODS Forty subjects (aged 18-28 years; 15 females and 25 males) with maxillary transverse deficiency were assigned to 1 of 3 groups (Class I, II, and III relationship) on the basis of their sagittal facial patterns. Each patient was treated with an individually customized expander. A similar expansion protocol was used for all patients. Cone-beam computed tomography scans were obtained before and after expansion. One-way analysis of variance was used to analyze differences among 3 groups in skeletal, dentoalveolar, and periodontal changes (P <0.05). RESULTS The success rates of expansion were higher in patients with a Class I or II relationship than those with a Class III relationship. Patients with a Class I or II relationship had greater changes in the anterior nasal spine and maxillary basal bone widths. A more parallel sutural opening in the anteroposterior direction was seen in those with a Class II relationship. The tipping of the maxillary first molar increased, and the buccal alveolar bone thickness decreased in all groups after expansion, especially in patients with a Class III relationship. CONCLUSIONS The pMARPE effectively split the midpalatal suture among adults. However, midpalatal suture expansion was more difficult, and there were more dentoalveolar side effects and fewer orthopedic effects in patients with a Class III relationship than in those with Class I or II relationships.
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Affiliation(s)
- Chunlin Wang
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Conghua Liu
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Qin Mao
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Lishu Zhou
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaosong Xiang
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China.
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Alves ACDM, de Carvalho NO, Cunha ÂCPDP, Rabelo SGF, Pereira HSG. Do the miniscrews of the prefabricated systems for the "appliance first" protocol of miniscrew-assisted rapid palatal expansion have lengths that meet the palatal thickness of patients? Am J Orthod Dentofacial Orthop 2023; 163:e152-e161. [PMID: 37125981 DOI: 10.1016/j.ajodo.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION In the "appliance first" protocol of miniscrew-assisted rapid palatal expansion, the prefabricated shape of the expanders limits the potential locations for miniscrew placement. Considering the influence of palatal thickness on the selection of the optimal length of miniscrews, this study aimed to evaluate the thickness of both bone and mucosa of the palate of patients aged 6-65 years and suggest optimal lengths of miniscrews for this approach. METHODS Two hundred and eighty-two cone-beam computed tomography of patients of both sexes were divided into 3 groups according to age. The thicknesses of bone and mucosa were measured in the anterior and posterior regions of the palate. RESULTS Males showed a greater thickness of palatal bone than females. The thickness of both bone and mucosa was greater in the anterior region of the palate. The young patients showed greater bone thickness than adults and mature adults. The mature adults showed thinner bone thickness in the posterior region of the palate and greater mucosal thickness along the palate than young patients and adults. Development of miniscrews with longer thread lengths is necessary. Miniscrews with a 3-mm thread length would prevent excessive extravasation in the posterior region of the palate. CONCLUSIONS The thickness of both bone and mucosa of the palate is variable and influenced by sex and age. Manufacturing additional miniscrews with different lengths of thread is suggested to achieve bicortical anchorage in patients undergoing the "appliance first" protocol of miniscrew-assisted rapid palatal expansion.
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Affiliation(s)
- Arthur César de Medeiros Alves
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Nathália Oliveira de Carvalho
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Sergei Godeiro Fernandes Rabelo
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Hallissa Simplício Gomes Pereira
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Shayani A, Merino-Gerlach MA, Garay-Carrasco IA, Navarro-Cáceres PE, Sandoval-Vidal HP. Midpalatal Suture Maturation Stage in 10- to 25-Year-Olds Using Cone-Beam Computed Tomography-A Cross-Sectional Study. Diagnostics (Basel) 2023; 13:diagnostics13081449. [PMID: 37189552 DOI: 10.3390/diagnostics13081449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 05/17/2023] Open
Abstract
In this study, we aimed to evaluate the frequency of midpalatal maturational stages in a Chilean urban sample of adolescents, post-adolescents and young adults, associated with chronological age and sex, by assessing CBCT scan images. Tomographic images in axial sections of the midpalatal sutures from 116 adolescents and young adults (61 females and 55 males, 10-25 years old) were classified according to their morphologic characteristics in five maturational stages (A, B, C, D and E), as proposed by Angelieri et al. The sample was divided into three groups: adolescents, post-adolescents and young adults. Three previously calibrated examiners (radiologist, orthodontist and general dentist) analyzed and classified the images. Stages A, B and C were considered to be an open midpalatal suture, and D and E were considered to be a partially or totally closed midpalatal suture. The most frequent stage of maturation was D (37.9%), followed by C (24%) and E (19.6%). The possibility of finding closed midpalatal sutures in individuals of 10 to 15 years was 58.4%, and in subjects aged 16 to 20 and 21 to 25 years, it was 51.7% and 61.7%, respectively. In males, Stages D and E were present in 45.4%; for females, this prevalence was 68.8%. Individual assessment of the midpalatal suture in each patient is of crucial importance before making the clinical decision of which is the best maxillary expansion method. Due to the extensive calibration and training required, it is advisable to always request a report from a radiologist. Individual evaluation with 3D imaging is recommended because of the great variability observed in the ossification of midpalatal sutures in adolescents, post-adolescents and young adults.
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Affiliation(s)
- Anis Shayani
- Master Program in Dental Science, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia 5090000, Chile
| | | | | | - Pablo Eliseo Navarro-Cáceres
- Centro de Investigación en Ciencias Odontológicas (CICO), Departamento de Odontología Integral de Adultos, Facultad de Odontología, Universidad de La Frontera, Temuco 4780000, Chile
- Universidad Autónoma de Chile, Temuco 4780000, Chile
| | - Héctor Paulo Sandoval-Vidal
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
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Nie X, Zhang X, Liu Y, Yan S, Men Y, Yu J, Guo J. Evaluation of palate-related factors of the effectiveness of microimplant-assisted rapid palatal expansion in late adolescents and adults. Clin Oral Investig 2023:10.1007/s00784-023-04967-7. [PMID: 36988823 DOI: 10.1007/s00784-023-04967-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION This study investigated the factors of the effectiveness of microimplant-assisted rapid palatal expansion (MARPE) in late adolescents and adults, such as age, midpalatal suture maturation (MPSM) stage, palate length (PL), palatal index (PI), and midpalatal bone thickness (MBT), and at each microimplant position, the palate bone thickness (PBT), the nasal cortical bone thickness (CoTN), the cancellous bone thickness (CaT), and the palate cortical bone thickness (CoTP) were evaluated. METHODS Cone-beam computed tomography (CBCT) images of 50 patients (mean, 23.30 ± 7.03 years; range, 16-51 years) treated with MARPE were evaluated. Maxillary expansion ratio (MER) was used to assess the MARPE effectiveness and grouped patients into low and high MER groups according to the mean of MER. MER was the ratio of maxillary expansion width to MARPE screw expansion measured in CBCT images. The t-test was used to analyze the differences between the low and high MER groups. The Pearson correlation test was performed to investigate the correlation between MER and age, MPSM stage, PL, PI, MBT, PBT, CoTN, CaT, and CoTP. RESULTS Age, MPSM stage, and MBT in regions 18 mm and 21 mm behind the incisor foramen correlated negatively with MER ([Formula: see text], - 0.390, - 0.386, and - 0.335, respectively, all [Formula: see text]), whereas PBT and CoTN of anterior microimplant positions correlated positively with MER ([Formula: see text] and 0.418, respectively, all [Formula: see text]). No correlation was observed between other variables and MER. CONCLUSIONS MARPE effectiveness decreased as age and midpalatal suture maturation stage increased, respectively. Thinner midpalatal suture bone in regions 18 mm and 21 mm behind the incisor foramen, thicker palate bone, and nasal cortical bone of anterior microimplant positions were related to more effective MARPE. CLINICAL RELEVANCE In patients with older chronological age and later MPSM stages, MARPE effectiveness might be unsatisfactory. Clinicians should carefully evaluate the palate bone thickness before MARPE treatment.
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Affiliation(s)
- Xiuping Nie
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China
| | - Xin Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China
| | - Ying Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China
| | - Shiyi Yan
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China
| | - Yanling Men
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China
| | - Jian Yu
- Department of Radiology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China.
| | - Jie Guo
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Shandong, Jinan, China.
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Meirelles CM, Ferreira RM, Suzuki H, Oliveira CB, Souza de Jesus A, Garcez AS, Suzuki SS. Analysis of factors associated with the success of microimplant-assisted rapid palatal expansion. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00063-X. [PMID: 36868909 DOI: 10.1016/j.ajodo.2022.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 03/05/2023]
Abstract
INTRODUCTION Success-related factors of microimplant-assisted rapid palatal expansion (MARPE) were evaluated, including age, palatal depth, suture, and parassutural bone thickness, suture density and maturation, and the relation to corticopuncture (CP) technique, as well as skeletal and dental effects. METHODS Sixty-six cone-beam computed tomography scans were analyzed before and after rapid maxillary expansion procedures in 33 patients aged 18-52 years for both sexes. The scans were generated in digital imaging and communications in medicine file format and analyzed in the multiplanar reconstruction of the regions of interest. Palatal depth, suture thickness, density and maturation, age, and CP were assessed. To evaluate dental and skeletal effects, the sample was divided into 4 groups: successful MARPE (SM), SM + CP technique (SMCP), failure MARPE (FM), and FM + CP (FMCP). RESULTS Successful groups presented more skeletal expansion and dental tipping than failure groups (P <0.05). The mean age of the FMCP group was significantly higher than the SM groups; suture and parassutural thickness significantly related to the success, and patients who received CP showed a success rate of 81.2% compared with 33.3% in the no CP group (P <0.05). Suture density and palatal depth did not show a difference between the success and failure groups. Suture maturation was higher in SMCP and FM groups (P <0.05). CONCLUSIONS Older age, thin palatal bone, and higher stage of maturation can influence the success of MARPE. CP technique in these patients appears to have a positive impact, increasing the chance of treatment success.
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Affiliation(s)
- Carolina Marques Meirelles
- Department of Post-graduation in Orthodontics, Faculdade São Leopoldo Mandic, Campinas, São Paulo, Brazil.
| | - Rafael Malagutti Ferreira
- Department of Post-graduation in Orthodontics, Faculdade São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Hideo Suzuki
- Department of Orthodontics, São Leopoldo Mandic School and Dental Institute, Campinas, São Paulo, Brazil
| | | | - Adriana Souza de Jesus
- Department of Orthodontics, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Aguinaldo Silva Garcez
- Department of Oral Microbiology, Faculdade São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Selly Sayuri Suzuki
- Department of Orthodontics, São Leopoldo Mandic School and Dental Institute, Campinas, São Paulo, Brazil
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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.
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Affiliation(s)
- Sercan Akyalcin
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Lee JM, Choi SH, Choi YJ, Lee KJ, Yu HS. Evaluation of miniscrew-assisted rapid palatal expansion success by comparing width of circummaxillary sutures before expansion in adult male patients. Angle Orthod 2022; 93:489524. [PMID: 36548811 PMCID: PMC9933570 DOI: 10.2319/062722-456.1] [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: 06/01/2022] [Accepted: 11/01/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To investigate the relationship between circummaxillary sutures and miniscrew-assisted rapid palatal expansion (MARPE) success in adult male patients and to evaluate the correlation between the width of the sutures and the maxilla expansion ratio. MATERIALS AND METHODS This retrospective study comprised 40 adult male patients treated with MARPE divided into a separation group (N = 20, mean age, 21.9 years) consisting of subjects with midpalatal suture opening and a nonseparation group (N = 20, mean age, 21.7 years) consisting of subjects with no midpalatal suture opening. Cone-beam computed tomography images were obtained before MARPE expansion for both groups and after expansion for the separation group. Vertical and horizontal skeletal relationships, palate length, and widths of 10 circummaxillary sutures before expansion were compared. The correlation between maxilla expansion ratio (jackscrew expansion to maxillary expansion ratio) and circummaxillary suture widths was also analyzed in the separation group. RESULTS There were no significant differences in age, vertical and horizontal skeletal relationships, and palate length between the two groups. Zygomaticomaxillary, pterygomaxillary, midpalatal, and transverse palatine sutures showed significantly greater width in the separation group (P < .05). The zygomaticomaxillary suture showed the greatest difference (Δ = 0.36 mm) between the groups. The zygomaticomaxillary and pterygomaxillary sutures showed significant positive correlation with the maxilla expansion ratio (P < .01). CONCLUSIONS In adult male patients, greater circummaxillary suture widths before MARPE expansion, especially zygomaticomaxillary and pterygomaxillary sutures, resulted in a better chance of successful suture separation and more maxillary expansion.
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Shayani A, Sandoval Vidal P, Garay Carrasco I, Merino Gerlach M. Midpalatal Suture Maturation Method for the Assessment of Maturation before Maxillary Expansion: A Systematic Review. Diagnostics (Basel) 2022; 12:diagnostics12112774. [PMID: 36428834 PMCID: PMC9689184 DOI: 10.3390/diagnostics12112774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Abstract
Assessment of midpalatal suture maturation is crucial before deciding which type of maxillary expansion technique will be performed to treat transverse discrepancies. In 2013, Angelieri et al. proposed a new method to evaluate midpalatal maturation using cone-beam computed tomography. The aim of this study was to systematically identify, evaluate, and provide a synthesis of the existing literature about this new method and to rigorously assess the methodological quality of these articles. A bibliographic search was carried out using PubMed, Cochrane Library, SciELO, LILACS, Web of Science, and Scopus using the terms midpalatal suture, cranial sutures, palate, maturation, interdigitation, ossification, maxillary expansion, evaluation, assessment, and assess. Quality assessment was performed using the Observational Cohort and Cross-Sectional Studies tool developed by the National Heart, Lung, and Blood Institute. Hence, 56 articles were obtained, of which only 10 met the selection criteria. We could not include any of the data into an analysis because of the large variation of the data collected and high methodological heterogeneity found among studies. Of all the studies included, 10% had poor quality, 70% fair, and 20% good quality, respectively. Even though age and sex play a role in midpalatal suture obliteration, there is a poor correlation between these variables. Thus, every patient should be assessed individually before choosing the best protocol for maxillary expansion. The midpalatal suture maturation method has the potential to be used for diagnostic purposes, but clinicians should be cautious of routinely using it because an extensive training and calibration program should be performed prior.
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Affiliation(s)
- Anis Shayani
- Master Program in Dental Science, Faculty of Dentistry, Universidad de la Frontera, Temuco 4780000, Chile
- School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Paulo Sandoval Vidal
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- Correspondence:
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Age, Sex, and Maxillary Position Are Associated with Successful Microimplant-Assisted Rapid Palatal Expansion in Adults. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the possible predictors of success of microimplant-assisted rapid palatal expansion (MARPE) in skeletally mature patients. Additionally, factors associated with the amount of maxillary expansion were analyzed. Factors associated with MARPE success were analyzed in 53 adult patients (27 males, 26 females, mean age 25.8 ± 8.9 years, and range 18.0 to 56.6 years) who had a maxillary transverse deficiency greater than 2 mm and a cervical vertebral maturation stage of 6. Age at pretreatment (T1), sex, sutural bone density at T1, type of appliance, mode of microimplant fixation, and lateral cephalometric variables at T1 were considered for inclusion as predictors for MARPE success. In patients who showed successful maxillary skeletal expansion, the linear distances of maxillary widths were measured on cone-beam-computed-tomography images at T1 and after MARPE (T2), and factors associated with the amount of expansion were analyzed. In total, 41 of the 53 patients showed successful maxillary expansion. Age (p = 0.019), sex (p = 0.002), and A-N perp (p = 0.015) were significantly associated with the success of MARPE. The factors associated with the amount of maxillary skeletal expansion were SN-MP and midpalatal-suture density at T1. In conclusion, there is a greater chance of failure in male patients who are older and have maxillary retrusion. A greater amount of maxillary expansion can be expected in patients with a higher mandibular-plane angle and with lower midpalatal-suture density.
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Siddhisaributr P, Khlongwanitchakul K, Anuwongnukroh N, Manopatanakul S, Viwattanatipa N. Effectiveness of miniscrew assisted rapid palatal expansion using cone beam computed tomography: A systematic review and meta-analysis. Korean J Orthod 2022; 52:182-200. [PMID: 35418520 PMCID: PMC9117794 DOI: 10.4041/kjod21.256] [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: 10/19/2021] [Accepted: 12/18/2021] [Indexed: 11/26/2022] Open
Abstract
Objective This study aims to examine the effectiveness of miniscrew assisted rapid palatal expansion (MARPE) treatment in late adolescents and adult patients using cone-beam computed tomography (CBCT). Methods Literature search was conducted in five electronic databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) based on the PICOS keyword design focusing on MARPE. Out of the 18 CBCT screened outcomes, only nine parameters were sufficient for the quantitative meta-analysis. The parameters were classified into three main groups 1) skeletal changes, 2) alveolar change, and 3) dental changes. Heterogeneity test, estimation of pooled means, publication bias, sensitivity analysis and risk of bias assessment were also performed. Results Upon database searching, only 14 full-text articles were qualified from the 364 obtained results. Heterogeneity test indicated the use of the random-effects model. The pooled mean estimate were as follows 1) Skeletal expansion zygomatic width, 2.39 mm; nasal width, 2.68 mm; jugular width, 3.12 mm; and midpalatal suture at the posterior nasal spine and anterior nasal spine, 3.34 mm and 4.56 mm, respectively; 2) Alveolar molar width expansion, 4.80 mm; and 3) Dental expansion inter-canine width, 3.96 mm; inter-premolar width, 4.99 mm and inter-molar width, 5.99 mm. The percentage of expansion demonstrated a skeletal expansion (PNS) of 55.76%, alveolar molar width expansion of 24.37% and dental expansion of 19.87%. Conclusions In the coronal view, the skeletal and dental expansion created by MARPE was of the pyramidal pattern. MARPE could successfully expand the constricted maxilla in late adolescents and adult patients.
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Affiliation(s)
| | | | - Niwat Anuwongnukroh
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Somchai Manopatanakul
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nita Viwattanatipa
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Savoldi F, Wong KK, Yeung AWK, Tsoi JKH, Gu M, Bornstein MM. Midpalatal suture maturation staging using cone beam computed tomography in patients aged between 9 to 21 years. Sci Rep 2022; 12:4318. [PMID: 35279692 PMCID: PMC8918350 DOI: 10.1038/s41598-022-08293-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/03/2022] [Indexed: 12/29/2022] Open
Abstract
Midpalatal suture was analysed with cone beam computed tomography to identify its maturation with respect to age and maxillary-complex growth in 72 patients 9- to 21-year-old. Maxillary-complex was divided in premaxillary, maxillary, and palatine segment. Interdigitation and ossification of midpalatal suture, its density relative to hard tissues and soft tissues, and midpalatal suture density ratio were measured for each segment. Correlation of each parameter with age and maxillary-complex length was analysed, and classification trees were developed for staging parameters. Midpalatal suture maturation stages (MPSMS, from A to E) were applied to assess relationship with age and maxillary-complex length. Regarding age, ossification increased in maxillary segment of males (rS = 0.39, p = 0.032), while suture density relative to soft tissues increased in maxillary (rS = 0.37, p = 0.042) and palatine segments (rS = 0.41, p = 0.027) of males and in palatine segment of females (rS = 0.32, p = 0.041). In males, suture density relative to soft tissues discriminated two age-stages (p = 0.024), and the same parameter (p = 0.023) paired with ossification (p = 0.027) discriminated two length-stages. MPSMS identified length-differences between stage A and B in females (p = 0.001). Midpalatal-suture ossification and its density relative to soft tissues showed some relationship with age and maxillary-complex length, especially in males. However, challenging staging and limitations in the imaging method may limit clinical applications.
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Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Ki Kwan Wong
- Department of Dentistry and Oral Health, La Trobe University, 109 Arnold St., Bendigo, VIC, 3550, Australia.,Oral and Maxillofacial Radiology, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Andy W K Yeung
- Oral and Maxillofacial Radiology, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - James K H Tsoi
- Dental Materials Science, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China.
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China. .,Department of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland.
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Ventura V, Botelho J, Machado V, Mascarenhas P, Pereira FD, Mendes JJ, Delgado AS, Pereira PM. Miniscrew-Assisted Rapid Palatal Expansion (MARPE): An Umbrella Review. J Clin Med 2022; 11:jcm11051287. [PMID: 35268377 PMCID: PMC8911209 DOI: 10.3390/jcm11051287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/09/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023] Open
Abstract
In postpubertal patients, maxillary transverse discrepancy is a common condition often requiring surgical approaches. To overcome the excess morbidity and discomfort, maxillary expansion through miniscrew-assisted rapid palatal expansion (MARPE) was proposed and studied in the last few years. This umbrella review aims to critically appraise the quality of evidence and the main clinical outcomes of available systematic reviews (SRs) on MARPE. An extensive search was carried out in five electronic databases (PubMed-Medline, Cochrane Database of SRs, Scielo, Web of Science, and LILACS) until December 2021. The methodological quality was appraised using the A Measurement Tool to Assess SRs criteria 2 (AMSTAR2). The primary outcome was the methodological quality of SRs. Overall, four SRs were included and analyzed, one of high methodological quality, one of low and two of critically low. Despite the verified methodological constraints, MARPE seems to present significant clinical changes when compared to conventional RPE, SARPE or controls and less adverse clinical outcomes. The quality of evidence produced by the available SRs was not favorable. Future high standard SRs and well-designed clinical trials are warranted to better clarify the clinical protocols and outcomes success of MARPE.
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Affiliation(s)
- Vanda Ventura
- Orthodontic Department, Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal; (F.D.P.); (A.S.D.); (P.M.P.)
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
- Correspondence:
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal
| | - Paulo Mascarenhas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal
| | - François Durand Pereira
- Orthodontic Department, Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal; (F.D.P.); (A.S.D.); (P.M.P.)
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
- Evidence-Based Hub, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal
| | - Ana Sintra Delgado
- Orthodontic Department, Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal; (F.D.P.); (A.S.D.); (P.M.P.)
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
| | - Pedro Mariano Pereira
- Orthodontic Department, Instituto Universitário Egas Moniz, 2829-511 Almada, Portugal; (F.D.P.); (A.S.D.); (P.M.P.)
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz–Cooperativa de Ensino Superior CRL, 2829-511 Almada, Portugal; (J.B.); (V.M.); (P.M.); (J.J.M.)
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Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults with the Dutch Maxillary Expansion Device: a prospective clinical cohort study. Clin Oral Investig 2022; 26:6253-6263. [PMID: 35731323 PMCID: PMC9525423 DOI: 10.1007/s00784-022-04577-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To provide a higher degree of evidence on the efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults, thereby applying the Dutch Maxillary Expansion Device (D-MED). MATERIALS AND METHODS D-MED was developed as an individualized, 3D-designed, and fabricated MARPE appliance supported by 4 palatal miniscrews. Patients from the age of 16 onwards with transverse maxillary deficiency were enrolled consecutively. Pre-expansion and immediate post-expansion CBCTs and intra-oral scans were acquired and measurements of skeletal, alveolar, and dental expansion as well as dental and periodontal side-effects were performed. RESULTS Thirty-four patients were enrolled (8 men, 26 women) with mean age 27.0 ± 9.4 years. A success rate of 94.1% was achieved (32/34 patients). The mean expansion duration, or mean observation time, was 31.7 ± 8.0 days. The mean expansion at the maxillary first molars (M1) and first premolars (P1) was 6.56 ± 1.70 mm and 4.19 ± 1.29 mm, respectively. The expansion was 60.4 ± 20.1% skeletal, 8.1 ± 27.6% alveolar, and 31.6 ± 20.1% dental at M1 and 92.2 ± 14.5% skeletal, 0.0 ± 18.6% alveolar, and 7.8 ± 17.7% dental at P1, which was both statistically (p < 0.001) and clinically significant. Buccal dental tipping (3.88 ± 3.92° M1; 2.29 ± 3.89° P1), clinical crown height increase (0.12 ± 0.31 mm M1; 0.04 ± 0.22 mm P1), and buccal bone thinning (- 0.31 ± 0.49 mm M1; - 0.01 ± 0.45 mm P1) were observed, while root resorption could not be evaluated. CONCLUSIONS MARPE by application of D-MED manifested its efficacy in a prospective clinical setting, delivering a high amount of skeletal expansion with limited side-effects in late adolescents and adults. CLINICAL RELEVANCE Higher quality evidence is supportive of MARPE as a safe and successful non-surgical treatment option for transverse maxillary deficiency.
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Minimally invasive surgical and miniscrew-assisted rapid palatal expansion (MISMARPE) in adult patients. J Craniomaxillofac Surg 2021; 50:211-217. [PMID: 34973887 DOI: 10.1016/j.jcms.2021.12.011] [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: 03/10/2021] [Revised: 10/08/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to evaluate maxillary expansion, operative time and pain associated with a new minimally invasive surgical technique to treat maxillary hypoplasia in adult patients. Consecutive patients were included and prospectively analyzed. The technique consists in miniscrew-assisted rapid palatal expansion (MARPE), minimally invasive approach to maxillary osteotomies, latency period and activation period until the desired expansion. The parameters evaluated included operative time, treatment-related pain by the visual analog scale (VAS), and transverse maxillary expansion. The Shapiro-Wilk test was used to assess the normality of data distribution. A paired t-test was used to compare the data between T0 (preoperative) and T1 (postoperative - end of activation). The significance level was set at 5%. Eleven patients were included. Mean operative time was 24.11 min (14.4-32 min) and overall postoperative VAS score was 2.81 (0-9). A comparative analysis showed significant increases in maxillary width at the skeletal, alveolar, and dental levels (p < 0.0001 for all), with a mean range of 1.8 (SD 0.3) mm to 4.7 (SD 0.5) mm. The present minimally invasive surgical MARPE (MISMARPE) technique appears to yield good skeletal outcomes with minimal trauma. It might have potential for clinical use, but larger comparative studies are needed to confirm the clinical relevance of the approach.
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Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol. Head Face Med 2021; 17:50. [PMID: 34895287 PMCID: PMC8665552 DOI: 10.1186/s13005-021-00301-2] [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: 06/04/2021] [Accepted: 11/13/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Bone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC). Methods This consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others. Results Successful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects’ complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019). Conclusions 1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%. 2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed. 3. Complications were significantly associated with age. 4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients. Trial registration Consecutive cohort study, Review Board No. EK-2-2014/0016.
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Jeon JY, Choi SH, Chung CJ, Lee KJ. The success and effectiveness of miniscrew-assisted rapid palatal expansion are age- and sex-dependent. Clin Oral Investig 2021; 26:2993-3003. [PMID: 34821980 PMCID: PMC8898235 DOI: 10.1007/s00784-021-04281-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to assess the success rate and the amount of suture separation after the miniscrew-assisted rapid palatal expansion (MARPE) procedure in relation to the chronological age and sex of the patients. MATERIALS AND METHODS The periapical radiographs of 215 subjects (95 male; 120 female; range, 6-60 years) who had undergone MARPE treatment were retrospectively analyzed. The success of suture separation was determined and, in suture-separated subjects, the amount of suture separation was evaluated by suture separation ratio calculated from the periapical radiograph obtained after active expansion. Association tests were performed using linear-by-linear association, the Jonckheere-Terpstra test, Fisher's exact test, and the Mann-Whitney U test, and linear regression models were also developed. RESULTS The success rate of suture separation was 61.05% in male, 94.17% in female, and 79.53% in both sexes. There was a statistically significant association between older age and suture nonseparation in male (p < 0.001), but not in female (p = 0.221). In suture-separated subjects, there was a statistically significant trend toward a low amount of suture separation with older age subgroups in both sexes (p < 0.001); however, there was no statistically significant difference in the amount of suture separation between male and female in all age subgroups. CONCLUSIONS Older patients treated with MARPE, particularly in male, may have a reduced likelihood of both success in suture separation and sufficient basal bone expansion. CLINICAL RELEVANCE This study demonstrates that clinicians should consider that the success rate of MARPE and the amount of suture separation may depend on chronological age and sex.
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Affiliation(s)
- Ji Yoon Jeon
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Chooryung Judi Chung
- Department of Orthodontics, Gangnam Severance Hospital, 211, Eonju-ro, Gangnam-gu, Seoul, Korea.,Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 06273, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Jesus ASD, Oliveira CBD, Murata WH, Suzuki SS, Santos-Pinto AD. Would midpalatal suture characteristics help to predict the success rate of miniscrew-assisted rapid palatal expansion? Am J Orthod Dentofacial Orthop 2021; 160:363-373. [PMID: 34175160 DOI: 10.1016/j.ajodo.2020.04.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate whether the success or failure of miniscrew-assisted rapid palatal expansion (MARPE) in patients with advanced bone maturation could be related to factors such as midpalatal suture density (MPSD), midpalatal maturation stage (MPSM), midpalatal bone thickness (MBTh), palatal length (PL), expander screw position (ESP), and patient's age. METHODS Cone-beam computed tomography scans of 25 patients of both sexes, aged 15-37 years (23 ± 7.2), presenting transverse maxillary deficiency and complete skeletal maturation (cervical vertebral maturation stage 5) treated using MARPE were evaluated. The success of MARPE was confirmed by the midpalatal suture opening and failure when no opening or limited separation of midpalatal suture occurred. Data were analyzed using t test for independent samples for differences in the variables of success and failure cases and the Pearson correlation test to evaluate the relation of the success and age, ESP, MPSD, MPSM, PL, and MBTh. RESULTS Age, MPSM, and MBTh at 12 mm and 16 mm presented statistically significant results (P <0.05). The older the patient with advanced bone maturation, the lower the success rates of MARPE (94.1%, 90%, and 76% for 25, 30, and 37 years, respectively). The ESP had similar averages in cases of success (15.34 mm) and failure (13.51 mm). There was no correlation between ESP, MPSD, MPSM, or PL and MARPE success. CONCLUSIONS MARPE success was related to age and a greater MBTh at 12 mm and 16 mm.
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Affiliation(s)
- Adriana Souza de Jesus
- Department of Orthodontics, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.
| | - Cibele Braga de Oliveira
- Department of Orthodontics, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Wilson Humio Murata
- Department of Orthodontics, São Leopoldo Mandic School and Dental Institute, Campinas, São Paulo, Brazil
| | - Selly Sayuri Suzuki
- Department of Orthodontics, São Leopoldo Mandic School and Dental Institute, Campinas, São Paulo, Brazil
| | - Ary Dos Santos-Pinto
- Department of Orthodontics, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
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Kapetanović A, Theodorou CI, Bergé SJ, Schols JGJH, Xi T. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. Eur J Orthod 2021; 43:313-323. [PMID: 33882127 PMCID: PMC8186837 DOI: 10.1093/ejo/cjab005] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its efficacy. Objectives This systematic review aims to evaluate the efficacy of MARPE in late adolescents and adults by assessing success rate and skeletal and dental transverse maxillary expansion, as well as treatment duration, dental and periodontal side effects and soft tissue effects. Search methods Seven electronic databases were searched (MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, ProQuest and ClinicalTrials.gov) without limitations in November 2020. Selection criteria Randomized and non-randomized clinical trials and observational studies on patients from the age of 16 onwards with transverse maxillary deficiency who were treated with MARPE and which included any of the predefined outcomes. Data collection and analysis Inclusion eligibility screening, data extraction and risk of bias assessment were performed independently in duplicate. When possible, exploratory meta-analyses of mean differences (MDs) with their 95% confidence intervals (CIs) were conducted, followed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis of the evidence quality. Results Eight articles were included: two prospective and six retrospective observational studies. One study had a moderate risk of bias, whereas seven studies had a serious risk of bias. GRADE quality of evidence was very low. MARPE showed a high success rate (mean: 92.5%; 95%CI: 88.7%–96.3%), resulting in a significant skeletal width increase (MD: 2.33 mm; 95%CI: 1.63 mm–3.03 mm) and dental intermolar width increase (MD: 6.55 mm; 95%CI: 5.50 mm–7.59 mm). A significant increase in dental tipping, a decrease in mean buccal bone thickness and buccal alveolar height, as well as nasal soft tissue change was present (P < 0.05). The mean duration of expansion ranged from 20 to 126 days. Limitations One of the main drawbacks was the lack of high-quality prospective studies in the literature. Conclusions and implications MARPE is a treatment modality that is associated with a high success rate in skeletal and dental maxillary expansion. MARPE can induce dental and periodontal side effects and affect peri-oral soft tissues. Given the serious risk of bias of the included studies, careful data interpretation is necessary and future research of higher quality is strongly recommended. Registration PROSPERO (CRD42020176618). Funding No grants or any other support funding were received.
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Affiliation(s)
- Aldin Kapetanović
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Orthodontics and Craniofacial Biology, Nijmegen, The Netherlands
| | | | - Stefaan J Bergé
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Oral and Maxillofacial Surgery, Nijmegen, The Netherlands
| | - Jan G J H Schols
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Orthodontics and Craniofacial Biology, Nijmegen, The Netherlands
| | - Tong Xi
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Oral and Maxillofacial Surgery, Nijmegen, The Netherlands
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21
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Oliveira CB, Ayub P, Angelieri F, Murata WH, Suzuki SS, Ravelli DB, Santos-Pinto A. Evaluation of factors related to the success of miniscrew-assisted rapid palatal expansion. Angle Orthod 2021; 91:187-194. [PMID: 33351888 DOI: 10.2319/051420-436.1] [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: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate whether the success of miniscrew-assisted rapid palatal expansion (MARPE), performed in patients with advanced bone maturation is related to factors such as midpalatal suture (MPS) maturation, age, sex, or bicortical mini-implant anchorage. MATERIALS AND METHODS Twenty-eight cone beam computed tomography (CBCT) scans of adults and post-pubertal adolescents treated by MARPE were included in the sample. CBCT images before (T0) and after expansion (T1) were used to evaluate the skeletal changes and the success or failure of MARPE. Axial images of MPS were extracted from T0 and classified into one of the five maturation stages. The correlation between MARPE success and the factors of age, sex, MPS maturation, and bicortical mini-implant anchorage was investigated. RESULTS Only the age showed a statistically significant negative correlation with MARPE success and all the skeletal measures. There was an 83.3% success rate among individuals aged 15 to 19 years, 81.8% from 20 to 29 years, and 20% from 30 to 37 years. MPS maturation showed a negative correlation with the expansion effect. Subjects with stages B or C of MPS maturation showed a 100% success rate, followed by stage D (62.5%) and stage E (58.3%). CONCLUSIONS As age increased, there was a decrease in MARPE success and the skeletal effects of maxillary expansion. Sex and bicortical mini-implant anchorage were not shown to be relevant factors. There was no correlation between MPS maturation and MARPE success; however, it was observed that all cases of MARPE failure were classified as stage D or E of MPS maturation.
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Jesus AS, Oliveira CB, Murata WH, Gonçales ES, Pereira-Filho VA, Santos-Pinto A. Nasomaxillary effects of miniscrew-assisted rapid palatal expansion and two surgically assisted rapid palatal expansion approaches. Int J Oral Maxillofac Surg 2021; 50:1059-1068. [PMID: 33478814 DOI: 10.1016/j.ijom.2020.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/18/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
This retrospective study was performed to evaluate nasomaxillary changes in 36 patients at an advanced stage of skeletal maturity who underwent miniscrew-assisted rapid palatal expansion (MARPE) or surgically assisted rapid palatal expansion (SARPE) with/without an alar base cinch. Cone beam computed tomography images taken before and after expansion were analysed. Changes in the width of the dental arch (D66S, D66I), maxillary base (MxMol), and nasal floor and nasal cavity in the molar and canine regions (NaFMol, NaFCan, NaCMol, NaCCan) were compared, as well as changes in the choanal aperture (CA) and nasal soft tissue (NW). The MARPE technique produced smaller dental changes (D66S; P=0.025) and greater nasomaxillary expansion (MxMol, P=0.010; NaCMol, P=0.016; NaCCan, P=0.017; NaFMol, P=0.001; CA, P=0.002) than both SARPE techniques. Changes in NW did not differ significantly between the groups (P=0.200). MARPE uniformly increased the anterior and posterior widths of the nasal cavity. SARPE expanded the nasal cavity in a 'V-shape' pattern. Changes in the nasal cavity and choanal aperture related to the amount of dental arch expansion were greater for MARPE than for SARPE. All three approaches increased the width of the nasal soft tissue, although the cinch in SARPE limited this increase.
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Affiliation(s)
- A S Jesus
- Department of Orthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil.
| | - C B Oliveira
- Department of Orthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
| | - W H Murata
- Department of Orthodontics, São Leopoldo Mandic School and Dental Institute, Campinas, SP, Brazil
| | - E S Gonçales
- Department of Stomatology, Bauru School of Dentistry, São Paulo University, Bauru, Brazil
| | - V A Pereira-Filho
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
| | - A Santos-Pinto
- Department of Orthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
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23
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Yu SK, Cho Y, Seo YS, Kim JS, Kim DK, Kim HJ. Radiological evaluation of the bone and soft tissue thicknesses of the palate for using a miniscrew-supported maxillary skeletal expander. Surg Radiol Anat 2021; 43:1001-1008. [PMID: 33386930 DOI: 10.1007/s00276-020-02634-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/19/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to determine the palatal bone and soft tissue thicknesses using a miniscrew-supported maxillary skeletal expander (MSE) in Class III malocclusion. METHODS The thicknesses of the palatal bone and soft tissue were measured in cone-beam computed tomography images obtained from 58 patients. All 20 points were crossing points between five levels, which were defined at 3 mm intervals relative to the line connecting the central fossae of the first molar (Level 0), and 2 mm and 4 mm lateral to the anteroposterior reference line (AP line). RESULTS The palatal bone was significantly thicker in males than females in the anterior palate up to Level 0, while there was no significant sex-related difference in the posterior palate. There was a tendency for the thickness to decrease in the posterior direction, except in females at 2 mm lateral to the AP line. The palatal soft tissue was significantly thicker in males than females in all positions. At 2 mm lateral to the AP line, the palatal soft tissue thickness decreased in the posterior direction. A 4 mm lateral to the AP line, it initially decreased in the posterior direction, and then increasing again at Level - 6 (6 mm posterior of Level 0). As the lateral distance from the AP line increased, the palatal bone thickness decreased while the palatal soft tissue thickness increased. CONCLUSIONS These findings provide quantitative data on the palatal bone and soft tissue thicknesses for the miniscrew-supported MSE in the posterior palate.
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Affiliation(s)
- Sun-Kyoung Yu
- Department of Anatomy and Orofacial Development, College of Dentistry, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Yonghwa Cho
- Department of Anatomy and Orofacial Development, College of Dentistry, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Yo-Seob Seo
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Gwangju, Korea
| | - Jae-Sung Kim
- The Institute of Dental Science, College of Dentistry, Chosun University, Gwangju, Korea
| | - Do Kyung Kim
- The Institute of Dental Science, College of Dentistry, Chosun University, Gwangju, Korea
| | - Heung-Joong Kim
- Department of Anatomy and Orofacial Development, College of Dentistry, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea.
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Baik HS, Kang YG, Choi YJ. Miniscrew-assisted rapid palatal expansion: A review of recent reports. J World Fed Orthod 2020; 9:S54-S58. [PMID: 33023733 DOI: 10.1016/j.ejwf.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/12/2020] [Indexed: 10/23/2022]
Abstract
The miniscrew-assisted rapid palatal expander (MARPE) has extended not only skeletal effects with fewer dental changes and but also the age limit of nonsurgical maxillary expansion treatment. Amid its gaining popularity in clinical orthodontics, our current understanding of treatment effectiveness, efficiency, and stability needs to be reassessed. In this review article, the authors have attempted to evaluate MARPE from various aspects with a focus on recent studies.
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Affiliation(s)
- Hyoung-Seon Baik
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Yoon-Goo Kang
- Department of Orthodontics, Kyung Hee University, Seoul, Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
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25
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Ahn YS, Choi SH, Lee KJ, Jung YS, Baik HS, Yu HS. Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion. Korean J Orthod 2020; 50:304-313. [PMID: 32938823 PMCID: PMC7500573 DOI: 10.4041/kjod.2020.50.5.304] [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: 03/05/2020] [Revised: 04/03/2020] [Accepted: 04/25/2020] [Indexed: 01/02/2023] Open
Abstract
Objective The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.
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Affiliation(s)
- Yoon-Soo Ahn
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.,BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Young-Soo Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyoung-Seon Baik
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
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26
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Li J, Yu T, Yan H, Qiao Y, Wang L, Zhang T, Li Q, Zhou Y, Liu D. T cells participate in bone remodeling during the rapid palatal expansion. FASEB J 2020; 34:15327-15337. [PMID: 32951236 DOI: 10.1096/fj.202001078r] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/02/2020] [Accepted: 09/09/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Jing Li
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Ting‐Ting Yu
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Hui‐Chun Yan
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Yi‐Qiang Qiao
- Department of Stomatology The First Affiliated Hospital of Zhengzhou University Zhengzhou China
| | - Lin‐Chuan Wang
- Eastman Institute for Oral HealthUniversity of Rochester Rochester NY USA
| | - Ting Zhang
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Qian Li
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Yan‐Heng Zhou
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Da‐Wei Liu
- Department of Orthodontics Peking University School and Hospital of Stomatology Beijing China
- National Clinical Research Center for Oral DiseasesNational Engineering Laboratory for Digital and Material Technology of Stomatology Beijing China
- Beijing Key Laboratory of Digital Stomatology Beijing China
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