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Wang S, Fu D, Zou L, Zhao Z, Liu J. Bibliometric and visualized analysis of randomized controlled trials in orthodontics between 1991 and 2022. Am J Orthod Dentofacial Orthop 2024; 165:471-487. [PMID: 38276931 DOI: 10.1016/j.ajodo.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION In many evidence-based approaches to orthodontic research, randomized controlled trials (RCTs) represent authoritative evidence to identify rational therapeutics. This study aimed to perform mappings of bibliometric networks on orthodontic RCTs and summarize visual characteristics between 1991 and 2022. METHODS The articles were retrieved from the Web of Science Core Collection in October 2022 without an initial time limit. Only orthodontic RCTs were eligible. Some bibliometric tools (HistCite, VOSviewer, SCImago Graphica, and CiteSpace) were applied for visualized analysis. Data such as geography, productive institutions, hot articles, journals, authors, references, and keywords were extracted and summarized for analysis. RESULTS A total of 1122 orthodontic RCTs were searched. A total of 3841 authors from 1157 institutions in 65 countries published orthodontic RCTs. The United States (149) was the most prolific country, and the University of Sao Paulo (35) was the most productive institution. The American Journal of Orthodontics and Dentofacial Orthopedics (206) was the most popular journal for scholars. The visualization results of keyword co-occurrence identified 5 clusters: (1) tooth movement and auxiliary measures, (2) appliances and oral health, (3) orthodontic discomfort and symptomatic therapy, (4) periodontal disease in orthodontics and health maintenance, and (5) retention and relapse. CONCLUSIONS Over the past 31 years, publications and citations on orthodontic RCTs from the Web of Science Core Collection have increased notably across many countries, authors, and institutions. Recently, there has been a significant increase in the attention to orthodontic RCTs that focus on accelerating tooth movement.
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Affiliation(s)
- Shuhua Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Di Fu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ling Zou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jun Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Bruni A, Abate A, Maspero C, Castroflorio T. Comparison of Mechanical Behavior of Clear Aligner and Rapid Palatal Expander on Transverse Plane: An In Vitro Study. Bioengineering (Basel) 2024; 11:103. [PMID: 38391589 PMCID: PMC10886082 DOI: 10.3390/bioengineering11020103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: This study aims to investigate, within a controlled laboratory environment, the magnitude of the transversal load and the force decay over time produced by clear aligners in comparison to a Rapid Palatal Expander (RPE). (2) Methods: Resin models of a dental maxillary arch, additively manufactured from an intraoral scan, were inserted in a testing machine with uniaxial load cells to measure the force trend over time expressed by RPE and clear aligners. The mechanical load was recorded during a certain timeframe for both appliances. (3) Results: The force expressed by the RPE ranged from 30 to 50 N for each activation, decreasing with a nonlinear pattern over time. The force expressed by the clear aligner ranged from 3 to 5 N, decreasing with a linear pattern over time. In contrast, the force generated by the clear aligner fell within the range of 3 to 5 N, showing a linear reduction in force magnitude over the observed period of time. (4) Conclusions: The RPE exerted a force magnitude approximately ten times greater than that generated by clear aligners. Nevertheless, it is essential to acknowledge that the oral environment can significantly influence these results. These limitations underscore the need for caution when applying these findings to clinical settings.
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Affiliation(s)
- Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16126 Genova, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142 Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Marino Merlo M, Quiroga Souki B, Nieri M, Bonanno A, Giuntini V, McNamara JA, Franchi L. Comparison of the effects on facial soft tissues produced by rapid and slow maxillary expansion using stereophotogrammetry: a randomized clinical trial. Prog Orthod 2024; 25:1. [PMID: 38168740 PMCID: PMC10761642 DOI: 10.1186/s40510-023-00498-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/28/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To compare the effects on facial soft tissues produced by maxillary expansion generated by rapid maxillary expansion (RME) versus slow maxillary expansion (SME). MATERIALS AND METHODS Patients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. A conventional RME screw was compared to a new expansion screw (Leaf expander) designed to produce SME. Both screws were incorporated in a fixed expander. The primary outcome was the difference of the facial tissue changes in the nasal area measured on facial 3D images captured immediately before application of the expander (T0) and after one year of retention, immediately after the expander removal (T1). Secondary outcomes were soft tissue changes of other facial regions (mouth, lips, and chin). Analysis of covariance was used for statistical analysis. RESULTS Fourteen patients were allocated to the RME group, and 14 patients were allocated to the SME group. There were no dropouts. Nasal width change showed a difference between the two groups (1.3 mm greater in the RME group, 95% CI from 0.4 to 2.2, P = 0.005). Also, intercanthal width showed a difference between treatments (0.7 mm greater in the RME group, 95% CI from 0.0 to 1.3, P = 0.044). Nasal columella width, mouth width, nasal tip angle, upper lip angle, and lower lip angle did not show any statistically significant differences. The Y-axis (anterior-posterior) components of the nasal landmark showed a statistically significant difference between the two groups (0.5 mm of forward displacement greater in the RME group, 95% CI from 0.0 to 1.2, P = 0.040). Also, Z-axis (superior-inferior) components of the lower lip landmark was statistically significant (0.9 mm of downward displacement in favor of the RME group, 95% CI from 0.1 to 1.7, P = 0.027). All the other comparisons of the three-dimensional assessments were not statistically significant. CONCLUSIONS RME produced significant facial soft tissue changes when compared to SME. RME induced greater increases in both nasal and intercanthal widths (1.3 mm and 0.7 mm, respectively). These findings, though statistically significant, probably are not clinically relevant. Trial registration ISRCTN, ISRCTN18263886. Registered 8 November 2016, https://www.isrctn.com/ISRCTN18263886?q=Franchi&filters=&sort=&offset=2&totalResults=2&page=1&pageSize=10.
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Affiliation(s)
- Matilde Marino Merlo
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy
| | - Agnese Bonanno
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor of Dentistry Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Professor Emeritus of Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy.
- Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, USA.
- Director of the Division of Dentistry, University Hospital of Careggi, Via del Ponte di Mezzo, 46-48, 50127, Florence, Italy.
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Abate A, Ugolini A, Maspero C, Silvestrini-Biavati F, Caprioglio A, Lanteri V. Comparison of the skeletal, dentoalveolar, and periodontal changes after Ni-Ti leaf spring expander and rapid maxillary expansion: a three-dimensional CBCT based evaluation. Clin Oral Investig 2023; 27:5249-5262. [PMID: 37466717 PMCID: PMC10492880 DOI: 10.1007/s00784-023-05144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND The aim of the present study was twofold:(1) three-dimensionally evaluate the quantitative skeletal and dentoalveolar changes after Ni-Ti leaf spring expander (leaf expander) and rapid maxillary expansion (RME) in mixed dentition patients;(2) analyze the modifications of the buccal alveolar bone plate of the maxillary first permanent molars. METHODS Patients who underwent CBCT scans before and after maxillary expansion were randomly selected from the records archived at the Department of Biomedical Surgical and Dental Sciences, University of Milan, Italy. Inclusion criteria were the following: no systemic disease or syndromes; maxillary transverse deficiencies (difference between the upper intermolar width and the lower intermolar width of at least 3 mm and/or clinical need based on radiographic evaluation), early mixed dentition with ages between 7 to 10 years old; cervical vertebra maturation stage (CVMS) 1 or 2; no pathologic periodontal status; skeletal class I or II; maxillary expander cemented on the upper second deciduous molars. Exclusion criteria were the following: patients with pubertal or post-pubertal stage of development (CVMS 3-6); late deciduous or late mixed dentition, impossibility to use the second primary molar as anchorage; skeletal class III malocclusion; craniofacial syndromes; patients unable to be followed during the treatment period. Twenty-three patients treated with Leaf Expander, 11 males (mean age 7.8 ± 0.6 years) and 12 females (mean age 8.1 ± 0.8 years), met the inclusion criteria and constituted the case group. Twenty-four (control group) treated with conventional RME, 12 males (mean age 8.4 ± 0.9 years) and 12 females (mean age 8.1 ± 0.7 years). The paired-sample T test was used for intra-group comparison to evaluate the difference between before (T1) and after (T2) maxillary expansion. Independent sample t-test was computed to perform between groups comparison of the skeletal, dentoalveolar, and periodontal changes. RESULTS The Leaf Expander and RME group showed a significant increase between T1 and T2 for most of the skeletal and dentoalveolar variables. Concerning the skeletal variables only the RME demonstrated a significant increase at the level of the posterior nasal (PNW) and apical base width (PABW) and maxillary mid-alveolar width (MMW). Despite this, when compare with the Leaf Expander, the RME group exhibited a statistically larger width increase for only two skeletal parameters: PNW (p = 0.03) and MMW (p = 0.02). No significant changes at the periodontal level were found in either group. CONCLUSIONS According to the current research, the authors confirm the effectiveness of the Leaf Expander and RME to produce similar skeletal and dentoalveolar effects in mixed dentition subjects. Moreover, the devices anchored to deciduous teeth did not reduce the thickness and height of the buccal bone at the level of the maxillary permanent first molars in either of the two groups.
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Affiliation(s)
- Andrea Abate
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, Genoa, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy.
| | | | - Alberto Caprioglio
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Valentina Lanteri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
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Inchingolo AM, Patano A, De Santis M, Del Vecchio G, Ferrante L, Morolla R, Pezzolla C, Sardano R, Dongiovanni L, Inchingolo F, Bordea IR, Palermo A, Inchingolo AD, Dipalma G. Comparison of Different Types of Palatal Expanders: Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1258. [PMID: 37508755 PMCID: PMC10378123 DOI: 10.3390/children10071258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the maxillary growth is unusually modest, are frequently treated with maxillary expansion. The purpose of this study is to compare the dental and skeletal effects of different types of expanders, particularly the Leaf Expander, rapid and slow dental-anchored or skeletal-anchored maxillary expanders. METHODS We chose studies that compared effects determined by palatal expansion using a rapid palatal expander, expander on palatal screws, and leaf expander. RESULTS Reports assessed for eligibility are 26 and the reports excluded were 11. A final number of 15 studies were included in the review for qualitative analysis. CONCLUSIONS Clinically and radiographically, the outcomes are similar to those obtained with RME and SME appliances; Therefore, it might be a useful treatment choice as an alternative to RME/SME equipment in cases of poor patient compliance or specific situations. Finally, all of the devices studied produce meaningful skeletal growth of the palate. The use of skeletally anchored devices does, without a doubt, promote larger and more successful growth in adolescent patients.
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Affiliation(s)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Matteo De Santis
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Roberta Morolla
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Carmela Pezzolla
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Roberta Sardano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Leonardo Dongiovanni
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | | | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
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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.
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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
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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.
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Silvestrini Biavati F, Schiaffino V, Signore A, De Angelis N, Lanteri V, Ugolini A. Evaluation of Enamel Surfaces after Different Techniques of Interproximal Enamel Reduction. J Funct Biomater 2023; 14:jfb14020110. [PMID: 36826909 PMCID: PMC9963069 DOI: 10.3390/jfb14020110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
According to the literature, interproximal enamel reduction (IER) has become a consolidated technique used in orthodontic treatments to gain space in particular situations such as dental crowding, non-extractive therapies, tooth-size discrepancies, and prevention of dental relapse. There are different methods to realize stripping, and enamel surfaces resulting after this procedure can be analyzed with SEM. The aim of this study was to analyze how different devices of IER leave the surface of the teeth. One hundred and sixty freshly extracted, intact human lower incisors were included in the study, fixed in a plaster support, and then processed with four different techniques of enamel reduction and finishing. Then, they were divided randomly into eight groups (A1-A2, B1-B2, C1-C2, D, and E), each containing twenty teeth. The A, B, and C groups were divided into two subgroups and then all the teeth were observed at SEM. Each digital image acquired by SEM showed that there were streaks on the surfaces, due to the cutter used. The results of this study showed that only group C2 (tungsten carbide bur followed by twelve steps of medium-fine-ultrafine 3M Soft Lex disks) has a few line, which is very similar to group E (untreated group), while the other groups have a lot of lines and show a rougher final surface.
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Affiliation(s)
| | - Viola Schiaffino
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, 16132 Genoa, Italy
| | - Antonio Signore
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, 16132 Genoa, Italy
- Therapeutic Dentistry Department, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 119992 Moscow, Russia
| | - Nicola De Angelis
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, 16132 Genoa, Italy
- Dental Department, University Trisakti, Jakarta 11440, Indonesia
| | - Valentina Lanteri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142 Milan, Italy
| | - Alessandro Ugolini
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-3538404; Fax: +39-010-3537584
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Rutili V, Nieri M, Franceschi D, Pierleoni F, Giuntini V, Franchi L. Comparison of rapid versus slow maxillary expansion on patient-reported outcome measures in growing patients: a systematic review and meta-analysis. Prog Orthod 2022; 23:47. [PMID: 36503984 PMCID: PMC9742070 DOI: 10.1186/s40510-022-00440-5] [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: 06/01/2022] [Accepted: 10/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND No systematic review and meta-analysis are present in the literature comparing patient-reported outcome measures (PROMs) in rapid maxillary expansion (RME) versus slow maxillary expansion (SME) in growing patients. OBJECTIVE The objective of this systematic review was to compare PROMs in RME versus SME in growing patients. MATERIALS AND METHODS Electronic search in PubMed (MEDLINE), Cochrane Library, Scopus, Embase, Web of Science, and OpenGrey was conducted. Only RCTs were included. Inclusion criteria were: growing patients in the mixed dentition or early permanent dentition, mild-to-moderate maxillary transverse deficiency, dental crowding, treatment with fixed expanders for rapid and slow maxillary expansion. Risk of bias was assessed using RoB 2. GRADE statement was performed. The mean of the differences (MD) and the risk ratio (RR) were used for the aggregation of data. A random effect model was applied. RESULTS Two articles with a total of 157 patients were finally included in the systematic review and meta-analysis. One article was at low risk of bias, while one was at risk of bias with some concerns. Pain presence was less, though not statistically significant, in SME patients (RR = 2.02, 95%CI from 0.55 to 7.49, P = 0.29, I2 = 95%, 2 studies, GRADE very low). Pain intensity was significantly lower in SME appliance in the first week of treatment (pooled MD = 0.86 favoring SME, 95%CI from 0.47 to 1.26, P < 0.0001, I2 = 6%, 2 studies, GRADE moderate). There were no significant differences between the two groups in difficulty in speaking, difficulty in swallowing, hypersalivation, difficulty in hygiene, and patient and parent satisfaction. CONCLUSIONS Pain intensity was significantly lower in SME compared to RME during the first week of treatment. For the following weeks, there were no differences in pain between the two protocols.
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Affiliation(s)
- Valentina Rutili
- grid.8404.80000 0004 1757 2304Postgraduate Program in Orthodontics, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Michele Nieri
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Debora Franceschi
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Felicita Pierleoni
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Veronica Giuntini
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Lorenzo Franchi
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy ,grid.214458.e0000000086837370Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, USA
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10
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Benhamour S, Brezulier D. Hyrax versus Leaf expander in growing patients, what about adverse dental effects? A retrospective study. Int Orthod 2022; 20:100684. [PMID: 36180336 DOI: 10.1016/j.ortho.2022.100684] [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: 06/20/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Transverse discrepancy is a Common problem in young patients. Many devices are employed to expand the palatal dimension, with different characteristics and biomechanical aspects. The Leaf expander, a new-born appliance containing nickel-titanium springs, free from activation by parents. We compared the maxillary and mandibular dental effects of Leaf expander to conventional Hyrax in growing patients. METHODS All patients who met the eligibility criteria between the period from January 2017 to December 2019 were included. The patients had transverse inter-arch discrepancy of at least 5mm and were treated with Hyrax expander (HEX) or Leaf expander (LEX). All patients had complete follow-up of expansion by remote monitoring. An algorithm established distances between the teeth. It was also used to measure the change in dental axes. RESULTS In the maxilla, LEX caused more tipping on the canines and premolars but significantly less on the molars compared to HEX: -0.154̊ vs. 3.05̊ (P<0.001). In the mandible, LEX caused a greater increase in arch widths and tipping (P<0.02) in the molars and second premolars, but not in the other teeth. No correlation was demonstrated between mandibular dental movements and increased maxillary arch widths. Alternatively, for the two devices, expansion and tipping were correlated within each dental arch (r>0.4). CONCLUSIONS The LEX produced more tooth movement on average than the HEX, except for the maxillary first molars. Several correlations exist between the movements within each arch for the two devices, most often between tipping and expansion.
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Affiliation(s)
- Sacha Benhamour
- Pôle odontologie, CHU Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France
| | - Damien Brezulier
- Pôle odontologie, CHU Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France; ISCR, CNRS-UMR 6226, université de Rennes, 2, avenue Léon Bernard, bâtiment 15, 35043 Rennes, France.
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11
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Rabah N, Al-Ibrahim HM, Hajeer MY, Ajaj MA, Mahmoud G. Assessment of Patient-Centered Outcomes When Treating Maxillary Constriction Using a Slow Removable Versus a Rapid Fixed Expansion Appliance in the Adolescence Period: A Randomized Controlled Trial. Cureus 2022; 14:e22793. [PMID: 35261839 PMCID: PMC8893008 DOI: 10.7759/cureus.22793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 12/18/2022] Open
Abstract
Objective This study aimed to evaluate and compare the levels of pain, discomfort, and functional impairments between slow and rapid maxillary expansion (RME) in treating skeletal maxillary constriction in the adolescence period (i.e., between 12 and 16 years). Materials and methods The study sample consisted of 52 patients (21 males and 31 females) with maxillary skeletal constriction in the posterior region. The patients were randomly distributed into either RME (26 patients, with a mean age of 13.87 (± 1.31) years) or slow maxillary expansion group (SME, 26 patients, with a mean age of 14.31 (± 1.19) years). The levels of pain, discomfort, and functional difficulties were assessed after 24 hours (T1), 7 days (T2), 15 days (T3), one month (T4), and four months (T5) following the onset of the expansion procedure. Results Patients in the RME group encountered significantly greater levels of pain and discomfort than those in the SME group at T1, T2, and T3 (p>0.001). Chewing and swallowing difficulties were significantly greater in the RME group at T1, T2, T3, and T4 (P≤0.001). The pressure on soft tissue was greater in the RME group at T2 and T3 (p>0.001). After four months (T5), the levels of pain and discomfort decreased to their lowest levels, as well as the difficulties of chewing and swallowing, and the pressure on soft tissue were almost non-existent in both groups. Conclusion Patients treated with the removable slow maxillary expander reported lower levels of pain and discomfort, fewer chewing and swallowing difficulties, and less pressure on soft tissues than those treated with the bonded rapid maxillary expander. These difficulties gradually decreased over time in both groups. The lower levels of pain and discomfort may make the SME an effective and comfortable treatment alternative for adolescents with skeletal maxillary constriction.
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Affiliation(s)
- Nancy Rabah
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Heba M Al-Ibrahim
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Mowaffak A Ajaj
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Ghiath Mahmoud
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
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12
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Ugolini A, Agostino P, Silvestrini-Biavati A, Harrison JE, Batista KB. Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev 2021; 12:CD000979. [PMID: 34951927 PMCID: PMC8709729 DOI: 10.1002/14651858.cd000979.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. The prevalence of posterior crossbite is around 4% and 17% of children and adolescents in Europe and America, respectively. Several treatments have been recommended to correct this problem, which is related to such dental issues as tooth attrition, abnormal development of the jaws, joint problems, and imbalanced facial appearance. Treatments involve expanding the upper jaw with an orthodontic appliance, which can be fixed (e.g. quad-helix) or removable (e.g. expansion plate). This is the third update of a Cochrane review first published in 2001. OBJECTIVES To assess the effects of different orthodontic treatments for posterior crossbites. SEARCH METHODS Cochrane Oral Health's Information Specialist searched four bibliographic databases up to 8 April 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA Randomised controlled trials (RCTs) of orthodontic treatment for posterior crossbites in children and adults. DATA COLLECTION AND ANALYSIS Two review authors, independently and in duplicate, screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. A third review author participated to resolve disagreements. We used risk ratios (RR) and 95% confidence intervals (CIs) to summarise dichotomous data (event), unless there were zero values in trial arms, in which case we used odds ratios (ORs). We used mean differences (MD) with 95% CIs to summarise continuous data. We performed meta-analyses using fixed-effect models. We used the GRADE approach to assess the certainty of the evidence for the main outcomes. MAIN RESULTS We included 31 studies that randomised approximately 1410 participants. Eight studies were at low risk of bias, 15 were at high risk of bias, and eight were unclear. Intervention versus observation For children (age 7 to 11 years), quad-helix was beneficial for posterior crossbite correction compared to observation (OR 50.59, 95% CI 26.77 to 95.60; 3 studies, 149 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 4.71 mm, 95% CI 4.31 to 5.10; 3 studies, 146 participants; moderate-certainty evidence). For children, expansion plates were also beneficial for posterior crossbite correction compared to observation (OR 25.26, 95% CI 13.08 to 48.77; 3 studies, 148 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 3.30 mm, 95% CI 2.88 to 3.73; 3 studies, 145 participants, 3 studies; moderate-certainty evidence). In addition, expansion plates resulted in higher inter-canine distances (MD 2.59 mm, 95% CI 2.18 to 3.01; 3 studies, 145 participants; moderate-certainty evidence). The use of Hyrax is probably effective for correcting posterior crossbite compared to observation (OR 48.02, 95% CI 21.58 to 106.87; 93 participants, 3 studies; moderate-certainty evidence). Two of the studies focused on adolescents (age 12 to 16 years) and found that Hyrax increased the inter-molar distance compared with observation (MD 5.80, 95% CI 5.15 to 6.45; 2 studies, 72 participants; moderate-certainty evidence). Intervention A versus intervention B When comparing quad-helix with expansion plates in children, quad-helix was more effective for posterior crossbite correction (RR 1.29, 95% CI 1.13 to 1.46; 3 studies, 151 participants; moderate-certainty evidence), final inter-molar distance (MD 1.48 mm, 95% CI 0.91 mm to 2.04 mm; 3 studies, 151 participants; high-certainty evidence), inter-canine distance (0.59 mm higher (95% CI 0.09 mm to 1.08 mm; 3 studies, 151 participants; low-certainty evidence) and length of treatment (MD -3.15 months, 95% CI -4.04 to -2.25; 3 studies, 148 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and Haas for posterior crossbite correction (RR 1.05, 95% CI 0.94 to 1.18; 3 studies, 83 participants; moderate-certainty evidence) or inter-molar distance (MD -0.15 mm, 95% CI -0.86 mm to 0.56 mm; 2 studies of adolescents, 46 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and tooth-bone-borne expansion for crossbite correction (RR 1.02, 95% CI 0.92 to 1.12; I² = 0%; 3 studies, 120 participants; low-certainty evidence) or inter-molar distance (MD -0.66 mm, 95% CI -1.36 mm to 0.04 mm; I² = 0%; 2 studies, 65 participants; low-certainty evidence). There was no evidence of a difference between Hyrax with bone-borne expansion for posterior crossbite correction (RR 1.00, 95% CI 0.94 to 1.07; I² = 0%; 2 studies of adolescents, 81 participants; low-certainty evidence) or inter-molar distance (MD -0.14 mm, 95% CI -0.85 mm to 0.57 mm; I² = 0%; 2 studies, 81 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: For children in the early mixed dentition stage (age 7 to 11 years old), quad-helix and expansion plates are more beneficial than no treatment for correcting posterior crossbites. Expansion plates also increase the inter-canine distance. Quad-helix is more effective than expansion plates for correcting posterior crossbite and increasing inter-molar distance. Treatment duration is shorter with quad-helix than expansion plates. For adolescents in permanent dentition (age 12 to 16 years old), Hyrax and Haas are similar for posterior crossbite correction and increasing the inter-molar distance. The remaining evidence was insufficient to draw any robust conclusions for the efficacy of posterior crossbite correction.
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Affiliation(s)
- Alessandro Ugolini
- Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Paola Agostino
- Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | | | - Jayne E Harrison
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | - Klaus Bsl Batista
- Department of Preventive and Public Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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13
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Nieri M, Paoloni V, Lione R, Barone V, Marino Merlo M, Giuntini V, Cozza P, Franchi L. Comparison between two screws for maxillary expansion: a multicenter randomized controlled trial on patient's reported outcome measures. Eur J Orthod 2021; 43:293-300. [PMID: 33215652 DOI: 10.1093/ejo/cjaa063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to compare an expansion screw of the maxilla that generates moderate and continuous forces versus a conventional screw for rapid maxillary expansion (RME) on patient-reported outcome measure during the first 12 weeks of treatment. TRIAL DESIGN This is a superiority, multicenter, two-arm parallel balanced randomization trial. METHODS Patients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. An expansion screw using moderate continuous forces (Leaf group, treated with an expansion screw with Ni-Ti springs) was compared to a conventional RME screw that generates intermittent heavy forces (RME group). The primary response variable was the visual analogue scale (VAS) on pain calculated in the first 12 weeks of therapy. The VAS on difficulty on speaking and oral hygiene, patient satisfaction, and complications were also evaluated. A computer-generated block randomization was used with allocation concealed in sequentially numbered opaque-sealed envelopes. Blinding was not applicable. Linear models were used for statistical analysis. RESULTS Twenty-eight patients in the Leaf group and 28 patients in the RME group were randomized and included in the study. There were no dropouts. The mean of the VAS for pain was 0.3 ± 0.4 in the Leaf group and 0.6 ± 0.5 in the RME group. The difference was -0.3 (95 per cent CI from -0.5 to -0.0; P = 0.017) in favour of the Leaf group. The difference in pain was marked in the first week (Leaf group 2.2 ± 2.3; RME group 3.7 ± 2.6; difference -1.5; 95 per cent CI from -2.7 to -0.3; P = 0.019). CONCLUSIONS Patients in the Leaf group experienced a lower degree of pain, especially during the first week following the application of the expander. For the other variables, no significant differences were reported between the two treatments. REGISTRATION The study was registered in the ISRCTN register on 8 November 2016 with the number ISRCTN18263886.
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Affiliation(s)
- Michele Nieri
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Valeria Paoloni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | | | - Matilde Marino Merlo
- Scuola di Specializzazione in Ortognatodonzia, The University of Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - Veronica Giuntini
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, The University of Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
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14
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Rutili V, Mrakic G, Nieri M, Franceschi D, Pierleoni F, Giuntini V, Franchi L. Dento-skeletal effects produced by rapid versus slow maxillary expansion using fixed jackscrew expanders: a systematic review and meta-analysis. Eur J Orthod 2021; 43:301-312. [PMID: 33950178 DOI: 10.1093/ejo/cjaa086] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND No systematic review and meta-analysis of dento-skeletal effects following rapid maxillary expansion (RME) and slow maxillary expansion (SME) using the same jackscrew expander with different activation protocols is available. OBJECTIVE To compare dento-skeletal effects produced by RME with those induced by SME using the same fixed jackscrew expanders in growing patients. SEARCH METHODS PubMed (MEDLINE), Cochrane Library, Scopus, Embase, and OpenGrey were searched with no language or publication date restrictions. SELECTION CRITERIA Only randomized controlled trials (RCTs) were selected and the following inclusion criteria were used: growing patients in mixed or permanent dentition, with maxillary transverse discrepancy, dental crowding, and treated with fixed jackscrew maxillary expander (e.g. Hyrax, Haas) activated to achieve either RME or SME. DATA COLLECTION AND ANALYSIS Data were extracted by two independent reviewers. The quality of the included RCTs was assessed according to the Cochrane risk-of-bias tool for randomized trials (RoB 2.0). For the aggregation of continuous data, the mean of the differences (MD) between treatments was used. A random effect model was applied. RESULTS From 4855 retrieved articles, 3 studies were selected, 1 at unclear risk and 2 at high risk of bias. Maxillary intermolar distance showed no significant differences between the two modalities of expansion [pooled MD = 0.99 mm favouring RME, with 95% confidence interval (CI) = -2.09 to 4.06, P = 0.53, I2 = 90%]. As for maxillary molar inclination measured as the angle formed by the axes passing through the disto-buccal cusps and the apexes of the palatine root of the first upper molars, it was significantly smaller in the SME group (MD = -11.51°, with 95% CI = -15.23 to -7.79, P < 0.0001). Posterior maxillary expansion was significantly greater in RME than SME (pooled MD = 0.75 mm, with 95% CI = 0.27-1.23, P = 0.002, I2 = 0%). CONCLUSIONS Both RME and SME produce an effective dento-skeletal expansion of the maxilla. RME is slightly more effective in increasing the posterior transverse skeletal width of the maxilla while SME induces smaller molar inclination. REGISTRATION PROSPERO CDR42018105530.
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Affiliation(s)
- Valentina Rutili
- Postgraduate Program in Orthodontics, Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | | | - Michele Nieri
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Debora Franceschi
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Felicita Pierleoni
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Veronica Giuntini
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, The University of Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, USA
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15
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Paoloni V, Giuntini V, Lione R, Nieri M, Barone V, Merlo MM, Mazza F, Passaleva S, Cozza P, Franchi L. Comparison of the dento-skeletal effects produced by Leaf expander versus rapid maxillary expander in prepubertal patients: a two-center randomized controlled trial. Eur J Orthod 2021; 44:163-169. [PMID: 34114608 DOI: 10.1093/ejo/cjab035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to compare the skeletal and dentoalveolar effects produced by slow maxillary expansion (SME) with the Leaf expander versus the conventional rapid maxillary expansion (RME) on digital dental casts, lateral and postero-anterior cephalometric radiographs. TRIAL DESIGN This is a superiority, two-center, two arms parallel balanced randomization trial. METHODS Patients in the mixed dentition were included with a transverse interarch discrepancy of at least 3 mm. An expansion screw using moderate continuous forces (Leaf group) was compared to a conventional RME screw (RME group). The primary response variable was the difference in maxillary intermolar width (U6-U6) measured at baseline (T0) and one-year follow-up (T1) on the digital dental casts. Other dento-skeletal variables were also measured on digital dental casts and cephalograms. Computer-generated block randomization was used with allocation concealed in sequentially numbered opaque sealed envelopes. The examiner was blinded on the type of expander used. Linear models were used for statistical analysis. RESULTS Twenty-eight patients in the Leaf group and 28 patients in the RME group were randomized and included in the study. There were no dropouts. U6-U6 did not show a statistically significant difference between the two groups (-0.4 mm in favor of the RME group, 95% CI from -1.2 to 0.5, P = 0.365). As for the other secondary variables no statistically significant differences were found between the two groups except maxillary intercanine width (U3-U3, -0.9 mm in favor of the RME group, 95%CI from -1.5 to -0.3, P = 0.005) and maxillary skeletal width (Mx-Mx, -1.4 mm in favor of the RME group, 95%CI from -2.4 to -0.3, P = 0.013). CONCLUSIONS No significant differences between the RME and Leaf groups were detected for any of the analyzed dento-skeletal variables except the T1-T0 differences in U3-U3 and Mx-Mx that were significantly greater in the RME group. REGISTRATION The study was registered in the ISRCTN register on 08/11/2016 with the number ISRCTN18263886. FUNDING No funding or conflict of interest to be declared.
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Affiliation(s)
- Valeria Paoloni
- Department of Systems Medicine, University of Rome, Tor Vergata, Italy
| | - Veronica Giuntini
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Roberta Lione
- Department of Systems Medicine, University of Rome, Tor Vergata, Italy.,UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | | | - Matilde Marino Merlo
- Postgraduate Program in Orthodontics, The University of Florence, Florence, Italy
| | - Francesca Mazza
- SOC Odontostomatologia, AUSL Toscana centro, Florence, Italy
| | | | - Paola Cozza
- Department of Systems Medicine, University of Rome, Tor Vergata, Italy.,UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy.,Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
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16
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Lanteri V, Farronato M, Ugolini A, Cossellu G, Gaffuri F, Parisi FMR, Cavagnetto D, Abate A, Maspero C. Volumetric Changes in the Upper Airways after Rapid and Slow Maxillary Expansion in Growing Patients: A Case-Control Study. MATERIALS 2020; 13:ma13102239. [PMID: 32414070 PMCID: PMC7287613 DOI: 10.3390/ma13102239] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/02/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022]
Abstract
The aim is to evaluate changes in the volume of the upper airways before and after slow maxillary expansion (SME) obtained with the flexible properties of a nickel titanium leaf spring and rapid maxillary expansion (RME) with a conventional Hyrax appliance in growing patients. The records of 1200 orthodontic patients undergoing maxillary expansion from 2018 to 2019 were analyzed; among these pre and post treatment CBCT scans of 22 patients (mean age 8.2 ± 0.6 years old) treated by SME were compared with those obtained from 22 patients (mean age 8.1 ± 0.7 years old) treated by RME banded on the second primary molars. The following inclusion criteria were used: Maxillary transverse constriction, good general health, and no previous orthodontic treatment. Volumes of nasal cavity (NCavV), nasopharynx (NsPxV), and right and left maxillary sinuses (MSV) were calculated with ITK-SNAP. Shapiro–Wilk test revealed a normal distribution of data in each group. Paired t-test was used for within-group comparisons and independent t-test for between-group comparisons. Statistically significant increases occurred in NCavV, NsPxV, and MSVs after treatment with both appliances. No statistically significant difference between the appliances occurred in NCavV, NsPxV, and MSVs. Method error was considered negligible (mean intra-operator and inter-operator intraclass correlation coefficient were 0.928 and 0.911, respectively). It appears that both appliances produce similar effects on the different segments of the upper airway tract.
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Affiliation(s)
- Valentina Lanteri
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16132 Genova, Italy;
| | - Gianguido Cossellu
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Francesca Maria Rita Parisi
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Davide Cavagnetto
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Andrea Abate
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (V.L.); (M.F.); (G.C.); (F.G.); (F.M.R.P.); (D.C.); (A.A.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
- Correspondence: ; Tel.: +39-338-334-4999
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