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Tortarolo A, Olivero V, Tomatis E, Crincoli V, Di Benedetto L, Vallelonga T, Piancino MG. Functional treatment of unilateral posterior crossbite improves condylar asymmetry in mixed dentition patients. Eur J Orthod 2025; 47:cjaf029. [PMID: 40396641 DOI: 10.1093/ejo/cjaf029] [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] [Indexed: 05/22/2025]
Abstract
BACKGROUND/OBJECTIVES This study's aim was to evaluate the effects of unilateral posterior crossbite (UPXB) treatment with the appliance Function Generating Bite (FGB) on the asymmetry of mandibular condyles and rami. MATERIALS/METHODS This retrospective study included 156 patients: 52 with UPXB (F = 30, M = 22, mean age ± SD = 7.9 ± 1.5 [yr.mo]) treated with FGB, 104 age and gender-matched control subjects without the malocclusion (control-T0: N = 52, F = 30, M = 22, mean age ± SD = 8.2 ± 1.3; control-T1, n = 52, F = 30, M = 22, mean age ± SD 9.7 ± 1.2). Pre- (T0) and post-treatment (T1) orthopantomographies were analyzed by finding the intersection between a line tangent to the lateral profile of the condyle and ramus and a perpendicular line tangent to the condylar head; the intersection and tangent points were used to measure condylar and ramal heights and to calculate the percentage difference between the sides (asymmetry index). Cephalometric analysis was performed on lateral skull X-rays taken at T0 and T1. RESULTS Condylar asymmetry was significantly increased in UPXB at T0 (P < 0.00001) but not at T1. Between T0/T1 the asymmetry was significantly reduced (P < 0.01). Cephalometric analysis showed that mandibular clockwise rotation was significantly increased in UPXB at T0 (P < 0,01) but not at T1, when the clockwise rotation was significantly reduced (P < 0.05). LIMITATIONS This study did not include an untreated UPXB group and did not evaluate condylar morphology, Conclusions/implications: Functional treatment of UPXB with FGB was associated with a significant reduction in condylar asymmetry and significant mandibular repositioning, highlighting that FGB could rebalance condylar growth in developing patients.
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Affiliation(s)
- Alessandro Tortarolo
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Virginia Olivero
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Elisabetta Tomatis
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Vito Crincoli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Piazza G. Cesare 11, 70124, University of Bari, Bari, Italy
| | - Laura Di Benedetto
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Teresa Vallelonga
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy
| | - Maria Grazia Piancino
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy
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Yang G, Lyu L, Wen A, Zhao Y, Wang Y, Li J, Yan H, Zhang M, Yu Y, Yu T, Liu D. Comparison of Mirroring and Overlapping Analysis and Three-Dimensional Soft Tissue Spatial Angle Wireframe Template in Evaluating Facial Asymmetry. Bioengineering (Basel) 2025; 12:79. [PMID: 39851353 PMCID: PMC11761234 DOI: 10.3390/bioengineering12010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Revised: 12/25/2024] [Accepted: 01/14/2025] [Indexed: 01/26/2025] Open
Abstract
AIM The purpose of this study was to evaluate the accuracy and efficacy of a new wireframe template methodology in analyzing three-dimensional facial soft tissue asymmetry. MATERIALS AND METHODS Three-dimensional facial soft tissue data were obtained for 24 patients. The wireframe template was established by identifying 34 facial landmarks and then forming a template on the face with the MeshLab 2020 software. The angle asymmetry index was automatically scored using the template. The mirroring and overlapping technique is accepted as the golden standard method to diagnose facial asymmetry by acquiring deviation values of one's face. Consistency rates between the two methodologies were determined through a statistical comparison of the angle asymmetry index and deviation values. RESULTS Overall consistency rates in the labial, mandibular angle, cheek, chin, and articular regions were 87.5%, 95.8%, 87.5%, 91.7%, and 100%, respectively. Regions with consistency rates in three dimensions of more than 85% are the x-axis and the z-axis of all regions and the y-axis of the mandibular angle, chin, and articular region. CONCLUSIONS Soft tissue facial asymmetry can be diagnosed accurately and effectively by using a three-dimensional soft tissue spatial angle wireframe template. Precise localization of asymmetry can be offered, and indiscernible tiny asymmetry can be identified.
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Affiliation(s)
- Gengchen Yang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Liang Lyu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Aonan Wen
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Yijiao Zhao
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Yong Wang
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - Jing Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Huichun Yan
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Mingjin Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Yi Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Tingting Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Dawei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, Beijing 100081, China; (G.Y.); (L.L.); (J.L.); (H.Y.); (M.Z.); (Y.Y.); (T.Y.)
- National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; (A.W.); (Y.Z.); (Y.W.)
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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López DF, Giraldo NG, Borrás VR, Muñoz JM, Flores-Mir C. Volumetric differences in temporomandibular joint components in patients with facial asymmetry: A 3D tomographic segmentation study. Semin Orthod 2024; 30:346-354. [DOI: 10.1053/j.sodo.2023.11.010] [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: 01/03/2025]
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Ronsivalle V, Isola G, Lo Re G, Boato M, Leonardi R, Lo Giudice A. Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis. Prog Orthod 2023; 24:41. [PMID: 38072875 PMCID: PMC10710971 DOI: 10.1186/s40510-023-00494-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Previous evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12-18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments. RESULTS At T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05). LIMITATIONS The small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials. CONCLUSIONS Subjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Gianmarco Lo Re
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Mattia Boato
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
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Chen S, Zhang C, Zhang K, Tan X, Xi X, Zhao Y, Liu D. Condylar morphology and position changes after miniscrew-assisted rapid palatal expansion in skeletal Class III malocclusion adult patients with mandibular deviation and unilateral posterior crossbite. Prog Orthod 2022; 23:30. [PMID: 36045260 PMCID: PMC9433628 DOI: 10.1186/s40510-022-00425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the morphological and positional changes of mandibular condyle after miniscrew-assisted rapid palatal expansion (MARPE) in skeletal Class III malocclusion adult patients with horizontal mandibular deviation (MD). METHODS The sample consisted of 15 patients with MD (6 males and 9 females, mean age 21.58 ± 3.12 years). The CBCT scans were taken before and after MARPE immediately. The pre- and post-registered images of the cranial base and mandible were measured, respectively, by Mimics. RESULTS After expansion, the distance between superior condylar point and the Frankfort horizontal plane on the deviated side and the non-deviated side increased by 0.96 ± 0.60 mm (P = 0.011) and 0.70 ± 0.65 mm (P = 0.046); coronal condylar angle of the deviated side increased by 0.39° ± 0.34 (P = 0.028) and 0.06° ± 0.49 (P = 0.917) on the non-deviated side. No statistically significant differences were found when comparing the condylar position on both sides before and after treatment. The degree of mandibular deviation decreased 0.43 mm (P = 0.270). CONCLUSIONS This study suggested that for skeletal Class III malocclusion adult patients with horizontal MD, the condyle on the deviated side rotated toward the non-deviated side in the coronal direction; the condylar remodeling occurred mainly on the deviated side after MARPE in the vertical direction.
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Affiliation(s)
- Shuai Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Chunxi Zhang
- The Center of Stomatology, Qingdao Municipal Hospital Affiliated to Qingdao University, #5 Donghai Middle Road, Qingdao, 266000, China
| | - Kaili Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Xiaoming Tan
- Department of Stomatology, Linyi Third People's Hospital, Linyi, 276023, China
| | - Xun Xi
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Yi Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Dongxu Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China.
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Schneider-Moser UEM, Moser L. Very early orthodontic treatment: when, why and how? Dental Press J Orthod 2022; 27:e22spe2. [PMID: 35703618 PMCID: PMC9191856 DOI: 10.1590/2177-6709.27.2.e22spe2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction: Several orthodontic problems should already be treated at an early age to prevent the necessity of future complex and expensive procedures. Scientific evidence suggests that posterior crossbites, mild to moderate Class III, as well as certain Class II malocclusions, open bites and arch length discrepancies can benefit from simple, but efficient interceptive therapy. Objective: To summarize the existing evidence-based literature on early orthodontic treatment, and to illustrate its application and effectiveness by showcasing multiple clinical examples. Conclusion: Early short-term interceptive orthodontic treatment with simple appliances, in the deciduous or early mixed dentition phase, can efficiently correct certain malocclusions and help to either reduce the complexity or even avoid the necessity of complex and expensive procedures during puberty. For certain patients with significant arch length discrepancy the concept of serial extractions should be part of the orthodontic armamentarium.
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Affiliation(s)
- Ute E M Schneider-Moser
- Private practice (Bolzano, Italy).,University of Ferrara, Ferrara School of Orthodontics (Ferrara, Italy).,University of Pennsylvania, School of Dental Medicine (Philadelphia/PA, USA)
| | - Lorenz Moser
- Private practice (Bolzano, Italy).,University of Ferrara, Ferrara School of Orthodontics (Ferrara, Italy)
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Evangelista K, Teodoro AB, Bianchi J, Cevidanes LHS, de Oliveira Ruellas AC, Silva MAG, Valladares-Neto J. Prevalence of mandibular asymmetry in different skeletal sagittal patterns. Angle Orthod 2022; 92:118-126. [PMID: 34546287 PMCID: PMC8691477 DOI: 10.2319/040921-292.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To analyze the prevalence of mandibular asymmetry in skeletal sagittal malocclusions. MATERIALS AND METHODS PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO and gray literature (OpenGrey, ProQuest, and Google Scholar) were electronically searched. Two independent investigators selected the eligible studies, and assessed risk of bias and certainty of evidence (GRADE). One reviewer independently extracted the data and the second reviewer checked this information. Any disagreement between the reviewers in each phase was resolved by discussion between them and/or involved a third reviewer for final decision. RESULTS Electronic search identified 5,132 studies, and 5 observational studies were included. Risk of bias was low in two studies, moderate in one, and high in two. The studies showed high heterogeneity. Mandibular asymmetry ranged from 17.43% to 72.95% in overall samples. Horizontal chin deviation showed a prevalence of 17.66% to 55.6% asymmetry in Class I malocclusions, and 68.98% in vertical asymmetry index. In Class II patients, prevalence of mandibular asymmetry varied from 10% to 25.5% in horizontal chin deviation, and 71.7% in vertical asymmetry index. The Class III sample showed a prevalence of mandibular asymmetry ranging from 22.93% to 78% in horizontal chin deviation and 80.4% in vertical asymmetry index. Patients seeking orthodontic or orthognathic surgery treatment showed greater prevalence of mandibular asymmetry. CONCLUSIONS Skeletal Class III malocclusion showed the greatest prevalence of mandibular asymmetry. Mandibular vertical asymmetry showed a marked prevalence in all malocclusions. However, conclusions should be interpreted with caution due to use of convenience samples and low-quality study outcomes.
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Leonardi RM, Aboulazm K, Giudice AL, Ronsivalle V, D'Antò V, Lagravère M, Isola G. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique. Clin Oral Investig 2021; 25:1775-1785. [PMID: 32743674 DOI: 10.1007/s00784-020-03480-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. MATERIALS AND METHODS Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a "best-fit" algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student's t tests. RESULTS A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). CONCLUSIONS Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. CLINICAL RELEVANCE Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings.
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Affiliation(s)
- Rosalia Maria Leonardi
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Khaled Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Alexandria, Egypt
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo D'Antò
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, Naples, Italy
| | - Manuel Lagravère
- Department of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gaetano Isola
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
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Maspero C, Cavagnetto D, Abate A, Cressoni P, Farronato M. Effects on the Facial Growth of Rapid Palatal Expansion in Growing Patients Affected by Juvenile Idiopathic Arthritis with Monolateral Involvement of the Temporomandibular Joints: A Case-Control Study on Posteroanterior and Lateral Cephalograms. J Clin Med 2020; 9:E1159. [PMID: 32325675 PMCID: PMC7230922 DOI: 10.3390/jcm9041159] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) affecting temporomandibular joints (TMJ) in growing patients results in maxillofacial deformities, especially if only one condyle has been affected by the rheumatic disease. Mandibular hypoplasia is the most common issue and it may be associated with maxillary hypoplasia. The aim of this retrospective case-control study is to evaluate the effects of rapid maxillary expansion (RME) in these patients. METHODS 25 growing patients affected by maxillary hypoplasia, currently in a quiescent phase of JIA for at least one year and monolateral involvement of the TMJs, were treated with RME. Data gathered from posteroanterior and lateral cephalograms before and after 1 year from RME were compared to those of 25 non-JIA controls. RESULTS Nasal cavity width, maxillary width and upper and lower intermolar width statistically increased. Maxillary and mandibular symmetry indexes presented a statistically significant increase, so did the skeletal class. No signs or symptoms of TMJ activity of JIA occurred according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) criteria. No difference was found when comparing JIA and non-JIA patients apart from the better improvement of several mandibular symmetry indexes in the affected TMJ side of JIA patients. This event is allegedly due to a worse baseline asymmetry in JIA patients that underwent a bigger relative improvement after treatment. CONCLUSIONS Results suggest that solving maxillary hypoplasia and, therefore, premature contacts are likely to have allowed mandibular repositioning and condylar growth. RME is a safe and effective solution that can substantially improve maxillary and mandibular symmetry in growing patients affected by JIA with TMJ involvement.
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Affiliation(s)
- Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- 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; (D.C.); (A.A.); (P.C.); (M.F.)
- 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; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Paolo Cressoni
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (D.C.); (A.A.); (P.C.); (M.F.)
- 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; (D.C.); (A.A.); (P.C.); (M.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
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