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Takagi T, Tanaka E. An adult case of unilateral posterior crossbite caused by maxillary transverse deficiency treated with miniscrew-assisted rapid palatal expansion. J Stomatol Oral Maxillofac Surg 2023; 124:101443. [PMID: 36933657 DOI: 10.1016/j.jormas.2023.101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/18/2023]
Abstract
This report describes the successful treatment of an adult case of unilateral posterior crossbite caused by maxillary transverse deficiency with miniscrew-assisted rapid palatal expansion (MARPE). A female patient aged 35.5 years presented with masticatory disturbance, facial asymmetry, and unilateral posterior crossbite. She was diagnosed with unilateral posterior crossbite with a skeletal Class III jaw-base relationship and high mandibular plane angle. Her maxillary right and mandibular bilateral second premolars were congenitally absent, and the maxillary left second premolar was impacted. After the improvement of the posterior crossbite with MARPE, 0.018″ slot lingual brackets were placed on the maxillary and mandibular dentition. The total active treatment period was 22 months, and acceptable occlusion with a functional Class I relationship was achieved. Pretreatment and posttreatment cone-beam computed tomography images showed the disarticulation of the midpalatal suture after MARPE, and changes in the dental and nasomaxillary structures, nasal cavity, and pharyngeal airway. The case results demonstrate that MARPE produces greater skeletal expansion with minimal buccal tipping of the molars. MARPE may be effective for the treatment of maxillary transverse deficiency in adult patients.
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Affiliation(s)
- Toyoaki Takagi
- Takagi Orthodontic Office, Pastral Takarazuka Bldg. 2F 2-5 Mukogawa-cho Takarazuka City, Hyogo 665-0844, Japan
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan.
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Echarri-Nicolás J, González-Olmo MJ, Echarri-Labiondo P, Romero M. Short-term outcomes in the upper airway with tooth-bone-borne vs bone-borne rapid maxillary expanders. BMC Oral Health 2023; 23:714. [PMID: 37794400 PMCID: PMC10552363 DOI: 10.1186/s12903-023-03461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND This study compared the area and minimal section of the nasal cavity, nasopharynx, oropharynx, and hypopharynx in cases treated with different methods of microimplant-assisted expansion. METHODS Based on a pilot study to calculate the sample size, 30 patients with transverse maxillary deficiency over 14 years of age were retrospectively selected. These patients had received two different types of microimplant-assisted maxillary expansion treatment (MARPE and BAME). The patient underwent Cone-Beam computed tomography (CBCT) before and after treatment (mean time 1.5 months) with MARPE or BAME and upper airway measurements (volume and minimum cross-sectional area) were taken to assess upper airways changes and compare changes between the groups. A paired sample t-test was performed to evaluate the T0-T1 change of airway measurements obtained with MARPE and BAME, and a student t-test to compare changes in airway measurements between MARPE and BAME. RESULTS This investigation shows a statistically significant increase in total nasopharyngeal airway volume (0.59 ± 1.42 cm3; p < 0.01), total oropharyngeal airway volume (3.83 ± 7.53 cm3; p < 0.01) and minimum oropharyngeal cross-section (53.23 ± 126.46 mm2; p < 0.05) in all cases treated with micro-screw assisted expansion. The minimal cross-sectional area of the oropharynx ((79.12 ± 142.28 mm2; p < 0.05) and hypopharynx (59.87 ± 89.79 mm2; p < 0.05) showed significant changes for cases treated with BAME. As for the comparison between cases treated with MARPE and BAME, no differences in upper airway changes have been observed, except for the minimum cross-sectional area of the nasal cavity, which increases for MARPE (52.05 ± 132.91 mm2) and decreases for BAME (-34.10 ± 90.85 mm2). CONCLUSIONS A significant increase in total area and minimal section at the level of nasopharynx and oropharynx was observed in cases treated with BAME. Regarding the comparison of MARPE and BAME treatments, no differences were found in the total airway volume and minimal section in upper airway except for the minimum cross section of the nasal cavity that increases for MARPE and decreases for BAME.
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Affiliation(s)
- Javier Echarri-Nicolás
- Doctoral Program in Health Sciences, International PhD School, Rey Juan Carlos University (URJC), Madrid, Spain
| | - María José González-Olmo
- Department of Orthodontics, University Rey Juan Carlos, Avda de Atenas S/N 28922, Alcorcón, Madrid, Spain.
| | | | - Martin Romero
- Department of Orthodontics, University Rey Juan Carlos, Avda de Atenas S/N 28922, Alcorcón, Madrid, Spain
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Ma T, Wang YH, Zhang CX, Liu DX. A novel maxillary transverse deficiency diagnostic method based on ideal teeth position. BMC Oral Health 2023; 23:82. [PMID: 36750809 PMCID: PMC9906842 DOI: 10.1186/s12903-023-02790-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND This study proposed a novel maxillary transverse deficiency diagnostic method and evaluated the skeletal Class I and the mild skeletal Class III groups. METHODS Pre-treatment data from 30 mild skeletal Class III and 30 skeletal Class I patients were collected and uploaded to the Emeiqi Case Management System to design the ideal teeth positions. On these positions, the first bi-molars width was measured at the central fossa and center resistance, the maxillary first bi-premolars width was measured at the central fossa, and the mandibular first bi-premolars width was measured at the distal contact point by Mimics, then width differences of two groups were calculated respectively. RESULTS At ideal teeth positions, there was no statistically significant difference in the maxillomandibular width in the premolar area between the two groups, but there was in the molar area, and this difference was caused by the difference in mandible width between the two groups. CONCLUSIONS We proposed a new transverse diagnostic method and found that even the Class I group was not quite up to standard in the molar area on ideal teeth positions, and the Class III group had more severe maxillary transverse deficiency than the Class I group. Meanwhile, the maxillary transverse deficiency in the Class III group was mainly caused by the larger width of the mandible.
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Affiliation(s)
- Ting Ma
- grid.27255.370000 0004 1761 1174Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, Jinan, 250012 Shandong China
| | - Yan-hai Wang
- Jinan Nursing Vocational College, No. 3636 Gangxi Road, Licheng District, Jinan, 250000 Shandong China
| | - Chun-xi Zhang
- grid.415468.a0000 0004 1761 4893Center of Oral Medicine, Qingdao Municipal Hospital, No. 1 Jiaozhou Road, Qingdao, 266011 Shandong China
| | - Dong-xu Liu
- grid.27255.370000 0004 1761 1174Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, No.44-1 Wenhua Road West, Jinan, 250012 Shandong China
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Chen J, Xu Y, Li C, Zhang L, Yi F, Lu Y. Displacement and stress distribution of the craniomaxillofacial complex under different surgical conditions: a three-dimensional finite element analysis of fracture mechanics. BMC Oral Health 2021; 21:596. [PMID: 34809636 PMCID: PMC8607715 DOI: 10.1186/s12903-021-01941-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To provide a simplified treatment strategy for patients with maxillary transverse deficiency. We investigated and compared the fracture mechanics and stress distribution of a midline palatal suture under dynamic loads during surgically-assisted rapid palatal expansion. Methods Based on the cone-beam computed tomography (CBCT) data of a 21-year-old female volunteer, a three-dimensional model of the cranio-maxillofacial complex (including the palatal suture) was constructed. A finite element analysis model was constructed based on meshwork. After the yield strength of the palatal suture was set, an increasing expansion force (0–500 N) was applied within 140 ms to calculate the time–load curve, which mimicked nonsurgical bone expansion (model A). The same method was used to evaluate the fracture process, time and stress distribution of the palatal suture in maxillary lateral osteotomy-assisted (model B) and LeFort osteomy I (LFIO)-assisted expansion of the maxillary arch (model C).
Results Compared with model A, the palatal suture of model B and model C showed a faster stress accumulation rate and shorter fracture time, and the fracture time of model B and model C was almost identical. Compared with model A, we discovered that model B and model C showed greater lateral extension of the maxilla, and the difference was reflected mainly in the lower part of the maxilla, and there was no difference between model B and model C in lateral extension of the maxilla. Conclusions Compared with arch expansion using nonsurgical assistance (model A), arch expansion using maxillary lateral wall-osteotomy (model B) or LFIO had a faster rate of stress accumulation, shorter time of fracture of the palatal suture and increased lateral displacement of the maxilla. Compared with arch expansion using LFIO (model C), arch expansion using lateral osteotomy (model B) had a similar duration of palatal suture rupture and lateral maxillary extension. In view of the trauma and serious complications associated with LFIO, maxillary lateral wall-osteotomy could be considered a substitute for LFIO.
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Affiliation(s)
- Junjie Chen
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Yuhan Xu
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Chengri Li
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Lingling Zhang
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Fang Yi
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Yanqin Lu
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China.
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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] [What about the content of this article? (0)] [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.
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Abstract
Maxillary transverse deficiency is one of the critical manifestations of malocclusion. It is of vital importance to diagnose maxillary transverse deficiency at the early stage because maxillary development in the transverse dimension stops early. Currently, there are several approaches to diagnose maxillary transverse deficiency, including clinical examination, dental cast measurement, poster-anterior cephalogram, and cone-beam CT. This narrative review will review these diagnostic and predictive approaches of maxillary transverse deficiency.
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Affiliation(s)
- Y W Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine Ministry of Education, School of Stomatology, Wuhan University, Wuhan 430079, China
| | - H He
- Department of Orthodontics Division 1, School of Stomatology, Wuhan University, Wuhan 430079, China
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Ugolini A, Cerruto C, Fastuca R, Giuntini V, Doldo T, Silvestrini-Biavati A, Caprioglio A. Upper canine response to rapid maxillary expander anchored to deciduous vs. permanent molars. J Orofac Orthop 2020; 81:220-5. [PMID: 32266438 DOI: 10.1007/s00056-020-00222-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To understand whether two different designs of Haas-type rapid maxillary expander (H‑RME) might have a different influence on canine eruption. PATIENTS AND METHODS In all, 108 subjects seeking orthodontic treatment were selected and divided into two groups-H‑RME with bands on the upper second deciduous molars (GrE), H‑RME with bands on the upper first permanent molars (Gr6)-and were also compared to an historical untreated control group (CG) of 29 subjects. Panoramic x‑rays (OPG) were performed before and after RME (T0-T1: 16 ± 7 months) and the upper canine angulation to the midline ("α" angle) was measured on both pre- and posttreatment OPG. RESULTS A significant improvement of the canine position (decrease of the α angle) following RME in subjects with mixed dentition was reported in both treated groups, although the different design of the RME did not significantly affect canine angulation. Canine angulation in untreated subjects with transversal discrepancy did not improve significantly. CONCLUSION Using RME in the early mixed dentition appears to be an effective procedure to increase the rate of eruption of maxillary canines, but the position of the bands on the upper second deciduous molars or on the upper first permanent molars and the significant different expansion of the upper dental arch at the canine level does not significantly influence the canine angulation following early treatment therapy.
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Leyder P, Altounian G, Quilichini J. Adjustable selective maxillary expansion combined with one-stage maxillomandibular surgery: A prospective study of osseous widening in fifty-five consecutive patients. J Craniomaxillofac Surg 2018; 46:1408-1420. [PMID: 30001885 DOI: 10.1016/j.jcms.2018.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/29/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE SARME is often considered to be the only available treatment for significant or severe maxillary transverse palatal deficiencies (MTD) in skeletally-mature patients. Despite this observation, the aim of our study was to assess a new type of maxilla distraction osteogenesis. Using two innovative tools, we performed selective expansion: the site to be widened and the amount of increase were both pre-selected. Patients were treated in a single maxillomandibular procedure. Our study focuses primarily on the extent of osseous widening. STUDY DESIGN Post-expansion computed tomography data from 55 non-syndromic patients were included in a prospective study and analyzed in two planes for transverse skeletal widening. Of the 55 patients, 16 underwent isolated posterior distraction for severe posterior endognathia (group I), and 39 were treated in both segments (group II). Diastemas and anterior spaces permitted resolution of crowding and patients with a small, narrow, tapering arch were given a more rounded form. All patients underwent a complete Le Fort I with down fracture. Two novel devices were used: first, an adjustable distractor to achieve an angular opening; and secondly, in group II, new modular plates interlocked for osteosynthesis to provide stability and anterior expansion. RESULTS In group I, analysis of the width of the gain showed significant posterior values decreasing from back to front, a result never achieved with the SARME procedure. The mean osseous gain at first molars was 7.1 mm. When anterior space was required in group II, it was created as wide as needed (mean 4.2 mm, at canine level) with good preservation of the 1st molar space gain (mean 6.8 mm). CONCLUSION Total Le Fort I osteotomy associated with two innovative devices provides a new, segmental and adaptable approach for transverse distraction osteogenesis. We demonstrate a good match with the dental enlargement required. All patients were managed in a single orthognathic procedure for all the anomalies to be treated. Long-term results show good stability.
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Affiliation(s)
- Patrick Leyder
- Department of Maxillofacial and Plastic Surgery, Robert Ballanger Hospital, Aulnay-sous-Bois, France
| | - Gérard Altounian
- Orthodontic Private Practice and Lingual Orthodontics, Enghien-les-Bains, Paris V University Since 1996, France
| | - Julien Quilichini
- Department of Maxillofacial and Plastic Surgery, Robert Ballanger Hospital, Aulnay-sous-Bois, France; HUPSSD, CHU avicenne, APHP Bobigny France, France.
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Moawad SG, Bouserhal J, Al-Munajed MK. Assessment of the efficiency of Erbium-YAG laser as an assistant method to rapid maxillary expansion: An in vivo study. Int Orthod 2016; 14:462-475. [PMID: 27856377 DOI: 10.1016/j.ortho.2016.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Maxillary transverse deficiency (MTD) is one of the most pervasive and common skeletal problems in the craniofacial complex. This study aimed to evaluate the effect of associating the application of Erbium-YAG laser with rapid maxillary expansion (RME) for treating MTD in young adult patients with permanent dentition in regard to skeletal and dental effects. METHODS Twenty-four subjects, aged from 15.5 to 19 years and needing RME as a therapeutic procedure, were randomly assigned to either the laser group (n=12) or the control group (n=12). The RME was realized by a two bands hyrax expander cemented on upper first molars. Patients in the laser group were undergone mucosal-bony perforations along the midpalatal suture every month, for three consecutive months, using Erbium-YAG laser. Postero-anterior cephalograms were taken for all patients. Skeletal and dental changes before and after RPE as well as at the end of the retention phase were collected and compared for both groups. Total time needed for expansion and retention were recorded and compared. RESULTS The findings showed more significant changes in most maxillofacial components in the laser group after the expansion phase. However, there was no significant differences with respect to retention or total treatment duration. CONCLUSIONS Laser assisted rapid maxillary expansion (LARME) can be a good approach to use for improving skeletal effects in young adult patients suffering from MTD.
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Affiliation(s)
- Shadi George Moawad
- Department of Orthodontics, Faculty of Dentistry, Tishreen University, Lattakia, Syria.
| | - Joseph Bouserhal
- Department of Orthodontics, School of Dental Medicine, Saint-Joseph University, Beirut, Lebanon; Department of Orthodontics, School of Dentistry, Beirut Arab University, Beirut, Lebanon; Department of Orthodontics and Dentofacial Orthopedics, Goldman School of Dental Medicine, Boston University, Boston, USA
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Sawchuk D, Currie K, Vich ML, Palomo JM, Flores-Mir C. Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review. Korean J Orthod 2016; 46:331-42. [PMID: 27668196 PMCID: PMC5033772 DOI: 10.4041/kjod.2016.46.5.331] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/29/2016] [Accepted: 03/15/2016] [Indexed: 12/03/2022] Open
Abstract
Objective To evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies. Methods An electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2. Results Nine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies. Conclusions Current evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority.
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Affiliation(s)
- Dena Sawchuk
- Department of Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kris Currie
- Department of Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Manuel Lagravere Vich
- Department of Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Carlos Flores-Mir
- Department of Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
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Ballanti F, Baldini A, Ranieri S, Nota A, Cozza P. Is there a correlation between nasal septum deviation and maxillary transversal deficiency? A retrospective study on prepubertal subjects. Int J Pediatr Otorhinolaryngol 2016; 83:109-12. [PMID: 26968064 DOI: 10.1016/j.ijporl.2016.01.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/26/2016] [Accepted: 01/31/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Deviated nasal septum may cause a reduction of the nasal airflow, thus, during the craniofacial development, a reduced nasal airflow could originate a chronic mouth-breathing pattern, related with moderate to severe maxillary constriction. The aim of this retrospective study is to analyze the correlation between maxillary transverse deficiency and nasal septum deviation. METHODS Frontal cephalograms were performed on 66 posterior-anterior radiographs of subjects (34M, 32F; mean age 9.95±2.50 years) with maxillary transverse deficiency and on a control group of 31 posterior-anterior radiographs of subjects (13M, 18F; 9.29±2.08 years). Angular parameters of the nasal cavities were recorded and compared between the two groups using a Student's t-test. RESULTS Generally all the parameters are very similar between the two groups except for the ASY angle that differs for about the 27%; anyway the Student's t-test showed no statistically significant differences between the two groups (mostly p>0.20). CONCLUSIONS This study failed to show an association between transverse maxillary deficiencies and nasal septum deviations. Moreover, no significant differences were found between the mean nasal cavities dimensions in subjects with transverse maxillary deficiency and the control group.
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Affiliation(s)
- Fabiana Ballanti
- Department of Orthodontics, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy.
| | - Alberto Baldini
- Department of Orthodontics, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy.
| | - Salvatore Ranieri
- Department of Orthodontics, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy.
| | - Alessandro Nota
- Department of Orthodontics, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy.
| | - Paola Cozza
- Department of Orthodontics, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy.
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Leyder P, Altounian G, Chardain J, Quilichini J. Adjustable selective maxillary expansion combined with maxillomandibular surgery: A case report. Int Orthod 2015; 13:320-31. [PMID: 26277457 DOI: 10.1016/j.ortho.2015.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Surgically assisted rapid maxillary expansion (SARME) is usually considered the gold standard for maxillary transverse expansion in adults. However, a second surgical procedure is needed in cases of associated sagittal or vertical discrepancies. We describe the use of two new innovative devices for the correction of discrepancies in all dimensions during a single surgical procedure, thus reducing treatment duration. MATERIAL We report the case of a 21-year-old female patient, referred to our department for skeletal Class III malocclusion associated with right-side laterognathism and transverse maxillary deficiency. The patient underwent one-stage surgery, using sliding osteosynthesis plates and an adjustable bone-borne distractor. Pre-surgical orthodontics consisted in leveling and aligning the mandibular arch; maxillary leveling was initiated 3 months before surgery. Postoperative palatal distraction combined with orthodontic finishing enabled complete correction of dental and bony discrepancies after 3 months. CONCLUSION In our experience, treatment of transverse, sagittal and vertical discrepancies has been possible in a single surgical procedure, using two innovative techniques: sliding osteosynthesis and an adjustable bone distractor. Two years post-surgery, the correction is stable in all dimensions.
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Affiliation(s)
- Patrick Leyder
- Department of maxillofacial and plastic surgery, Robert-Ballanger Hospital, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois, France.
| | - Gérard Altounian
- Private practice, 2, rue Malleville, 95880 Enghien-Les-Bains, France
| | - Jacques Chardain
- Department of maxillofacial and plastic surgery, Robert-Ballanger Hospital, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois, France
| | - Julien Quilichini
- Department of maxillofacial and plastic surgery, Robert-Ballanger Hospital, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois, France
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Lee HW, Kim SJ, Kwon YD. Salvage rapid maxillary expansion for the relapse of maxillary transverse expansion after Le Fort I with parasagittal osteotomy. J Korean Assoc Oral Maxillofac Surg 2015; 41:97-101. [PMID: 25922822 PMCID: PMC4411735 DOI: 10.5125/jkaoms.2015.41.2.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/10/2015] [Accepted: 01/13/2015] [Indexed: 11/07/2022] Open
Abstract
Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case.
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Affiliation(s)
- Hyun-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
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