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Choi JY, Choo H, Kim MJ, Chung KR, Kim SH. Miniscrews position for a tissue bone borne palatal C-expander affects the displacement pattern of nasomaxillary complex: a finite element study. Sci Rep 2023; 13:17135. [PMID: 37816861 PMCID: PMC10564718 DOI: 10.1038/s41598-023-44432-9] [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: 06/02/2023] [Accepted: 10/08/2023] [Indexed: 10/12/2023] Open
Abstract
This study aimed to evaluate the difference in expansion patterns based on the position of miniscrews for a tissue-bone-borne palatal C-expander using a finite element method. Ten expansion models were examined, each representing a different position of miniscrews on the palate. Models A and B had miniscrews symmetrically placed 7 mm and 15 mm below the cementoenamel junction (CEJ), respectively. Models C to J had miniscrews positioned in a triangular manner at 7 mm and 15 mm below CEJ. Stress, displacement, angular changes of the bone and teeth, and changes in the nasomaxillary complex were measured using elastoplastic behavior models through static-nonlinear simulation employing an implicit method. The anterior and posterior parts of paramidpalatal suture area were identified as ANT, TPS-M, and TPS-L, and their ratio was assessed. Model A, which featured three miniscrews located 7 mm below the CEJ, exhibited the least molar inclination and the smallest amount of skeletal expansion. Model I, with two miniscrews placed between the first and second molars, demonstrated the greatest lateral displacement at point N on the nasal cavity wall, along with the smallest ratio of ANT to TPS-M or TPS-L. This finding suggests that the posterior expansion of the palate in relation to the anterior expansion was maximized. The results of this study indicate that strategic positioning of miniscrews is effective in achieving various expansion patterns based on the targeted correction areas within the nasomaxillary complex.
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Affiliation(s)
- Jin-Young Choi
- Department of Orthodontics, Graduate School, Biocreative Orthodontic Strategy (BOS) Center, Kyung Hee University, Seoul, Korea
| | - HyeRan Choo
- Division of Plastic and Reconstruction Surgery, Neonatal and Pediatric Craniofacial and Airway Orthodontics, Department of Surgery, Stanford Orthodontic AIrway Plate Treatment Center, Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Min-Jung Kim
- Department of Orthodontics, Graduate School, Biocreative Orthodontic Strategy (BOS) Center, Kyung Hee University, Seoul, Korea
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School, Biocreative Orthodontic Strategy (BOS) Center, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Biocreative Orthodontic Strategy (BOS) Center, Kyung Hee University, Seoul, Korea.
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Khdairi N, Halilah T, Khandakji M, Bartzela T. Rapid Maxillary Expansion Treatment in Patients with Cleft Lip and Palate: A Survey on Clinical Experience in the European Cleft Centers. J Clin Med 2023; 12:jcm12093159. [PMID: 37176600 PMCID: PMC10179601 DOI: 10.3390/jcm12093159] [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: 03/30/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Cleft lip and palate patients require complex interdisciplinary treatment, including maxillary expansion and secondary alveolar bone grafting. However, the evidence on these treatment procedures and outcomes is lacking. Therefore, this study aimed to survey the subjective observations of European maxillofacial surgeons and orthodontists on the maxillary expansion and bone grafting treatment protocols and the associated complications. An online questionnaire was sent to 131 centers. The questions assessed the participants' demographic data, maxillary expansion and alveolar bone grafting protocols, and the associated complications. Descriptive statistics and a t-test were used to analyze the data. The response rate was 40.5%. The average age for maxillary expansion was 9-10 years. The secondary alveolar bone grafting was planned 5-10 months after the expansion. The most common complications were asymmetric expansion, relapse, and fistula formation. The protocols and materials used vary widely among centers. Anatomical alterations and developmental processes, like tooth eruption adjacent to the cleft, should be seriously considered for treatment planning. This survey showed that there is still a lack of consensus on these treatment procedures. Further clinical trials should focus on long-term outcome evaluation to identify treatment components for optimal alveolar bone substitution and transversal maxillary expansion treatment in patients with clefts.
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Affiliation(s)
| | | | - Mohannad Khandakji
- Dental Department, Hamad Dental Center, Hamad Medical Cooperation, Doha P.O. Box 3050, Qatar
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 14197 Berlin, Germany
- Department of Orthodontics, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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Kim J, Oh J. READER’S FORUM. Korean J Orthod 2022; 52:247-248. [PMID: 35875848 PMCID: PMC9314213 DOI: 10.4041/kjod22.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jaehyun Kim
- Department of Orthodontics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jiyoung Oh
- Department of Orthodontics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Inchingolo AD, Ferrara I, Viapiano F, Netti A, Campanelli M, Buongiorno S, Latini G, Carpentiere V, Ciocia AM, Ceci S, Patano A, Piras F, Cardarelli F, Nemore D, Malcangi G, Di Noia A, Mancini A, Inchingolo AM, Marinelli G, Rapone B, Bordea IR, Scarano A, Lorusso F, Di Venere D, Inchingolo F, Dipalma G. Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report. CHILDREN 2022; 9:children9071046. [PMID: 35884030 PMCID: PMC9317392 DOI: 10.3390/children9071046] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Aim: In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. Methods: A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. Results: A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. Conclusions: From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Silvio Buongiorno
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Filippo Cardarelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angela Di Noia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy; (A.S.); (F.L.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
- Correspondence: (B.R.); (I.R.B.); (F.I.); Tel.: +39-3477619817 (B.R.); +40-744919319 (I.R.B.); +39-3312111104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (I.F.); (F.V.); (A.N.); (M.C.); (S.B.); (G.L.); (V.C.); (A.M.C.); (S.C.); (A.P.); (F.P.); (F.C.); (D.N.); (G.M.); (A.D.N.); (A.M.); (A.M.I.); (G.M.); (D.D.V.); (G.D.)
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