1
|
Leonardi R, Ronsivalle V, Isola G, Cicciù M, Lagravère M, Flores-Mir C, Lo Giudice A. External root resorption and rapid maxillary expansion in the short-term: a CBCT comparative study between tooth-borne and bone-borne appliances, using 3D imaging digital technology. BMC Oral Health 2023; 23:558. [PMID: 37573295 PMCID: PMC10422725 DOI: 10.1186/s12903-023-03280-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND The aim of the study was to analyze and compare external root resorption (ERR) in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). METHODS The sample included 40 subjects who received tooth-borne RME (TB group, average age: 13.1 ± 1.08 years) or bone-borne RME (BB group, average age: 14.5 ± 1.11 years) and Cone-beam computed tomography (CBCT) scans before treatment (T0) and after 3-month of retention (T1). A specific 3D Imaging technology was used to generate 3D models of posterior dentition (M1 = maxillary first molars, P2 = second premolars, P1 = first premolar) and calculate volumetric data (mean and percentage values) and shape changes, the latter obtained from deviation analysis between the radicular models at different time points. Evaluation of radicular length changes was performed for each tooth. Data were statistically analysed to perform intra-timing and inter-groups comparisons. RESULTS A significant reduction of radicular volume and length was found in posterior dentition in both groups (p < 0.05), and the M1 (volume) and its palatal root (length) were mostly involved in this response. No differences were found between M1, P1 and P2 (p > 0.05) when volumetric changes were calculated as percentage of the total volume. Deviation analysis revealed that the radicular areas mostly affected by shape change were the apex and bucco-medial side. The amount of ERR was significantly greater in TB group compared to BB group. CONCLUSIONS BB-RME treatment could reduce the amount of ERR at the post-expansion stage.
Collapse
Affiliation(s)
- Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Periodontology, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Catania, Italy
| | - Manuel Lagravère
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB, Canada
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy.
| |
Collapse
|
2
|
Altuhafy M, Jabr L, Michelogiannakis D, Khan J. Self-perceived pain in Hyrax versus other maxillary expansion orthodontic appliances: a systematic review of clinical studies. Eur Arch Paediatr Dent 2023; 24:279-292. [PMID: 37022607 DOI: 10.1007/s40368-023-00795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/19/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE To evaluate self-perceived pain levels in the Hyrax compared to other types of maxillary expansion (ME) appliances in growing patients. METHODS An unrestricted search of indexed databases and manual searching were performed up to October 2022. Randomized controlled trials (RCTs) comparing the Hyrax appliance with other ME appliances were included. Data screening, extraction, and Risk of Bias (RoB) assessment with the Cochrane tool were performed by two authors. RESULTS Six RCTs were included. The number of participants in the included RCTs ranged between 34 to 114 and included both male and female growing patients. Various tools were used to measure self-perceived pain including the Graphic Rating Scale for Pain, the Wong-Baker Faces Pain Scale, the Numerical Rating Scale, the visual analogue scale, and a questionnaire. One RCT reported that pain intensity in patients treated with the Hyrax was higher than in the Haas appliance, with a statistically significant difference limited to the first day. Two RCTs reported that pain intensity in patients treated with the Leaf expander was lower than in the Hyrax during the first 7 days of treatment. Two RCTs reported no significant differences in pain intensity between the Hyrax and other ME appliances. One RCT reported that pain intensity in patients using the computer-guided skeletal ME appliance was higher than in the Hyrax appliance at the first day after expansion. Four RCTs had a high RoB, and two RCTs had a moderate RoB. CONCLUSIONS Within the limitations of the present systematic review and based on the currently available evidence, it is challenging and inconclusive to identify the best maxillary expansion appliances, regarding pain levels for growing patients.
Collapse
Affiliation(s)
- M Altuhafy
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY, 14620, USA.
| | - L Jabr
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY, USA
| | - D Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY, USA
| | - J Khan
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY, 14620, USA
| |
Collapse
|
3
|
Barone M, De Stefani A, Cavallari F, Gracco A, Bruno G. Pain during Rapid Maxillary Expansion: A Systematic Review. CHILDREN 2023; 10:children10040666. [PMID: 37189916 DOI: 10.3390/children10040666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
Aim: The aim of the present systematic review is to evaluate the pain perceived by patients during rapid maxillary expansion (RME) in relation to factors such as demographic characteristics, appliance type, activation protocol, and the eventual use of medication or pain management strategies. Materials and methods: An electronic search of available articles on the subject was conducted on three electronic databases, using predefined keywords. Sequential screenings based on pre-established eligibility criteria were performed. Results: Ten studies were ultimately included in this systematic review. The main data of the reviewed studies were extracted according to the PICOS approach. Conclusions: Pain is a common effect of RME treatment that tends to decrease over time. Gender and age differences in pain perception are not clear. Perceived pain is influenced by the expander design and expansion protocol used. Some pain management strategies can be useful for reducing RME-associated pain.
Collapse
|
4
|
Wilmes B, Drescher D. CAD-CAM workflows for palatal TAD anchored appliances. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
5
|
Leonardi R, Ronsivalle V, Barbato E, Lagravère M, Flores-Mir C, Lo Giudice A. External root resorption (ERR) and rapid maxillary expansion (RME) at post-retention stage: a comparison between tooth-borne and bone-borne RME. Prog Orthod 2022; 23:45. [PMID: 36464753 PMCID: PMC9719874 DOI: 10.1186/s40510-022-00439-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/29/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The study aimed to compare external root resorption (ERR) three-dimensionally in subjects treated with tooth-borne (TB) versus bone-borne (BB) rapid maxillary expansion (RME). Forty subjects who received tooth-borne RME (TB group, average age 13.3 years ± 1.10 years) or bone-borne RME (BB group, average age 14.7 ± 1.15 years) were assessed using CBCT imaging before treatment (T0) and after a 6-month retention period (T1). 3D reconstructions of the radicular anatomy of maxillary first molars (M1), first and second premolars (P1 and P2) were generated to calculate volumetric (mean and percentage values) and shape changes (deviation analysis of the radicular models) obtained at each time point. 2D assessment of radicular length changes was also performed for each tooth. Data were statistically analyzed to perform intra-group (different teeth) and inter-group comparisons. RESULTS In both groups, all the investigated teeth showed a significant reduction in radicular volume and length (p < 0.05), with the first molars being the teeth most affected by the resorption process (volume and palatal root length). When volumetric radicular changes were calculated as a percentage of the pre-treatment volumes, no differences were found among the investigated teeth (p > 0.05). Based on the deviation analysis from radicular models superimposition, the areas most affected by shape change were the apex and bucco-medial root surface. Overall, the amount of ERR was significantly greater in the TB group (mm3: M1 = 17.03, P1 = 6.42, P2 = 5.26) compared to the BB group (mm3: M1 = 3.11, P1 = 1.04, P2 = 1.24). CONCLUSIONS Despite the statistical significance, the difference in the amount of ERR of the posterior maxillary dentition between TB-RME and BB-RME remains clinically questionable.
Collapse
Affiliation(s)
- Rosalia Leonardi
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Ersilia Barbato
- grid.7841.aDepartment of Oral and Maxillofacial Sciences, School of Dentistry, “Sapienza” University of Rome, Rome, Italy
| | - Manuel Lagravère
- grid.17089.370000 0001 2190 316XOrthodontic Graduate Program, University of Alberta, Edmonton, AB Canada
| | - Carlos Flores-Mir
- grid.17089.370000 0001 2190 316XOrthodontic Graduate Program, University of Alberta, Edmonton, AB Canada
| | - Antonino Lo Giudice
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| |
Collapse
|
6
|
Investigation of the role of midpalatal and circummaxillary sutures in bone-anchored rapid maxillary expansion using a verified finite-element model. Am J Orthod Dentofacial Orthop 2022. [DOI: 10.1016/j.ajodo.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
Solano Mendoza P, Aceytuno Poch P, Solano Reina E, Solano Mendoza B. Skeletal, Dentoalveolar and Dental Changes after "Mini-Screw Assisted Rapid Palatal Expansion" Evaluated with Cone Beam Computed Tomography. J Clin Med 2022; 11:jcm11164652. [PMID: 36012886 PMCID: PMC9410327 DOI: 10.3390/jcm11164652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate skeletal, dentoalveolar and dental changes after Mini-screw Assisted Rapid Palatal Expansion (MARPE) using tooth bone-borne expanders in adolescent patients after analyzing different craniofacial references by Cone beam computed tomography (CBCT) and digital model analysis. This prospective, non-controlled intervention study was conducted on fifteen subjects (mean age 17 ± 4 years) with transversal maxillary deficiency. Pre (T1) and post-expansion (T2) CBCTs and casts were taken to evaluate changes at the premolars and first molar areas. To compare means between two times, paired samples t- or Wilcoxon test were used following criteria. Significant skeletal changes were found after treatment for Nasal width and Maxillary width with means of 2.1 (1.1) mm and 2.5 (1.6) mm (p < 0.00005). Midpalatal suture showed a tendency of parallel suture opening in the axial and coronal view. For dentoalveolar changes, a significant but small buccal bone thickness (BBT) reduction was observed in all teeth with a mean reduction of 0.3 mm for the right and left sides, especially for the distobuccal root of the first molar on the left side (DBBTL1M) [IC95%: (−0.6; −0.2); p = 0.001] with 0.4 (0.4) mm. However, a significant augmentation was observed for the palatal bone thickness (PBT) on the left side. The buccal alveolar crest (BACL) and dental inclination (DI) showed no significant changes after treatment in all the evaluated teeth. MARPE using tooth bone-borne appliances can achieve successful skeletal transverse maxillary expansion in adolescent patients, observing small dentoalveolar changes as buccal bone thickness (BBT) reduction, which was not clinically detectable. Most maxillary expansions derived from skeletal expansion, keeping the alveolar bone almost intact with minor buccal dental tipping.
Collapse
|
8
|
Wilmes B. “Appliance First” or “Bone First” for miniscrew assisted rapid palatal expansion? APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_57_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
9
|
Mehta S, Wang D, Upadhyay M, Vich ML, Yadav S. Long-term effects on alveolar bone with bone-anchored and tooth-anchored rapid palatal expansion. Am J Orthod Dentofacial Orthop 2022; 161:519-528. [PMID: 35272886 DOI: 10.1016/j.ajodo.2020.10.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the long-term effects of bone-anchored and tooth-anchored expansion appliances on alveolar bone in vertical and horizontal dimensions, compared with controls, using cone-beam computed tomography. METHODS We evaluated 180 cone-beam computed tomography scans for 60 patients at 3-time points: T1 (pretreatment), T2 (postexpansion), and T3 (posttreatment), for 3 groups: bone-anchored expansion appliance (BA), tooth-anchored expansion appliance (TA), and controls (T1-T3: BA, 2 years 8 months; TA, 2 years 9 months; control: 2 years 7 months). The intermolar width, molar angulation, palatal width, vertical buccal bone height, buccal bone thickness at the alveolar crest, and root apex were measured in the 3 groups at different time points. RESULTS In the short term, both BA and TA led to a statistically significant increase in the intermolar width and vertical buccal bone loss after expansion compared with controls. Vertical buccal bone loss was significantly greater in TA than in BA. In addition, TA led to significantly increased molar angulation (buccal tipping) compared with controls at T2. There were no significant differences in the 3 groups in the long term except vertical buccal bone loss, which was significantly greater in TA than controls. A substantial correlation was found between molar angulation and vertical buccal bone loss, and a moderate negative correlation was found between intermolar width and buccal bone thickness at the alveolar crest at T3. CONCLUSIONS There was no difference in the treatment outcomes between the 3 groups in the long term except vertical buccal bone loss, which was significantly increased in the TA group compared with controls.
Collapse
Affiliation(s)
- Shivam Mehta
- Department of Developmental Sciences/Orthodontics, Marquette University School of Dentistry, Milwaukee, Wis
| | - Dennis Wang
- Division of Orthodontics, University of Connecticut Health, Farmington, Conn
| | - Madhur Upadhyay
- Division of Orthodontics, University of Connecticut Health, Farmington, Conn
| | | | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health, Farmington, Conn.
| |
Collapse
|
10
|
OUP accepted manuscript. Eur J Orthod 2022; 44:679-689. [DOI: 10.1093/ejo/cjac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
11
|
Mehta S, Arqub SA, Vich ML, Kuo CL, Tadinada A, Upadhyay M, Yadav S. Long-term effects of conventional and miniscrew-assisted rapid palatal expansion on root resorption. Am J Orthod Dentofacial Orthop 2021; 161:e235-e249. [PMID: 34876312 DOI: 10.1016/j.ajodo.2021.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to use cone-beam computed tomography to compare immediate and long-term effects of conventional and miniscrew-assisted rapid palatal expansion (MARPE) appliances on root resorption in 2 treatment groups and a control group. METHODS One hundred eighty cone-beam computed tomography images of 60 patients at 3 time points were assessed: initial, postexpansion, and debond. The patients were divided into 3 groups: control (n = 19), rapid palatal expansion (RPE) appliance (n = 21), and MARPE (n = 20). The period of initial to debond varied for the 3 groups: 2 years, 7 months for controls; 2 years, 9 months for RPE; and 2 years, 8 months for MARPE. The length of mesiobuccal, distobuccal, and palatal root of the maxillary first molar (1M); the buccal root of maxillary first premolar; and second premolar were measured. The inclination of the 1M, intercuspal width (ICW), interroot width (IRW), ICW/IRW ratio, maxillary skeletal width were measured in all 3 groups at different time points. RESULTS Immediately after expansion, RPE and MARPE groups showed a significant increase in the molar inclination, ICW, ICW/IRW ratio, and maxillary skeletal width compared with controls at postexpansion. However, the long-term comparison did not show any significant difference for root resorption and expansion parameters between the 3 groups, except the ICW/IRW ratio, which was higher in MARPE than controls at debond. A significant negative association was observed between the length of the mesiobuccal root of 1M and molar inclination (β = -0.025; 95% confidence interval, -0.050 to 0.0008; P <0.05). The expansion of ICW and IRW did not show a significant association with root resorption. CONCLUSIONS The long-term outcomes showed no difference in the amount of root resorption between the RPE, MARPE, and control groups. Molar inclination showed a significant negative association with the length of the mesiobuccal root of the 1M.
Collapse
Affiliation(s)
- Shivam Mehta
- Department of Developmental Sciences/Orthodontics, Marquette University School of Dentistry, Milwaukee, Wis
| | - Sarah Abu Arqub
- Division of Orthodontics, University of Connecticut Health, Farmington, Conn
| | | | - Chia-Ling Kuo
- Department of Community Medicine and Health Care, University of Connecticut Health, Farmington, Conn
| | - Aditya Tadinada
- Division of Oral and Maxillofacial Radiology, University of Connecticut Health, Farmington, Conn
| | - Madhur Upadhyay
- Division of Orthodontics, University of Connecticut Health, Farmington, Conn
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health, Farmington, Conn.
| |
Collapse
|
12
|
Oh SH, Lee SR, Choi JY, Ahn HW, Kim SH, Nelson G. Geometry of anchoring miniscrew in the lateral palate that support a tissue bone borne maxillary expander affects neighboring root damage. Sci Rep 2021; 11:19880. [PMID: 34615963 PMCID: PMC8494793 DOI: 10.1038/s41598-021-99442-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022] Open
Abstract
Anchoring miniscrews used for a tissue bone borne maxillary expander (C-expander) can fail if they contact tooth roots or perforate the maxillary sinus. Cone beam computed tomography images were reviewed retrospectively to evaluate the geometric factors of miniscrew placement in the palate that contribute to root proximity (RP) and sinus perforation (SP), and to investigate the differences of miniscrew placement depth (PD) and placement angle (PA) among the groups in each variable from 340 anchoring miniscrews on 70 patients whose C-expanders showed sufficient stability after palatal expansion for orthodontic treatment. Two types of miniscrews were used: a self-tapping miniscrew with 1.8 mm-in-diameter, and a self-drilling miniscrew with 1.6 mm-in-diameter. While the self-tapping larger diameter miniscrew influenced root proximity significantly, the screw location and PD affected the rate of sinus perforation. PA was significantly different between the right and left sides of the palate. The results of this study confirmed that root proximity and sinus perforation of anchoring miniscrews in a tissue bone borne palatal expander occurred due to certain risk factors, even when the palates were expanded successfully. Knowledge of these factors can help the clinician place miniscrews with less risk of root proximity or sinus perforation.
Collapse
Affiliation(s)
- Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sae Rom Lee
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea.
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
13
|
Colak C, Aras B, Cheng LL, Elekdag-Turk S, Turk T, Darendeliler MA. Effects of rapid and slow maxillary expansion on root resorption: a micro-computed tomography study. Eur J Orthod 2021; 43:682-689. [PMID: 34345908 DOI: 10.1093/ejo/cjab024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIM To compare root resorption (RR) after rapid maxillary expansion (RME) and slow maxillary expansion (SME) through micro-computed tomography (micro-CT). SUBJECTS AND METHODS Twenty-six subjects who required maxillary expansion and bilateral upper first premolar extraction were randomly assigned to RME (n = 13, mean age: 13.25 ± 0.88 years) or SME (n = 13, mean age: 13.53±1.28 years) group. A hyrax-type acrylic bonded expansion appliance was used. The Hyrax screw was activated ¼ turn twice a day for 20 days in the RME group and ¼ turn every second day for 80 days in the SME group. One randomly selected upper first premolar was extracted in each patient after active expansion. The appliance was left in situ for a 24-week retention period then the contralateral upper first premolar was extracted. Extracted teeth were scanned with micro-CT and the volume of the resorption craters was analysed with a specialized software. Transversal skeletal and dental widths were measured on posteroanterior radiographs taken before and after expansion and retention periods. RESULTS The resorption craters were concentrated mostly on the buccal surface and middle level in all samples. The total RR in the RME group was less post-expansion (P ≤ 0.05) and more post-retention (P > 0.05) than the SME group. During retention, there was a significant decrease in the total RR in the SME group (P > 0.05) and an increase in the RME group. Both RME and SME groups displayed a similar increase in skeletal transverse dimensions, but inter-molar width increased significantly more in the SME group during the whole experimental period. CONCLUSION RME does not have an advantage over SME in terms of skeletal expansion and the amount of RR when a retention period of six months is followed.
Collapse
Affiliation(s)
- Canan Colak
- Orthodontist, Private Practice, Esentepe Mah. FSM Bulvari Bahar Sitesi A Blok No: 96/5 Nilüfer/Bursa, Turkey
| | - Banu Aras
- Orthodontist, Former Senior Dental Registrar, Sydney Dental Hospital, Sydney, Australia
| | - Lam L Cheng
- Department of Orthodontics and Paediatric Dentistry, Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Sydney, Australia
| | - Selma Elekdag-Turk
- Department of Orthodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Tamer Turk
- Department of Orthodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - M Ali Darendeliler
- Department of Orthodontics and Paediatric Dentistry, Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Sydney, Australia
| |
Collapse
|
14
|
Alcin R, Malkoç S. Does mini-implant-supported rapid maxillary expansion cause less root resorption than traditional approaches? A micro-computed tomography study. Korean J Orthod 2021; 51:241-249. [PMID: 34275880 PMCID: PMC8290090 DOI: 10.4041/kjod.2021.51.4.241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 12/24/2020] [Accepted: 12/31/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the volume, amount, and localization of root resorption in the maxillary first premolars using micro-computed tomography (micro-CT) after expansion with four different rapid maxillary expansion (RME) appliances. METHODS In total, 20 patients who required RME and extraction of the maxillary first premolars were recruited for this study. The patients were divided into four groups according to the appliance used: miniimplant- supported hybrid RME appliance, hyrax RME appliance, acrylic-bonded RME appliance, and full-coverage RME appliance. The same activation protocol (one activation daily) was implemented in all groups. For each group, the left and right maxillary first premolars were scanned using micro-CT, and each root were divided into six regions. Resorption craters in the six regions were analyzed using special CTAn software for direct volumetric measurements. Data were statistically analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test with Bonferroni adjustment. RESULTS The hybrid expansion appliance resulted in the lowest volume of root resorption and the smallest number of craters (p < 0.001). In terms of overall root resorption, no significant difference was found among the other groups (p > 0.05). Resorption was greater on the buccal surface than on the lingual surface in all groups except the hybrid appliance group (p < 0.05). CONCLUSIONS The findings of this study suggest that all expansion appliances cause root resorption, with resorption craters generally concentrated on the buccal surface. However, the mini-implant-supported hybrid RME appliance causes lesser root resorption than do other conventional appliances.
Collapse
|
15
|
de Araújo MC, Bocato JR, Berger SB, Oltramari PVP, de Castro Ferreira Conti AC, de Almeida MR, Freire Fernandes TM. Perceived pain during rapid maxillary expansion in children with different expanders. Angle Orthod 2021; 91:484-489. [PMID: 33621314 DOI: 10.2319/092820-829.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate and compare the intensity of pain caused by rapid maxillary expansion (RME) with two expanders: Hyrax and Haas type, in growing patients. MATERIALS AND METHODS Thirty-nine patients (23 girls and 16 boys) with an average age of 9.3 years (SD = 1.39 years) were randomized into two groups and treated with Hyrax- and Haas-type expanders. In both groups, initial activation of the expander screw was one full turn on the first day followed by 2/4 of a turn two times a day (morning and night) for 7 days. Inclusion criteria were patients presenting with a posterior crossbite or maxillary atresia between 7 and 12 years old. To evaluate the intensity of pain during the active phase of the treatment, a combination of the Numerical Rating Scale and Wong-Baker Faces Pain Scale was used. Mann-Whitney test was used to compare the two treatment groups. RESULTS There was significant inverse correlation between days following insertion and pain. During the expansion period, 100% of the children reported some pain. Hyrax expander subjects reported greater pain than those treated with the Haas-type expander only on the first day. The level of pain remained greater in girls throughout treatment. CONCLUSIONS Pain was reported regardless of the type of expander and was higher in the Hyrax group only on the first day of activation.
Collapse
|
16
|
Quinzi V, Federici Canova F, Rizzo FA, Marzo G, Rosa M, Primozic J. Factors related to maxillary expander loss due to anchoring deciduous molars exfoliation during treatment in the mixed dentition phase. Eur J Orthod 2021; 43:332-337. [PMID: 33215659 DOI: 10.1093/ejo/cjaa061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim was to identify factors associated with maxillary expander loss due to anchoring deciduous molars exfoliation and assess the diagnostic accuracy of the upper second premolar cusp position as a prognostic factor for the exfoliation of its corresponding deciduous molar. MATERIALS/METHODS Ninety-two subjects aged 8.4 ± 1.1 years, treated with a Haas or hyrax expander, and using the same expansion protocol and deciduous teeth as anchorage were included. The position of the upper second premolar cusp, according to the half pulp chamber (HPC) line of the ipsilateral upper first permanent molar, was assessed on pre-treatment panoramic radiographs. RESULTS A significant association between anchoring deciduous molar exfoliation and the position of the upper second premolar cusp according to the HPC line (P = 0.002; odds ratio = 5.7) was seen, while there was no association with gender, age, treatment duration, and type of expander. The median survival time for an anchoring deciduous molar, when the underlying premolar cusp was touching/crossing the HPC line, was 13.0 (11.7; 14.2) months. The upper second premolar cusp position to the HPC line showed high accuracy (at least 76.11 per cent) and substantial repeatability (at least 0.7) as a prognostic factor for the corresponding second deciduous molar exfoliation. LIMITATIONS Applicability in the mixed dentition phase with fully erupted upper first permanent molars. CONCLUSIONS The probability of a second deciduous molar to be successfully used as maxillary expander anchorage for at least 16 months is above 94 per cent; when at baseline, the corresponding premolar cusp is apical to the HPC line.
Collapse
Affiliation(s)
- Vincenzo Quinzi
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, Italy
| | | | - Fiorella Alessandra Rizzo
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, Italy
| | - Giuseppe Marzo
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, Italy
| | | | - Jasmina Primozic
- Department of Orthodontics and Jaw Orthopaedics, Medical Faculty, University of Ljubljana, Slovenija
| |
Collapse
|
17
|
Gökçe G, Akan B, Veli İ. A postero-anterior cephalometric evaluation of different rapid maxillary expansion appliances. J World Fed Orthod 2021; 10:112-118. [PMID: 34031017 DOI: 10.1016/j.ejwf.2021.04.002] [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: 03/25/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate dental and skeletal changes induced by tooth-bone-borne, tooth-tissue-borne, and tooth-borne rapid maxillary expansion (RME) appliances using postero-anterior (PA) cephalometric radiographs. METHODS A total of 54 patients' (25 boys, 29 girls) PA cephalometric radiographs who had bilateral posterior crossbite and RME treatment were included and divided into three groups according to the type of appliance used during treatment: tooth-bone-borne RME appliance (hybrid Hyrax) (7 boys, 11 girls, mean age 13.28 ± 1.20 years), tooth-tissue-borne RME appliance (TTB) (8 boys, 10 girls, mean age 13.08 ± 1.06 years) and tooth-borne RME appliance (Hyrax) (10 boys, 8 girls, mean age 12.05 ± 1.35 years). Pretreatment (T0) and posttreatment (T1) PA cephalometric radiographs were analyzed with Dolphin software v. 11.7 (Chatsworth, CA). The comparisons of the groups were performed with Two-way analysis of variance. P < 0.05 was considered statistically significant. RESULTS Significant and equal increase of right molar relationship and upper intermolar molar widths occurred in all groups. Dental midline discrepancy showed significant increase in only hybrid Hyrax group between T0 and T1. Significant increases were reported for lateronasal width in hybrid Hyrax and tooth-tissue-borne groups (P < 0.05). CONCLUSIONS Both skeletal and dental changes were observed after RME in all groups. However, the greatest skeletal changes were seen in hybrid Hyrax and tooth-tissue-borne groups.
Collapse
Affiliation(s)
- Gökçenur Gökçe
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey.
| | - Burçin Akan
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - İlknur Veli
- Associate Professor, Department of Orthodontics, Izmir Katip Celebi University, Izmir, Turkey
| |
Collapse
|
18
|
Malkoç S, Alçin R, Uzel A. Does the rhythm and appliance type of rapid maxillary expansion have an effect on root resorption? Angle Orthod 2021; 91:293-300. [PMID: 33492378 PMCID: PMC8084455 DOI: 10.2319/052220-465.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the volume, amount, and localization of root resorption in the upper first premolars by micro-computed tomography (micro-CT) after three different rapid maxillary expansion appliances and two different activation rhythms. MATERIALS AND METHODS The patients were divided into three groups; Hyrax, acrylic cap splint (ACS), and full coverage acrylic bonded (FCAB) appliances. Each group was then divided into the following two subgroups: rapid maxillary expansion (RME) and semirapid maxillary expansion (SRME). After expansion was completed, the appliances were stabilized for 12 weeks during the retention period. For each group, 10 premolars (for a total of 60 premolars) were scanned with the micro-CT (SkyScan). The reconstructed 3D images of each root sample were divided into six regions. The resorption craters on these six different root surfaces were analyzed by special CTAn (SkyScan) software for direct volumetric measurements. Kruskal-Wallis one-way analysis of variance and Mann-Whitney U tests were used for statistical analysis. RESULTS The total volume of root resorption was less with FCAB than with ACS and Hyrax (P < .001). In all groups, a greater volume of resorption was found on the buccal surface than on the lingual surface (P < .001). No significant differences were found between the RME and SRME groups (P > .05). CONCLUSIONS All expansion appliances caused root resorption in the upper first premolar teeth, but FCAB may be safer in terms of root resorption. The resorption craters were generally concentrated on the buccal surface. There was no effect of activation rhythm on root resorption.
Collapse
|
19
|
Wilmes B, Tarraf N, Drescher D. Treatment of maxillary transversal deficiency by using a mini-implant-borne rapid maxillary expander and aligners in combination. Am J Orthod Dentofacial Orthop 2021; 160:147-154. [PMID: 33906772 DOI: 10.1016/j.ajodo.2020.11.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/30/2022]
Abstract
Bone-borne rapid maxillary expansion distraction devices are used to achieve a more skeletal expansion and to avoid dental side effects of conventional expanders such as tipping of anchorage teeth. In this article, we report the use of a prefabricated expander fixed on 2 mini-implants in the anterior palate. This allows for the insertion of the mini-implants and the expander to occur without the need for an impression or any laboratory procedures. Especially when aligners are going to be used, the use of a mini-implant-borne expander seems to be reasonable because the expander can be left in place as a skeletal retainer during the aligner finishing.
Collapse
Affiliation(s)
- Benedict Wilmes
- Department of Orthodontics, University of Duesseldorf, Duesseldorf, Germany.
| | - Nour Tarraf
- Private practice, Sydney, Australia, and Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Dieter Drescher
- Department of Orthodontics, University of Duesseldorf, Duesseldorf, Germany
| |
Collapse
|
20
|
Primozic J, Federici Canova F, Rizzo FA, Marzo G, Quinzi V. Diagnostic ability of the primary second molar crown-to-root length ratio and the corresponding underlying premolar position in estimating future expander anchoring teeth exfoliation. Orthod Craniofac Res 2021; 24:561-567. [PMID: 33606329 DOI: 10.1111/ocr.12478] [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: 11/01/2020] [Revised: 01/30/2021] [Accepted: 02/12/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aim was to assess the diagnostic ability of the crown-to-root length ratio of the primary second molar and the position of the corresponding underlying premolar in estimating future anchoring teeth exfoliation during maxillary expansion. SETTING AND SAMPLE POPULATION Fifty-four subjects (30 females, 24 males; 108 teeth) aged 8.2 ± 1.0 years that underwent palatal expansion. METHODS The upper second premolar position of the corresponding expander anchoring primary molar was determined in relation to the ipsilateral first permanent molar half-pulp chamber (HPC) line on panoramic radiographs. Subjective and objective (based on measurements) assessments of the crown-to-root length ratio of anchoring primary molars were performed. Exfoliation after the expansion was recorded over a retention period of 12 months. All the assessments were performed individually by three examiners at two 3-week-apart sessions, trained and calibrated before enrolment. The intra-/inter-examiner agreements were evaluated, and the diagnostic accuracy of the methods was calculated. RESULTS All methods exhibited almost perfect intra- and at least substantial inter-examiner agreement (Kappa >0.8 and ≥0.63, respectively). Good diagnostic accuracy was seen for the premolar position to the HPC line (0.7-0.8), while the crown-to-root length ratio methods exhibited hardly sufficient accuracy. The diagnostic agreement of the methods was fair. CONCLUSIONS When primary molars are considered as anchoring teeth for maxillary expansion, the premolar position in relation to the HPC line appears to be the most valid and reliable method for predicting their stability. Despite high repeatability values, the crown-to-root length ratio needs a cut-off point re-definition to increase its predicting ability.
Collapse
Affiliation(s)
- Jasmina Primozic
- Department of Orthodontics and Jaw Orthopaedics, Medical Faculty, University of Ljubljana
| | | | - Fiorella Alessandra Rizzo
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, L'Aquila, Italy
| | - Giuseppe Marzo
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, L'Aquila, Italy
| | - Vincenzo Quinzi
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, L'Aquila, Italy
| |
Collapse
|
21
|
Xia K, Sun WT, Yu LY, Liu J. Influence of different types of rapid maxillary expansion on root resorption: a systematic review. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:38-47. [PMID: 33723935 DOI: 10.7518/hxkq.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to assess the influence of different types of rapid maxillary expansion on root resorption (RR). METHODS Literature searches were carried out electronically in five English and two Chinese databases. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies, and case-control studies were included. The data were extracted by three authors. The risk of bias in the RCTs and nonrandomized studies were assessed in accordance with corresponding scales. RESULTS Among the 400 articles identified, seven were included for the final analysis. Three studies were graded as high value of evidence, while two and another two studies were graded as moderate value and low value, respectively. According to the available evidence, the tooth-borne maxillary expansion caused more obvious RR of anchorage teeth than the bone-borne one. In addition, the Haas-type palatal acrylic pads could not effectively reduce the degree of RR. The difference in the design of the retainer between the tooth-borne maxillary expansion (the use of a band or wire framework to connect the anchorage tooth) did not cause the difference in the incidence and degree of RR. CONCLUSIONS Clinical evidence suggested that bone-borne maxillary expansion may decrease the amount of RR, while the amounts of resorption did not significantly differ between Haas and Hyrax and between different retainer types of Hyrax.
Collapse
Affiliation(s)
- Kai Xia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wen-Tian Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li-Yuan Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
22
|
Park KH, Choi JY, Kim KA, Kim SJ, Chung KR, Kim SH. Critical issues concerning biocreative strategy in contemporary temporary skeletal anchorage device orthodontics: A narrative review. Orthod Craniofac Res 2020; 24 Suppl 1:39-47. [PMID: 33237622 DOI: 10.1111/ocr.12444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 01/24/2023]
Abstract
Biocreative Orthodontic Strategy (BOS) is designed to establish a physiologically stable occlusion in harmony with masticatory and TMJ function and healthy supporting tissues with strategic use of temporary skeletal anchorage devices (TSADs). This narrative review surveys current research that demonstrates how BOS with TSADs uses a target approach to overcome the limitations experienced with conventional orthodontic treatment. A narrative review article including research on TSADs orthodontics in the permanent dentition. This review is a brief survey of five BOS principles for contemporary TSAD orthodontics: elegant selection of TSADs, bracket prescription to enhance TSAD orthodontics, antero-posterior dimension control, transverse dimension control and airway control issues. Severe malocclusion and craniofacial dysmorphology can be treated with Biocreative Orthodontic Strategy with a minimum number of TSADs. In order to achieve successful treatment outcome using TSADs, it is critical to understand the key diagnosis and treatment principles of BOS and how to develop a target approach for the tooth and bone movement.
Collapse
Affiliation(s)
- Ki-Ho Park
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Kyung A Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| |
Collapse
|
23
|
Oliveira PLE, Campos V, de Andrade RM, de Souza Araújo MT, Pithon MM, Sant'Anna EF. Deformation of the circummaxillary sutures during acute micro-implant assisted rapid palatal expansion and tooth-supported expansion: An ex vivo study. Orthod Craniofac Res 2020; 24:396-404. [PMID: 33277817 DOI: 10.1111/ocr.12450] [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: 06/29/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study aimed to assess and compare the deformation that develops in the circummaxillary sutures during activation of micro-implant assisted rapid palatal expander (MARPE) and tooth-supported expander (Hyrax) s, in the rapid maxillary expansion. SETTINGS AND SAMPLE 7 pigs Sus Scrofa received custom-made MARPE (n = 3) and Hyrax (n = 4) appliances. MATERIAL AND METHODS The devices were activated 25 times with strain readings captured by strain gauges attached to the following regions: posterior midpalatal suture (MPS), maxilla-premaxilla suture (MPM), maxilla-zygomatic suture (MZ) and maxilla pterygoid-process suture (MPP). The intermolar distance and suture width were measured immediately before activation and at the 20th and 25th activation. ANOVA and Kruskal-Wallis test was applied. RESULTS The MARPE group presented greater MPS displacement in all measured regions, and one of the devices produced a significant opening (1.7 mm) in the posterior region. The accumulated tension in the MPS was higher compared to the other sutures (P < .05). A MARPE animal presented higher median tension in the MPS region (294.77με) compared to all other animals except one Hyrax animal (P < .05). Regarding the median tensions of the different activation intervals, the median tension measured during the 16th to 25th activation interval in the Hyrax group was lower than that measured during the first 8 activations, in both the MPS and MZ (P < .05). CONCLUSIONS MARPE expanders developed more constant tensions during all activations (MPS and MZ), while Hyrax showed lower tension in the 16th to 25th activation.
Collapse
Affiliation(s)
- Pedro Lima Emmerich Oliveira
- Department of Orthodontics and Pediatric Dentistry, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil
| | - Vinicius Campos
- Department of Mechanical Engineering, Universidade Federal do Espírito Santo, UFES, Vitoria, Brazil
| | | | - Mônica Tirre de Souza Araújo
- Department of Orthodontics and Pediatric Dentistry, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics and Pediatric Dentistry, Universidade Estadual do Sudoeste da Bahia, UESB, Jequié, Brazil
| | - Eduardo Franzotti Sant'Anna
- Department of Orthodontics and Pediatric Dentistry, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, Brazil
| |
Collapse
|
24
|
Nam HJ, Gianoni-Capenakas S, Major PW, Heo G, Lagravère MO. Comparison of Skeletal and Dental Changes Obtained from a Tooth-Borne Maxillary Expansion Appliance Compared to the Damon System Assessed through a Digital Volumetric Imaging: A Randomized Clinical Trial. J Clin Med 2020; 9:jcm9103167. [PMID: 33007851 PMCID: PMC7601060 DOI: 10.3390/jcm9103167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/19/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to evaluate and compare dental and skeletal changes associated with the Damon and Rapid Maxillary Expander (RME) expansion using Cone-Beam Computed Tomography (CBCT). Eighty-two patients, from The University of Alberta Orthodontic Clinic, were randomly allocated to either Group A or B. Patients in Group A received orthodontic treatment using the Damon brackets. Patients in Group B received treatment using the Hyrax (a type of RME) appliance. CBCT images were taken two times (baseline and after expansion). The AVIZO software was used to locate 18 landmarks (dental and skeletal) on sagittal, axial, and coronal slices of CBCT images. Comparison between two groups showed that transverse movement of maxillary first molars and premolars was much greater in the Hyrax group. The lateral movements of posterior teeth were associated with buccal tipping of crowns. No clinically significant difference in the vertical or anteroposterior direction between the two groups was noted. Alveolar bone next to root apex of maxillary first premolar and molar teeth showed clinically significant lateral movement in the Hyrax group only. The comparison between two groups showed significantly greater transverse expansion of the first molar and first premolars with buccal tipping in the RME group.
Collapse
|
25
|
Seker ED, Yagci A, Kurt Demirsoy K. Dental root development associated with treatments by rapid maxillary expansion/reverse headgear and slow maxillary expansion. Eur J Orthod 2020; 41:544-550. [PMID: 30855665 DOI: 10.1093/ejo/cjz010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To assess dental root development in two groups of paediatric patients who received treatments with reverse headgear and rapid maxillary expansion and slow maxillary dental arch expansion. MATERIALS AND METHODS The 20 subjects (13 girls, 7 boys; mean age: 8.9 ± 1.3 years) in the first group were treated with a Petit-type reverse headgear attached to a full-coverage bonded rapid maxillary expander via elastics (RME&RHg group). The 20 subjects included in the second group (9 girls, 11 boys; mean age: 9.1 ± 2.2 years) were selected among patients who were treated with Hawley appliances for slow maxillary expansion (SME group). Digitized panoramic radiographs were used. A total of 960 permanent teeth (maxillary-mandibular incisors, canines, premolars, and first molars) were measured quantitatively for pre-treatment and post-treatment. RESULTS No significant increase was found except for the right and left maxillary and mandibular second premolars and left mandibular and first premolar in the RME&RHg group (P < 0.05). Teeth length values increased significantly in all maxillary and mandibular teeth except maxillary first molars and mandibular incisors in the SME group (P < 0.05). Inter-group comparisons showed that statistically significant differences were observed in maxillary and mandibular incisors, left maxillary first premolar, and molar teeth (P > 0.05). LIMITATION A limitation of this study is the use of two-dimensional radiographic images for root length measurement. However, ethical obligations limit the dental cone beam computed tomography imaging application for protection of paediatric patients from harm. CONCLUSIONS RME&RHg therapy inhibits root development of maxillary and mandibular teeth in the early period. However, further studies should be performed to determine whether this effect on root development is reversible or irreversible.
Collapse
Affiliation(s)
- Elif Dilara Seker
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Yagci
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Kevser Kurt Demirsoy
- Department of Orthodontics, Faculty of Dentistry, Nevsehir Hacı Bektas VeliUniversity, Nevsehir, Turkey
| |
Collapse
|
26
|
Krishnaswamy NR. Expansion in the absence of crossbite – rationale and protocol. APOS TRENDS IN ORTHODONTICS 2019. [DOI: 10.25259/apos_115_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Transverse maxillomandibular discrepancies are a major component of several malocclusions. Clinically, posterior crossbite is a common and valid indicator of maxillary transverse problems and orthopedic and orthodontic forces are routinely used to correct maxillary transverse deficiency. However, crossbite and transverse discrepancies are not a homologous group but must be viewed as a continuum with varying degree of abnormality. The etiology, diagnostic protocol, rationale, and procedures employed for correcting maxillary transverse discrepancy in the absence of crossbite are discussed in the article.
Collapse
|
27
|
Moon HW, Kim MJ, Ahn HW, Kim SJ, Kim SH, Chung KR, Nelson G. Molar inclination and surrounding alveolar bone change relative to the design of bone-borne maxillary expanders: A CBCT study. Angle Orthod 2019; 90:13-22. [PMID: 31461306 DOI: 10.2319/050619-316.1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the molar inclination and skeletal and alveolar bone changes when comparing tooth bone-borne (MSE) and tissue bone-borne type maxillary expanders (C-expander) using cone-beam computed tomography (CBCT) in late adolescence. MATERIALS AND METHODS A sample of 48 late-adolescent patients were divided into two groups according to the type of expander: MSE group (n = 24, age = 19.2 ± 5.9 years) and C-expander group (n = 24, age = 18.1 ± 4.5 years). CBCT scans were taken before treatment and 3 months after expansion. Transverse skeletal and dental expansion, alveolar inclination, tooth axis, buccal alveolar bone height, thickness, dehiscence, and fenestration were evaluated on the maxillary first molar. Paired t-test, independent t-test, Pearson's chi-square test, and Spearman correlation analysis were performed. RESULTS The MSE group produced greater dental expansion (P < .05), whereas skeletal expansion was similar in both groups (P = .859). The C expander group had more alveolar bone inclination change (P < .01), and the MSE group had more buccal tipping of the anchorage teeth (P < .01 or .001). Buccal alveolar bone height loss and thickness changes were greater in the MSE group (P < .01 or <.001). Formation of dehiscences was more frequent in the MSE group (P < .001), whereas for fenestrations, there were no significant differences between the two groups. Buccal bone height loss in the MSE group had a negative correlation with initial buccal bone thickness. CONCLUSIONS The incorporation of teeth into bone-borne expanders resulted in an increase in the severity of side effects. For patients in late adolescence, tissue bone-borne expanders offer comparable skeletal effects to tooth bone-borne expanders, with fewer dentoalveolar side effects.
Collapse
|
28
|
Jacob HB, Ribeiro GLU, English JD, Pereira JDS, Brunetto M. A 3-D evaluation of transverse dentoalveolar changes and maxillary first molar root length after rapid or slow maxillary expansion in children. Dental Press J Orthod 2019; 24:79-87. [PMID: 31390454 PMCID: PMC6677328 DOI: 10.1590/2177-6709.24.3.079-087.oar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of the present study was to conduct a randomized clinical trial comparing the effects of rapid maxillary expansion (RME) and slow maxillary expansion (SME). Maxillary permanent first molar root length and tooth movement through the alveolus were studied using cone-beam computed tomography (CBCT). METHODS Subjects with maxillary transverse deficiencies between 7 and 10 years of age were included. Using Haas-type expanders, children were randomly assigned to two groups: RME (19 subjects, mean age of 8.60 years) and SME (13 subjects, mean age of 8.70 years). RESULTS Buccal cortical, buccal bone thicknesses and dentoalveolar width decreased in both groups. In the RME group the greatest decrease was related to distal bone thickness (1.26 mm), followed by mesial bone thickness (1.09 mm), alveolar width (0.57 mm), and the buccal cortical (0.19 mm). In the SME group the mesial bone thickness decreased the most (0.87 mm) and the buccal cortical decreased the least (0.22 mm). The lingual bone thickness increased in the RME and SME groups (0.56 mm and 0.42 mm, respectively). The mesial root significantly increased in the RME group (0.52 mm) and in the SME group (0.40 mm), possibly due to incomplete root apex formation at T1 (prior to installation of expanders). CONCLUSIONS Maxillary expansion (RME and SME) does not interrupt root formation neither shows first molar apical root resorption in juvenile patients. Although slightly larger in the RME group than SME group, both activation protocols showed similar buccal bone thickness and lingual bone thickness changes, without significant difference; and RME presented similar buccal cortical bone changes to SME.
Collapse
Affiliation(s)
- Helder Baldi Jacob
- The University of Texas Health Science Center at Houston School of Dentistry, Department of Orthodontics (Houston/ TX, USA)
| | | | - Jeryl D English
- The University of Texas Health Science Center at Houston School of Dentistry, Department of Orthodontics (Houston/ TX, USA)
| | | | | |
Collapse
|
29
|
Nojima LI, Nojima MDCG, Cunha ACD, Guss NO, Sant'Anna EF. Mini-implant selection protocol applied to MARPE. Dental Press J Orthod 2019; 23:93-101. [PMID: 30427498 PMCID: PMC6266324 DOI: 10.1590/2177-6709.23.5.093-101.sar] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 08/19/2018] [Indexed: 12/15/2022] Open
Abstract
Introduction: Rapid maxillary expansion (RME) is the therapy of choice to correct skeletal transverse dimension in children and adolescents, associating orthopedic and dental effects. In an attempt to prevent the undesirable dentoalveolar effects and optimize the potential of skeletal expansion in individuals in advanced stages of skeletal maturation, the miniscrew-assisted rapid palatal expander (MARPE) was proposed by Lee et al. in 2010. Objective: This paper presents a systematized protocol for selection of miniscrews indicated for MARPE, by the evaluation of cone-beam computed tomographies (CBCT). Variables related with the bone and soft tissue thicknesses at the palatal regions of interest, as well as in relation to the fixation rings of miniscrews of the palatal expander are analyzed and discussed to provide better performance in the clinical practice.
Collapse
Affiliation(s)
- Lincoln Issamu Nojima
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| | | | - Amanda Carneiro da Cunha
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| | - Natan Oliveira Guss
- Universidade Federal do Rio de Janeiro, Post-graduation Program in Orthodontics (Rio de Janeiro/RJ, Brazil)
| | - Eduardo Franzotti Sant'Anna
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| |
Collapse
|
30
|
Yildirim M, Akin M. Comparison of root resorption after bone-borne and tooth-borne rapid maxillary expansion evaluated with the use of microtomography. Am J Orthod Dentofacial Orthop 2019; 155:182-190. [PMID: 30712689 DOI: 10.1016/j.ajodo.2018.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Root resorption was compared between bone-borne and tooth tissue-borne rapid maxillary expansion patients with the use of microtomography. METHODS The study included 20 patients (ages 11-16 years) requiring fixed orthodontic treatment who underwent extraction of their first premolars after rapid maxillary expansion with the use of modified appliances. One side of the appliance covered the teeth with acrylic, while the other side was fixed to the palatal bone by means of a miniscrew. After 3 months' retention, the appliance was removed and teeth were extracted and examined with the use of microtomography. RESULTS When the apical, middle, and cervical thirds, as well as the buccal and lingual sides, were compared, the volume loss was significantly higher in the tooth tissue-borne group than in the bone-borne group (P <0.01). The least volume loss occurred on the cervical third lingual surface in the tooth tissue-borne group and on the middle third buccal surface in the bone-borne group. In the former group, least resorption occurred on the cervical third and highest resorption on the buccal side. In the latter group, surfaces showed no significant changes. CONCLUSIONS More root resorption occurred in the tooth tissue-borne group, mostly in the apical and middle thirds. The amount of resorption on the buccal surface was higher than that on the lingual surface.
Collapse
Affiliation(s)
- Mucahid Yildirim
- Department of Orthodontics, Faculty of Dentistry, Konya Necmettin Erbakan University, Konya, Turkey.
| | - Mehmet Akin
- Department of Orthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| |
Collapse
|
31
|
Lemos Rinaldi MR, Azeredo F, Martinelli de Lima E, Deon Rizzatto SM, Sameshima G, Macedo de Menezes L. Cone-beam computed tomography evaluation of bone plate and root length after maxillary expansion using tooth-borne and tooth-tissue-borne banded expanders. Am J Orthod Dentofacial Orthop 2018; 154:504-516. [PMID: 30268261 DOI: 10.1016/j.ajodo.2017.12.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The objective of this research was to evaluate the buccal bone plate and root length of maxillary permanent first molars using cone-beam computed tomography after maxillary expansion with different activation protocols. METHODS Cone-beam computed tomography images of growing patients were obtained from the orthodontic department of Pontifical Catholic University of Rio Grande do Sul in Brazil. The groups were Haas-type 2/4 turns, Haas-type 4/4 turns, hyrax-type 2/4 turns, and hyrax-type with alternate rapid maxillary expansions and constrictions (alt-RAMEC) 4/4 turns a day. Tooth length, periodontal insertion, alveolar bone thickness, and intermolar distances were evaluated. The data at the start of treatment and 6 months later were compared using generalized linear models. The intergroup differences were determined by univariate analysis of variance with the Bonferroni adjustment. RESULTS Tooth length was significantly shortened after expansion in all groups (-0.28 to -0.51 mm), except for the alt-RAMEC group. Bone level variables (bone level and bone level at the tooth tip) changed statistically in all groups, except for the Haas 4/4 turns group. There was significant periodontal attachment loss after rapid maxillary expansion with the hyrax/alt-RAMEC (5.09 mm). The hyrax/alt-RAMEC and hyrax groups had more dehiscences, fenestrations, and exposures of the root. CONCLUSIONS The consequence of rapid maxillary expansion using the hyrax was alveolar bone resorption, especially in the hyrax/alt-RAMEC group, whereas the Haas expander caused mild root resorption.
Collapse
Affiliation(s)
- Mariana Roennau Lemos Rinaldi
- Department of Orthodontics, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fabiane Azeredo
- Department of Orthodontics, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Martinelli de Lima
- Department of Orthodontics, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Susana Maria Deon Rizzatto
- Department of Orthodontics, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Glenn Sameshima
- Advanced Dental Education Program in Orthodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif
| | - Luciane Macedo de Menezes
- Department of Orthodontics, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
| |
Collapse
|
32
|
LaBlonde B, Vich ML, Edwards P, Kula K, Ghoneima A. Three dimensional evaluation of alveolar bone changes in response to different rapid palatal expansion activation rates. Dental Press J Orthod 2018; 22:89-97. [PMID: 28444010 PMCID: PMC5398847 DOI: 10.1590/2177-6709.22.1.089-097.oar] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/05/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this multi-center retrospective study was to quantify the changes in alveolar bone height and thickness after using two different rapid palatal expansion (RPE) activation protocols, and to determine whether a more rapid rate of expansion is likely to cause more adverse effects, such as alveolar tipping, dental tipping, fenestration and dehiscence of anchorage teeth. METHODS The sample consisted of pre- and post-expansion records from 40 subjects (age 8-15 years) who underwent RPE using a 4-banded Hyrax appliance as part of their orthodontic treatment to correct posterior buccal crossbites. Subjects were divided into two groups according to their RPE activation rates (0.5 mm/day and 0.8 mm/day; n = 20 each group). Three-dimensional images for all included subjects were evaluated using Dolphin Imaging Software 11.7 Premium. Maxillary base width, buccal and palatal cortical bone thickness, alveolar bone height, and root angulation and length were measured. Significance of the changes in the measurements was evaluated using Wilcoxon signed-rank test and comparisons between groups were done using ANOVA. Significance was defined at p ≤ 0.05. RESULTS RPE activation rates of 0.5 mm per day (Group 1) and 0.8 mm per day (Group 2) caused significant increase in arch width following treatment; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Buccal alveolar height and width decreased significantly in both groups. Both treatment protocols resulted in significant increases in buccal-lingual angulation of teeth; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). CONCLUSION Both activation rates are associated with significant increase in intra-arch widths. However, 0.8 mm/day resulted in greater increases. The 0.8 mm/day activation rate also resulted in more increased dental tipping and decreased buccal alveolar bone thickness over 0.5 mm/day.
Collapse
Affiliation(s)
- Brian LaBlonde
- School Dentistry, Indiana University, Indianapolis, IN, USA
| | | | - Paul Edwards
- School of Dentistry, Indiana University, Indianapolis, IN, USA
| | - Katherine Kula
- School Dentistry, Indiana University, Indianapolis, IN, USA
| | - Ahmed Ghoneima
- School of Dentistry, Indiana University, Indianapolis, IN, USA
| |
Collapse
|
33
|
The impact of rapid maxillary expansion on maxillary first molar root morphology of cleft subjects. Clin Oral Investig 2017; 22:369-376. [DOI: 10.1007/s00784-017-2121-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 05/01/2017] [Indexed: 10/19/2022]
|
34
|
da Cunha AC, Lee H, Nojima LI, Nojima MDCG, Lee KJ. Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient. Dental Press J Orthod 2017; 22:97-108. [PMID: 28746493 PMCID: PMC5525451 DOI: 10.1590/2177-6709.22.3.097-108.oar] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/11/2017] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION: Etiology of dental crowding may be related to arch constriction in diverse dimensions, and an appropriate manipulation of arch perimeter by intervening in basal bone discrepancies cases, may be a key for crowding relief, especially when incisors movement is limited due to underlying pathology, periodontal issues or restrictions related to soft tissue profile. OBJECTIVES: This case report illustrates a 24-year old woman, with maxillary transverse deficiency, upper and lower arches crowding, Class II, division 1, subdivision right relationship, previous upper incisors traumatic episode and straight profile. A non-surgical and non-extraction treatment approach was feasible due to the miniscrew-assisted rapid palatal expansion technique (MARPE). METHODS: The MARPE appliance consisted of a conventional Hyrax expander supported by four orthodontic miniscrews. A slow expansion protocol was adopted, with an overall of 40 days of activation and a 3-month retention period. Intrusive traction miniscrew-anchored mechanics were used for correcting the Class II subdivision relationship, managing lower arch perimeter and midline deviation before including the upper central incisors. RESULTS: Post-treatment records show an intermolar width increase of 5 mm, bilateral Class I molar and canine relationships, upper and lower crowding resolution, coincident dental midlines and proper intercuspation. CONCLUSIONS: The MARPE is an effective treatment approach for managing arch-perimeter deficiencies related to maxillary transverse discrepancies in adult patients.
Collapse
Affiliation(s)
- Amanda Carneiro da Cunha
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| | | | - Lincoln Issamu Nojima
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| | | | - Kee-Joon Lee
- Yonsei University,Department of Orthodontics, Seoul, Korea
| |
Collapse
|
35
|
Carlson C, Sung J, McComb RW, Machado AW, Moon W. Microimplant-assisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult. Am J Orthod Dentofacial Orthop 2017; 149:716-28. [PMID: 27131254 DOI: 10.1016/j.ajodo.2015.04.043] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 11/29/2022]
Abstract
This case report describes the use of a microimplant-assisted rapid palatal expansion (MARPE) appliance to orthopedically correct a transverse maxillary deficiency in an adult patient. Expansion forces transmitted through the teeth in traditional rapid palatal expansion appliances create unwanted dental effects rather than true skeletal expansion, particularly in older patients with more rigid interdigitation of the midpalatal suture. This 19-year-old patient had maxillary constriction with a unilateral posterior crossbite. A MARPE appliance secured to the palatal bones with 4 microimplants was expanded by 10 mm. Pre-MARPE and post-MARPE cone-beam computed tomography cross sections demonstrated 4 to 6 mm of expansion of the maxillofacial structures, including the zygoma and nasal bone area, and widening of the circummaxillary sutures. Minor buccal tipping of the dentition was observed, but the integrity of the alveolar bone was preserved. This report demonstrates that careful design and application of the MARPE appliance can achieve successful transverse expansion of the maxilla and the surrounding structures in a patient beyond the age typically considered acceptable for traditional rapid palatal expansion.
Collapse
Affiliation(s)
| | - Jay Sung
- Graduate student, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Calif
| | | | - Andre Wilson Machado
- Associate professor, Department of Orthodontics, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Won Moon
- Associate professor, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Calif.
| |
Collapse
|
36
|
Pham V, Lagravère MO. Alveolar bone level changes in maxillary expansion treatments assessed through CBCT. Int Orthod 2017; 15:103-113. [PMID: 28065704 DOI: 10.1016/j.ortho.2016.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Determine changes in alveolar bone levels during expansion treatments as assessed through cone-beam computer tomography (CBCT). METHODS Sixty-one patients from Edmonton, Canada, with maxillary transverse deficiencies were split into three groups. One group was treated with a bone-anchored expander, another group was treated with a tooth-borne maxillary expander (Hyrax) and one group was untreated. CBCTs were obtained from each patient at two time points (initialT1 and at removal of appliance after 6 months T2). CBCTs were analyzed using AVIZO software and landmarks were placed on different dental and skeletal structures. Intra-examiner reliability for landmarks was done by randomly selecting 10 images and measuring each landmark 3 times, 1 week apart. Descriptive statistics, intraclass correlation coefficients (ICC) and ANOVA analysis were used to determine if there were changes to the alveolar bone levels and if these changes were statistically significant within each group. RESULTS Landmarks reliability showed an ICC of at least 0.99 with a 95% confidence interval and a mean measurement error of at least 0.2067mm. Descriptive statistics show that changes in alveolar bone levels were less than 1mm for all three groups and therefore clinically insignificant. Changes between groups were not statistically different (P<0.05) from one another with the exception of 8 distances. However, since the distances were small, they were not considered clinically significant. CONCLUSION Alveolar bone level changes were similar in maxillary expansion treatments and in the control group. The effects of maxillary expansion treatments on alveolar bone levels are not clinically significant.
Collapse
Affiliation(s)
- Vi Pham
- ECHA 5-524, Department of Dentistry, University of Alberta, T5G 2N8 Edmonton, AB, Canada
| | - Manuel O Lagravère
- ECHA 5-524, Department of Dentistry, University of Alberta, T5G 2N8 Edmonton, AB, Canada.
| |
Collapse
|
37
|
Changements du niveau de l’os alvéolaire lors du traitement par expansion maxillaire évalué par CBCT. Int Orthod 2017; 15:103-113. [PMID: 28065705 DOI: 10.1016/j.ortho.2016.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
38
|
Carvalho Trojan L, Andrés González-Torres L, Claudia Moreira Melo A, Barbosa de Las Casas E. Stresses and Strains Analysis Using Different Palatal Expander Appliances in Upper Jaw and Midpalatal Suture. Artif Organs 2016; 41:E41-E51. [DOI: 10.1111/aor.12817] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 06/26/2016] [Accepted: 07/06/2016] [Indexed: 11/27/2022]
|
39
|
Almuzian M, Short L, Isherwood G, Al-Muzian L, McDonald J. Rapid maxillary expansion: a review of appliance designs, biomechanics and clinical aspects. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/ortu.2016.9.3.90] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Laura Short
- Clinical University Teacher in Orthodontics/Post CCST, Glasgow Dental Hospital and School, Glasgow, UK
| | | | | | - Jim McDonald
- Professor in Orthodontics, University of Glasgow, Glasgow, UK
| |
Collapse
|
40
|
Uzuner FD, Odabasi H, Acar S, Tortop T, Darendeliler N. Evaluation of the effects of modified bonded rapid maxillary expansion on occlusal force distribution: A pilot study. Eur J Dent 2016; 10:103-108. [PMID: 27011748 PMCID: PMC4784139 DOI: 10.4103/1305-7456.175695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective: To evaluate the effects of modified bonded rapid maxillary expansion (RME) on occlusal force distribution. Materials and Methods: The sample included 12 patients (7 girls and 5 boys; mean age: 13.1 years) at the permanent dentition stage with bilateral posterior cross-bite. The patients were treated with a modified bonded RME appliance, activated twice a day. The study was terminated when the palatal cusps of the maxillary posterior teeth were occluding with the buccal cusps of the mandibular posterior teeth. The postretention period was 3 months. The T-Scan III device was used to analyze the percentages of occlusal force distribution, and records were taken at the pretreatment (T1), the postreatment (T2), and the postretention (T3) periods. Wilcoxon signed rank test was used for statistical analyses. Results: Incisors were most frequently without contact, followed by canines. The highest forces were seen in the second and first molar regions. A significant decrease was seen in total occlusal force during treatment (T1–T2); however, during retention, the force returned to its initial value, and no significant differences were found (T1–T3). No differences were found between right and left sides and in occlusal forces of the teeth in all time periods. Conclusion: The use of modified bonded RME decreases the total occlusal forces during the treatment period, but it does returns to its initial value after the postretention period.
Collapse
Affiliation(s)
- Fatma Deniz Uzuner
- Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkiye
| | - Hande Odabasi
- Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkiye
| | - Secil Acar
- Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkiye
| | - Tuba Tortop
- Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkiye
| | - Nilufer Darendeliler
- Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkiye
| |
Collapse
|
41
|
Martins DC, Souki BQ, Cheib PL, Silva GAB, Reis IDG, Oliveira DD, Nunes E. Rapid maxillary expansion: Do banded teeth develop more external root resorption than non-banded anchorage teeth? Angle Orthod 2016; 86:39-45. [PMID: 25938174 PMCID: PMC8603965 DOI: 10.2319/011015-20.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 03/01/2015] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVE To compare external root resorption (ERR) when bands and wires are used as orthodontic anchorage during rapid maxillary expansion (RME). MATERIALS AND METHODS Histologic analysis was performed on 108 sites from 18 maxillary first premolars and on 36 sites from six mandibular first premolars in nine subjects (mean age = 15.2 ± 1.4 years) 3 months after RME. Maxillary teeth were pooled into two groups (n = 54 each) according to the type of orthodontic anchorage (band group [BG] vs wire group [WG]). Anchorage type was randomly chosen in a split-mouth design. Mandibular first premolars, which were not subjected to orthodontic forces, were used as the control group (CG). RESULTS All premolars in the BG and WG showed ERR at the level of the cementum and dentin. Repair with cementum cells was observed in all resorption areas, but complete repair was rarely found. No statistically significant difference was found between the BG and WG with regard to the ERR. No association was found between the root height position (middle or cervical third) and the incidence of ERR. Buccal root surfaces showed a higher amount of ERR compared with the palatal and interproximal surfaces. ERR was not found in any teeth in the CG. CONCLUSION All maxillary first premolars subjected to RME showed ERR and partial cementum repair. Banded teeth did not develop more ERR than nonbanded anchorage teeth.
Collapse
Affiliation(s)
- Débora C Martins
- a Currently serving the Brazilian Army Dental Service, Manaus, Brazil; Former Orthodontic Resident, Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Bernardo Q Souki
- b Associate Professor of Orthodontics, Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Paula L Cheib
- a Currently serving the Brazilian Army Dental Service, Manaus, Brazil; Former Orthodontic Resident, Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Gerluza A B Silva
- c Associate Professor of Histology, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Igor D G Reis
- d Biomedicine undergraduate student, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Dauro D Oliveira
- b Associate Professor of Orthodontics, Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo Nunes
- e Associate Professor of Endodontics, Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
42
|
Akin M, Akgul YE, Ileri Z, Basciftci FA. Three-dimensional evaluation of hybrid expander appliances: A pilot study. Angle Orthod 2016; 86:81-86. [PMID: 25923245 PMCID: PMC8603971 DOI: 10.2319/121214-902.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/01/2015] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE To evaluate transverse dimensional changes in dentoalveolar and skeletal structures caused by hybrid expander, using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT records of nine patients (five boys and four girls) (mean age 13.61 ± 0.72 years) treated with hybrid expander were examined. CBCT images were taken at pretreatment and after the expansion. ELSA (point equidistant to both foramina spinosa) was determined as a reference point to compare the distances in all three dimensions. Nineteen transversal dimensions and four angles were measured for both right and left sides. Wilcoxon signed rank test was used for statistical comparison at P < .05 levels. RESULTS A V-shaped expansion of suture was successfully achieved in all patients without teeth support. The amount of opening was greater in anterior than posterior and in inferior than superior. An 8.75-mm screw expansion was achieved for all patients. Expansion effects reverberated to maxillary central incisor, canine, first premolar, and first molar at 70%, 75%, 92%, and 89%, respectively. The molar teeth tipped buccally (right 3.06° and left 3.24°) as did premolars (right 2.88° and left 3.02°). CONCLUSION The hybrid expander, minimally invasive expansion appliance that protects teeth by including bone support, can be used easily for rapid maxillary expansion treatment.
Collapse
Affiliation(s)
- Mehmet Akin
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Yasin Erdem Akgul
- Research Assistant, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Zehra Ileri
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Faruk Ayhan Basciftci
- Professor, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| |
Collapse
|
43
|
Dindaroğlu F, Doğan S. Evaluation and comparison of root resorption between tooth-borne and tooth-tissue borne rapid maxillary expansion appliances: A CBCT study. Angle Orthod 2016; 86:46-52. [PMID: 25993251 PMCID: PMC8603957 DOI: 10.2319/010515-007.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 03/01/2015] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVE To compare volumetric root resorption after rapid maxillary expansion (RME) between tooth-borne and tissue-borne appliances using CBCT. Repair in resorption cavities after 6 months of fixed retention was also compared. MATERIALS AND METHODS A sample of 33 subjects were randomly divided into two groups: Hyrax (n = 16) and Haas (n = 17). CBCT scans were taken 6 months before expansion, immediately after expansion, and 6 months after fixed retention. Mimics Innovation V 16.0 software was used for segmentation and volumetric measurement of 198 teeth. Bland-Altman plots, independent samples t test, repeated measures analysis of variance, and the Friedman test were used for statistical analysis. RESULTS Differences in root resorption after RME and repair after retention were not significant between the hyrax and Haas appliances or between male and female. Significant differences were found between preexpansion and postexpansion root volumes in the first premolars and molars--even in unattached second premolars. When the percentage of root volume loss is considered, no significant difference was found between the first premolar, second premolar, and first molar. Volumetric changes after 6 months of retention were not statistically significant. CONCLUSIONS More resorption was observed in the Hyrax expander group. But it was not statistically significant. Repair was observed after 6 months of retention. Heavy RME forces affected premolars and molar similarly.
Collapse
Affiliation(s)
- Furkan Dindaroğlu
- Research Assistant, Department of Orthodontics, School of Dentistry, Ege University, Izmir, Turkey
| | - Servet Doğan
- Professor, Department of Orthodontics, School of Dentistry, Ege University, Izmir, Turkey
| |
Collapse
|
44
|
Kayalar E, Schauseil M, Kuvat SV, Emekli U, Fıratlı S. Comparison of tooth-borne and hybrid devices in surgically assisted rapid maxillary expansion: A randomized clinical cone-beam computed tomography study. J Craniomaxillofac Surg 2015; 44:285-93. [PMID: 26782847 DOI: 10.1016/j.jcms.2015.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/08/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The objective of this 2-arm, parallel, single-center trial was to compare the skeletal, dental, and periodontal effects of tooth-borne (TB) and hybrid devices in surgically assisted rapid maxillary expansion (SARME). MATERIALS AND METHODS Twenty consecutive patients (9 male and 11 female) with skeletal transverse maxillary deficiency seeking treatment at the Department of Orthodontics at Istanbul University in Istanbul, Turkey, were randomly assigned to 2 groups (10 patients each). Hybrid devices were inserted in the first group and TB (Hyrax) devices in the second. All of the patients had undergone SARME operations, which were carried out by the same surgeons using the same procedure (a Le Fort I osteotomy with pterygomaxillary dysjunction). All of the patients had similar transverse deficits, and 7 mm of expansion was achieved in all of them over 14 days. CBCT was carried out preoperatively (T0), at the end of the active expansion phase (T1), and after 6 months of retention (T2). Measurements were made using Mimics 16.0. RESULTS Anterior skeletal maxillary widening parameters increased significantly in the T0-T1 and T0-T2 periods in the 2 groups (P = 0.001). There was significantly less dental expansion anteriorly with the hybrid devices (T0-T2: 4.03 mm vs. 6.29 mm). The first molars tipped buccally more in the group with TB devices during the T0-T1 phase (P = 0.029) and moved upright more than those in the group with hybrid devices during the retention phase (P = 0.035). Dental tipping, buccal alveolar bone resorption, and root resorption were observed significantly more often with the TB devices. CONCLUSION Hybrid RME devices, with similar skeletal effects, different dental movement patterns, and fewer dental and periodontal side effects, thus appear to be a beneficial alternative to TB devices for SARME procedures.
Collapse
Affiliation(s)
- Emre Kayalar
- Department of Orthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Michael Schauseil
- Department of Orthodontics, University of Marburg, Marburg, Germany.
| | - Samet Vasfi Kuvat
- Department of Plastic Reconstructive and Aesthetic Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Ufuk Emekli
- Department of Oral and Maxillofacial Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sönmez Fıratlı
- Department of Orthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| |
Collapse
|
45
|
Baldini A, Nota A, Santariello C, Assi V, Ballanti F, Cozza P. Influence of activation protocol on perceived pain during rapid maxillary expansion. Angle Orthod 2015; 85:1015-1020. [PMID: 25757063 PMCID: PMC8612036 DOI: 10.2319/112114-833.1] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 02/01/2015] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE To investigate the influence of two different activation protocols on the timing and intensity of pain during rapid maxillary expansion (RME). MATERIALS AND METHODS A total of 112 prepubertal patients (54 males and 58 females, mean age 11.00 ± 1.80 years) with constricted maxillary arches underwent RME with two different activation protocols (group 1: one activation/day; group 2: two activations/day). Patients were provided with a numeric rating scale (NRS) and the Faces Pain Scale (FPS) to correctly assess their daily pain. RESULTS Subjects treated with RME at two activations/day reported statistically significantly greater amounts of pain than subjects treated with RME at one activation/day. Differences related to gender and skeletal maturity were found. CONCLUSION The choice of activation protocol influences the perceived pain during RME, and less daily expansion is correlated to less pain. Pain reported during RME could be influenced by skeletal maturity and gender of the subjects under treatment.
Collapse
Affiliation(s)
- Alberto Baldini
- PhD Student, Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Nota
- PhD Student, Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| | - Claudia Santariello
- Postgraduate Student, Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Assi
- Statistician, Edinburgh Clinical Trials Unit (ECTU), University of Edinburgh, Edinburgh, United Kingdom
| | - Fabiana Ballanti
- PhD Student, Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| | - Paola Cozza
- Professor and Department Chair, Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
46
|
New palatal distraction device by both bone-borne and tooth-borne force application in a paramedian bone anchorage site: surgical and occlusal considerations on clinical cases. J Craniofac Surg 2015; 25:589-95. [PMID: 24577304 DOI: 10.1097/scs.0000000000000674] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Maxillary constriction is a very common pathology with implications on dental occlusion, temporomandibular joint dysfunction, nasal breathing, and impairment on the smile and face esthetic.New techniques for expansion of the maxillary bones are particularly useful in relation to the new esthetic ideals of smile and face beauty.To achieve a bodily expansion of the maxillary bones, we developed a new rigid palatal distractor device with both tooth-borne and paramedian bone-borne anchorages to achieve a safe and simple anchorage site suitable also for orthodontic appliances.The reported cases show good results, with bodily maxillary expansion and cross-bite correction without any problems or complications. Substantial advantages of this new device and technique, in comparison with other commonly used palatal distractors, consisting of bodily maxillary movements, avoidance of relapse risks, and safe and simple screw insertion site for bone anchorage also suitable for orthodontic movements, are discussed.
Collapse
|
47
|
Gunyuz Toklu M, Germec-Cakan D, Tozlu M. Periodontal, dentoalveolar, and skeletal effects of tooth-borne and tooth-bone-borne expansion appliances. Am J Orthod Dentofacial Orthop 2015; 148:97-109. [PMID: 26124033 DOI: 10.1016/j.ajodo.2015.02.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/01/2015] [Accepted: 02/01/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purposes of this study were to evaluate and compare the periodontal, dentoalveolar, and skeletal effects of tooth-borne and tooth-bone-borne expansion devices using cone-beam computed tomography. METHODS Twenty-five patients requiring maxillary expansion were randomly allocated into 2 groups. A tooth-borne hyrax appliance was used in the first group, consisting of 13 patients (8 girls, 5 boys; mean age, 14.3 ± 2.3 years), and a tooth-bone-borne hybrid hyrax appliance was used in the second group of 12 patients (6 girls, 6 boys; mean age, 13.8 ± 2.2 years). Cone-beam computed tomography records were taken before and 3 months after expansion, and periodontal, dentoalveolar, and skeletal measurements were made on the cone-beam computed tomography images with a software program. The 2 independent-samples t test and the Mann-Whitney U test were used to evaluate treatment changes for both groups. Paired-samples t test and Wilcoxon test were used to compare the measurements at 2 time points for variables. RESULTS Significant skeletal changes and increases in interdental distances were observed in both groups. However, the distances between the first and second premolars increased more with the hyrax appliance (7.5 ± 4.2 and 7.9 ± 3.3 mm, respectively) than with the hybrid hyrax (3.2 ± 2.6 and 4.5 ± 3.8 mm, respectively) (P <0.05). Similar reductions in buccal bone plate thickness and increases in palatal bone plate thickness of the anchored teeth occurred in both groups, whereas changes in buccal and palatal bone thicknesses of the left first premolars significantly differed between groups (P <0.001). No significant intergroup difference was found in terms of absolute dental tipping. CONCLUSIONS Both tooth-borne and tooth-bone-borne rapid expansion are effective methods for treating a narrow maxilla. However, the hyrax appliance resulted in greater expansion in the premolar region. On the other hand, the hybrid hyrax appliance did not cause changes in the bony support of the first premolars.
Collapse
Affiliation(s)
| | - Derya Germec-Cakan
- Associate professor, Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
| | - Murat Tozlu
- Assistant professor, Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| |
Collapse
|
48
|
A new palatal distractor device for bodily movement of maxillary bones by rigid self-locking miniplates and screws system. J Craniofac Surg 2015; 24:1341-6. [PMID: 23851803 DOI: 10.1097/scs.0b013e31828041a7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
METHODS A new palatal distractor device for bodily movement of the maxillary bones after complete segmented Le Fort I osteotomy for 1-stage transversal distraction and tridimensional repositioning on 1 patient is presented. The new distractor has an intrinsic tridimensional rigidity also in the fixation system by self-locking miniplates and screws for better control of the 2 maxillary fragments during distraction. RESULTS Le Fort I distraction and repositioning procedure in association with a bilateral sagittal split osteotomy were performed on 1 patient with complete solution of the cross-bite and class III malocclusion. Results of dental and cephalometric analysis performed before surgery (T1), after surgery and distraction time (T2), and 18 months after surgery and orthodontic appliance removal (T3) are reported. CONCLUSIONS No complications were encountered using the new distractor device. Advantages of this device and technique are presented including improved rigidity of both distraction (jackscrew) and fixation (4 self-locking miniplates and screws) systems resulting in complete control of the position of the 2 maxillary fragments during distraction and surgery. In addition, this new device allows resuming palatal distraction in the event of cross-bite relapse without causing dental-related problems or the risks of screw slackening.
Collapse
|
49
|
Yurttadur G, Ileri Z, Akin M. Hybrid Rapid Palatal Expansion With 2 Mini-Screws: A Case Report. Turk J Orthod 2015. [DOI: 10.13076/tjo-d-14-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
50
|
Akyalcin S, Alexander SP, Silva RM, English JD. Evaluation of three-dimensional root surface changes and resorption following rapid maxillary expansion: a cone beam computed tomography investigation. Orthod Craniofac Res 2015; 18 Suppl 1:117-26. [DOI: 10.1111/ocr.12069] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 11/27/2022]
Affiliation(s)
- S. Akyalcin
- Department of Orthodontics; School of Dentistry; The University of Texas Health Science Center at Houston; Houston TX USA
| | - S. P. Alexander
- Department of Orthodontics; School of Dentistry; The University of Texas Health Science Center at Houston; Houston TX USA
| | - R. M. Silva
- Department of Endodontics; School of Dentistry; The University of Texas Health Science Center at Houston; Houston TX USA
| | - J. D. English
- Department of Orthodontics; School of Dentistry; The University of Texas Health Science Center at Houston; Houston TX USA
| |
Collapse
|