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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Fernandes LC, Farinazzo Vitral RW, Noritomi PY, Maximiano GS, José da Silva Campos M. Influence of the hyrax expander screw position on displacement and stress distribution in teeth: A study with finite elements. Am J Orthod Dentofacial Orthop 2021; 160:266-275. [PMID: 34006424 DOI: 10.1016/j.ajodo.2020.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aimed to simulate the different positions of the hyrax appliance expander screw and evaluate tooth displacement and the stress distribution standard on the periodontal ligament using the finite element method. METHODS Part of the maxilla with anchorage teeth, periodontal ligament, midpalatal suture, and the hyrax appliance was modeled, and finite element method models were created to simulate 6 different screw positions. There were 2 vertical positions at distances of 20 mm and 15 mm from the occlusal plane. Another position was anteroposterior, the center of the screw placed between and equidistant from the mesial face of the first molar and the distal face of the first premolar, aligned to the center of the crown of the first molar, with the anterior edge of the screw aligned to the distal face of the first molar. A 1 mm activation of the expander screw was simulated. The displacement (total, vertical, and buccolingual) and the stress distribution on the periodontal ligament of supporting teeth in each model were registered. RESULTS The model simulating the expander screw in a more occlusal and anterior position presented higher displacement values and higher stress concentration, followed by the model with the screw in a more posterior but same vertical position. With the exception of the first premolar, the teeth presented cervical-apical displacement in the vestibular face and apical-cervical displacement in palatal faces. This displacement is compatible with the vestibular inclination associated with the activation of the expander screw. The first premolar presented an atypical tendency for the mesial and lingual displacement of the vestibular surface and counterclockwise rotation. CONCLUSIONS The supporting teeth presented a tendency for vestibular crown displacement and lingual root displacement associated with compression areas in the vestibular-cervical region and tensile strength in the linguoapical region. Placing the expander screw in a more occlusal and anterior position generated more mechanical stress transfer, resulting in greater dental displacement.
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Affiliation(s)
| | | | | | - Gustavo Silva Maximiano
- Department of Orthodontics, Juiz de Fora Federal University, Juiz de Fora, Minas Gerais, Brazil
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Garib D, Miranda F, Palomo JM, Pugliese F, da Cunha Bastos JC, dos Santos AM, Janson G. Orthopedic outcomes of hybrid and conventional Hyrax expanders. Angle Orthod 2021; 91:178-186. [PMID: 33434282 PMCID: PMC8028483 DOI: 10.2319/060820-527.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/01/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To compare the effects of a hybrid miniscrew-supported expander versus a conventional Hyrax (CH) expander in growing patients. MATERIALS AND METHODS Forty patients were randomized into two groups: a hybrid Hyrax (HH) expander group using a Hyrax expander with two miniscrews and a CH expander group. The final sample had 18 subjects (8 female, 10 male; initial age of 10.8 years) in the HH group and 14 subjects (6 female, 8 male; initial age of 11.4 years) in the CH group. Cone-beam computed tomography examinations and digital dental models were obtained before expansion and 11 months postexpansion. The primary outcomes included the orthopedic transverse effects of expansion. Intergroup comparison was performed using analysis of covariance (P < .05). RESULTS Significantly greater increases in the nasal cavity width, maxillary width, and buccal alveolar crest width were found for the HH group. No intergroup differences were observed for dental arch width or shape changes. CONCLUSIONS The HH group showed greater increases in the nasal cavity width, maxillary width, and buccal alveolar crest width. No differences were observed for intermolar, interpremolar, or intercanine widths; arch length; or arch perimeter. Arch size and shape showed similar changes in both groups.
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Zhao B, Zhao G, Shen T, Wang C, Xiao Y, Han Y, Ke J. A pilot study of mandibular expansion in combination with a fixed-appliance for increasing the effective space of the mandibular arch: Finite element analysis and three-dimensional cone-beam computed tomography. Medicine (Baltimore) 2021; 100:e24869. [PMID: 33663114 PMCID: PMC7909137 DOI: 10.1097/md.0000000000024869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023] Open
Abstract
Techniques for enhancing the effective space of the mandibular arch are urgently needed. Therefore, this study aimed to perform mandibular expansion in combination with a fixed-appliance technique, with preliminary monitoring by finite element analysis and 3-dimensional cone-beam computed tomography (CBCT).Finite element models were structured according to CBCT images of a 14-year-old girl. The von Mises stress of the alveolar bone and tooth displacement were assessed in different models. The technique was also applied in an 11-year-old boy. CBCT was performed at post-expansion, post-retention, post-treatment and 2 years after treatment. Tooth movement and alveolar bone stress were assessed by the CAD software.Finite element analysis suggested that the teeth tended to stand upright in the buccal side in the expander model compared with the expander-remove model. However, minimum tooth change was observed in the normal model, indicating highest stability. The von Mises stress of the alveolar bone was decreased in the normal model compared with the expander model, suggesting that buccal-inclined teeth could more easily lead to alveolar bone stress than normal ones. Based on CBCT data and the 3D mandibular dentition model fitting, mandibular teeth tended to be upright in the buccal side after retention compared with the post-expansion condition, which somewhat differed from finite element analysis results. Furthermore, dehiscence and fenestration were not observed.This expansion technique is expected to increase the effective space after mandibular expansion and reduce buccal alveolar bone stress.
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Affiliation(s)
- Bingjing Zhao
- Department of Stomatology, Air Force Medical Center. PLA
| | - Guizhi Zhao
- Department of Stomatology, Air Force Medical Center. PLA
| | - Tao Shen
- Department of Stomatology, General Hospital of the PLA, Beijing
| | - Chao Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yihan Xiao
- Department of Stomatology, Air Force Medical Center. PLA
| | - Yichen Han
- Department of Stomatology, General Hospital of the PLA, Beijing
| | - Jie Ke
- Department of Stomatology, Air Force Medical Center. PLA
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Othman A, Arnold J, Ströbele D, Von See C. A digitally designed and sinter laser-melted Hybrid Hyrax. J Clin Orthod 2020; 54:336-340. [PMID: 32966251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Ahmed Othman
- Center for Digital Technologies in Dentistry and CAD/CAM, Division of Dentistry, Danube Private University, Krems an der Donau, Austria.
| | - Jassin Arnold
- Center for Digital Technologies in Dentistry and CAD/CAM, Division of Dentistry, Danube Private University, Krems an der Donau, Austria. Private practice of orthodontics in Waldbröel, Germany
| | - Dragan Ströbele
- Center for Digital Technologies in Dentistry and CAD/CAM, Division of Dentistry, Danube Private University, Krems an der Donau, Austria
| | - Constantin Von See
- Center for Digital Technologies in Dentistry and CAD/CAM, Division of Dentistry, Danube Private University, Krems an der Donau, Austria
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Gokce G, Veli I, Yuce YK, Isler Y. Efficiency evaluation of rapid maxillary expansion treatment on nasal septal deviation using tortuosity ratio from cone-beam computer tomography images. Comput Methods Programs Biomed 2020; 188:105260. [PMID: 31862681 DOI: 10.1016/j.cmpb.2019.105260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/12/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE This study aims to assess the effect of Rapid Maxillary Expansion (RME) on Nasal Septal Deviation (NSD) changes from three-dimensional (3D) images. METHODS In this study, cone-beam computed tomography (CBCT) images from 15 patients with maxillary constriction (mean age 12 ± 1.6 years) were included. RME treatment with Hyrax appliance was performed in all patients. CBCT scans were taken at three different times; before appliance insertion (T0), after active expansion (T1) and 3 months after appliance insertion (T2). We developed a novel Matlab-based application to quantify NSD based on the tortuosity ratio by dividing the actual length of the septum by the ideal length in the mid-sagittal plane by using this application. RESULTS Tortuosity ratio (TR) values were found as 1.03 ± 0.03 (T0), 1.02 ± 0.02 (T1), and 1.02 ± 0.02 (T2). Differences of TR values among these groups were evaluated using the statistical method of ANOVA (ANalysis Of VAriance) for repeated measures with the significance level of p ≤ .05. Results showed significant reductions in TR values between T0-T1 (p ≤ .05) and between T0-T2 (p ≤ .05). Nonetheless, a significant difference between T1-T2 was not determined (p > .05). CONCLUSIONS As a result, we can conclude that the NSD degree is affected by the RME treatment. The developed application can be used for both educational and research purposes.
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Affiliation(s)
- Gokcenur Gokce
- Faculty of Dentistry, Department of Orthodontics, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Ilknur Veli
- Faculty of Dentistry, Department of Orthodontics, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Yilmaz Kemal Yuce
- Rafet Kayis Faculty of Engineering, Department of Computer Engineering, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey
| | - Yalcin Isler
- Faculty of Engineering and Architecture, Department of Biomedical Engineering, Izmir Katip Celebi University, Cigli, Izmir, Turkey.
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Khosravi M, Ugolini A, Miresmaeili A, Mirzaei H, Shahidi-Zandi V, Soheilifar S, Karami M, Mahmoudzadeh M. Tooth-borne versus bone-borne rapid maxillary expansion for transverse maxillary deficiency: A systematic review. Int Orthod 2019; 17:425-436. [PMID: 31280998 DOI: 10.1016/j.ortho.2019.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to compare dentoskeletal effects of bone-borne expanders with those of conventional expanders in adolescent and adults having transverse maxillary deficiency. METHODS All randomized clinical trials (RCTs) comparing the effects of bone-borne with those of tooth-borne expansion for treatment of maxillary transverse deficiency in adults and adolescents with maxillary transverse deficiency or posterior crossbite were included. The systematic search was irrespective of language and publication type. The electronic search was conducted from 1980 to January 2018. RESULTS The electronic searches retrieved 713 references after screening for eligibility criteria. Eight studies met the inclusion criteria for this systematic review involving 289 participants. Four studies compared rapid maxillary expansion (RME) between bone-borne and tooth-borne devices and indicated effectiveness of both devices on maxillary expansion. In the first molar region, there was no significant difference between two devices in either skeletal or dental expansion. Two studies compared the effects of bone-borne and tooth-borne device following SARME and suggested no significant difference regarding amount and pattern of expansion at various levels and in molar and premolar region between two groups. Two studies compared bone-borne and tooth-bone-borne devices. CONCLUSION Within the limit of the present evidence regarding maxillary expansion, it seems that both tooth-borne and bone-borne devices result in the same outcome in terms of the amount of maxillary expansion, dental tipping, stability and perceived pain both in RME and SARME procedure. PROSPERO registration: CRD42017061078.
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Affiliation(s)
- Mahdieh Khosravi
- Orthodontic Department Dental Faculty, 17 Shahrivar boulevard, Seman, Iran
| | - Alessandro Ugolini
- University of Genoa, Orthodontic Department, Largo Rosanna Benzi 10, Genova, Italy
| | - Amirfarhang Miresmaeili
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Hamed Mirzaei
- Faculty of Management of University of Tehran, Tehran, Iran
| | - Vahid Shahidi-Zandi
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Sepideh Soheilifar
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Manoochehr Karami
- Hamedan University of medical sciences, Department of Epidemiology School of Health, Shahid Fahmide boulevard, Hamedan, Iran
| | - Majid Mahmoudzadeh
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran.
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Guerrero-Vargas JA, Silva TA, Macari S, de Las Casas EB, Garzón-Alvarado DA. Influence of interdigitation and expander type in the mechanical response of the midpalatal suture during maxillary expansion. Comput Methods Programs Biomed 2019; 176:195-209. [PMID: 31200906 DOI: 10.1016/j.cmpb.2019.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/02/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE The orthopedic Maxillary Expansion (ME) procedure is used for treating the transverse maxillary deficiency. This pathology consists in a smaller transverse dimension in the maxilla and leads to malocclusion. The treatment takes advantage of the existence of the midpalatal suture (MPS), which corresponds to the junction at the palatine bones of its horizontal portions. The technique employs a device, conventionally a palatal expander attached to the posterior teeth, to separate the two maxillary bones in the MPS. The objective of this study was to analyze, using the Finite Element Method, the biomechanical behavior of the MPS when an expansion is applied. METHODS A Computer Tomography image of the maxilla was reconstructed, the suture geometry was modeled with different interdigitation levels and types of hyrax devices. A total of 12 geometric models (three levels for interdigitation and four types of hyrax devices) were prepared and analyzed taking into account the chewing forces and the expansion displacement. For each case, maximum principal stresses on the maxilla (bone), and equivalent stresses on the expander device (stainless steel) were observed. In the MPS, maximum principal stresses and directional displacement were evaluated. RESULTS The results showed that the interdigitation does not have an important influence on the deformation behavior of the maxilla but it affects the stress distribution. In addition, the type of expander device and anchorage have a direct relationship with the treatment effectiveness; larger deformation in the expansion direction was obtained with skeletal when compared to dental anchorage. CONCLUSIONS A study that allows a better understanding of the oral biomechanics during the application of ME was presented. To our knowledge, it is the first study based on computational simulations that takes into account bone structures, like maxilla and part of the skull, to analyze the interdigitation influence on the MPS behavior when exposed to a ME.
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Affiliation(s)
- J A Guerrero-Vargas
- Department of Mechanical and Mechatronic Engineering, Faculty of Engineering, Universidad Nacional de Colombia, Bogotá, Colombia; Department of Mechanical Engineering, School of Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Mechanical Engineering, Faculty of Engineering, Universidad ECCI, Bogotá, Colombia.
| | - T A Silva
- Department of Clinical, Pathology and Dental Surgery, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - S Macari
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - E B de Las Casas
- Department of Structural Engineering, School of Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - D A Garzón-Alvarado
- Department of Mechanical and Mechatronic Engineering, Faculty of Engineering, Universidad Nacional de Colombia, Bogotá, Colombia
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Greco M, Gatto R, Caruso S, Severino M. Modified bonded acrylic expander in patient with anterior crossbite and pseudo-class III. J BIOL REG HOMEOS AG 2019; 33:63-72. DENTAL SUPPLEMENT. [PMID: 31538451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The open-bite treatment can be considered one of the most difficult malocclusions to treat in children as well as in adult patients. Several papers show that the traditional maxillary expander device contribute to increase the vertical face dimension and bite opening due to posterior rotation of the mandible, buccal tipping of lateral segments and cuspal interferences. Other more specific studies compared the effects of traditional maxillary expander to those of bonded acrylic expander and evidenced that the acrylic expander can better control the vertical effects of the maxillary expansion by the resin bite plane on which the heavy occlusal forces are exerted. We decided to use an acrylic expander in order to prevent worsening of anterior openbite after a careful assessment of nasal airflow by the otorhinolaryngologist.
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Affiliation(s)
- M Greco
- Department of Orthodontics University of Ferrara, Ferrara Italy
| | - R Gatto
- Department of Pediatric Dentistry, University of L'Aquila, L'Aquila Italy
| | - S Caruso
- Department of Pediatric Dentistry, University of L'Aquila, L'Aquila Italy
| | - M Severino
- Department of Pediatric Dentistry, University of L'Aquila, L'Aquila Italy
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Yi J, Mei L, Li X, Zheng W, Li Y, Zhao Z. Effects of continuous and intermittent parathyroid hormone administration on midpalatal suture expansion in rats. Arch Oral Biol 2019; 99:161-168. [PMID: 30710837 DOI: 10.1016/j.archoralbio.2019.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/12/2019] [Accepted: 01/23/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of continuous parathyroid hormone (cPTH) and intermittent parathyroid hormone (iPTH) on bone formation and bone resorption in midpalatal suture during maxillary expansion. METHODS Forty-eight male SD rats were randomly divided into four groups (n = 12 each), including the control, the expansion (E), the E + cPTH, and the E + iPTH. A thermosensitive controlled-release hydrogel was synthesized for cPTH administration. All animals were sacrificed after seven days. Microcomputed tomography, histochemical staining and real-time PCR were used to investigate the bone remodeling of midpalatal suture. Serum chemistry was adopted to evaluate the systemic condition of experimental animals. RESULTS The suture width was increased by the expansion, and further elevated by cPTH and iPTH administration. Both regimes improved bone volume fraction and trabecular thickness of suture bone region. Moreover, both cPTH and iPTH decreased SOST expression and enhanced the expression of β-catenin and Col-I. cPTH increased RANKL expression, inhibited OPG expression, and resulted in an increment of osteoclasts, while iPTH had no influence on osteoclastogenesis. The serum calcium concentration was enhanced by PTH administration. CONCLUSION Both cPTH and iPTH promote midpalatal suture expansion by enhancing bone formation, probably via SOST downregulation and the resulting β-catenin activation. Our results demonstrated that PTH administration may have potential to be an adjunctive approach for maxillary expansion treatment.
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Affiliation(s)
- Jianru Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontic and Pediatric dentistry, West China Hospital of Stomatology, Sichuan University, China
| | - Li Mei
- Discipline of Orthodontics, Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand
| | - Xue Li
- Department of stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, China
| | - Wei Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Medical Cosmetology, West China Hospital of Stomatology, Sichuan University, China
| | - Yu Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontic and Pediatric dentistry, West China Hospital of Stomatology, Sichuan University, China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontic and Pediatric dentistry, West China Hospital of Stomatology, Sichuan University, China
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Demura N, Hasumoto M, Demura T. Nonsurgical orthodontic treatment of adolescent patients with severe jaw deformities. J Clin Orthod 2018; 52:477-483. [PMID: 30256223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Noboru Demura
- Orthodontic Division of Oral-Maxillofacial Surgery, Kanazawa Medical University, Ishikawa, Japan. n-demura@kanazawa-med
| | - Miho Hasumoto
- Orthodontic Division of Oral-Maxillofacial Surgery, Kanazawa Medical University, Ishikawa, Japan
| | - Taichi Demura
- Orthodontic Division of Oral-Maxillofacial Surgery, Kanazawa Medical University, Ishikawa, Japan
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Celenk-Koca T, Erdinc AE, Hazar S, Harris L, English JD, Akyalcin S. Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial. Angle Orthod 2018; 88:702-709. [PMID: 30102085 DOI: 10.2319/011518-42.1] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES: To evaluate and compare the dental and skeletal changes with conventional and miniscrew-supported maxillary expansion appliances in adolescents. MATERIALS AND METHODS: Forty patients were divided into two groups, with one group receiving a tooth-borne expander and the other group receiving an expander supported by four miniscrews (bone-borne). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images were used to measure the changes in transverse skeletal widths, buccal bone thickness, tooth inclination, and root length. Paired t-tests and independent-sample t-tests were used to compare the two expansion methods. RESULTS: Bone-borne expansion increased the maxillary suture opening more than 2.5 times than tooth-borne expansion both anteriorly and posteriorly. Between the maxillary first premolars, sutural expansion accounted for 28% and 70% of the total transverse width increase in the tooth-borne and bone-borne expander groups, respectively. Similarly, 26% and 68% of the total expansion was of skeletal nature in the tooth-borne and bone-borne expander groups between the maxillary first molars. The pattern of expansion was variable, with most of the patients in both groups demonstrating a triangular-shaped sutural opening that was wider anteriorly. Subjects in the conventional group experienced significantly more buccal bone reduction and greater buccal inclination of the teeth. No significant differences were observed for root length measurements between the two groups. CONCLUSION: Use of bone-borne expansion in the adolescent population increased the extent of skeletal changes in the range of 1.5 to 2.8 times that of tooth-borne expansion and did not result in any dental side effects.
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Dhole P, Maheshwari D. In-office fabrication of a simple miniscrew-assisted rapid palatal expander. J Clin Orthod 2018; 52:347-348. [PMID: 30048957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Prashant Dhole
- Smiles N Faces, Indira Nagar, Vile Parle West Mumbai, Maharashtra, India.
| | - Divya Maheshwari
- Smiles N Faces, Indira Nagar, Vile Parle West Mumbai, Maharashtra, India
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Cunha AS, Castillo WO, Takahashi CS, Küchler EC, Segato RAB, da Silva LAB, Romano FL, Matsumoto MAN, Nelson-Filho P. Genotoxic and cytotoxic effects of Haas appliance in exfoliated buccal mucosa cells during orthodontic treatment. Angle Orthod 2018; 88:590-595. [PMID: 29761706 DOI: 10.2319/101117-687.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To evaluate the genotoxic and cytotoxic effects of Haas appliances through micronuclei test and cytogenetic damage analysis in buccal mucosa epithelial cells of patients undergoing orthodontic treatment. MATERIALS AND METHODS Twenty-eight patients, 6-12 years of age and of both genders, who required a Haas appliance for the correction of a posterior crossbite were included. Epithelial cells from the mucosa were collected by gently scraping the inside of both the right and left cheeks. The cells were collected before the insertion of the appliance (T0), 1 month after the device was installed (T1), and again 3 months after the appliance was immobilized (T2). The cells were processed to obtain slides. Feulgen/Fast Green was used as the staining method, and the number of normal, karyolytic, pyknotic, nuclear buds, bi/trinucleated, and micronucleus cells were counted under light microscopy. Cellular abnormalities were evaluated with parametric and nonparametric tests for comparison of the means by analysis of variance testing, Tukey posttest, or the Kruskal-Wallis test and then by Dunn's posttest. The significance level was 5%. RESULTS There were no statistically significant changes in the micronuclei in the evaluated periods ( P > .05). Nuclear buds increased at T1 ( P < .05), returning to baseline levels at T2. Other abnormalities (cariolytic, pyknotic, and bi/trinucleated cells) showed a significant increase at T1 and T2 ( P < .0001). CONCLUSIONS The Haas appliance did not cause an increase in micronuclei in cells of the buccal mucosa. However, statistically significant increases in cariolytic, pyknotic, and bi/trinucleated cells were observed during treatment, suggesting possible DNA damage.
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Lombardo L, Carlucci A, Maino BG, Colonna A, Paoletto E, Siciliani G. Class III malocclusion and bilateral cross-bite in an adult patient treated with miniscrew-assisted rapid palatal expander and aligners. Angle Orthod 2018; 88:649-664. [PMID: 29714067 DOI: 10.2319/111617-790.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This case report describes the use of a miniscrew-assisted rapid palatal expander and aligners to correct bilateral cross-bite and crowding in an adult patient with a Class III skeletal pattern. A digitally designed surgical guide was three-dimensionally printed and used to accurately insert four miniscrews into the palate; these were employed to anchor a novel miniscrew-assisted rapid palatal expander appliance without any dental anchorage. Cone-beam computed tomograms before and after miniscrew-assisted rapid palatal expander treatment demonstrated the orthopedic expansion of the maxilla without dental tipping. The patient was then fitted with aligners to correct crowding and malocclusion. This case report demonstrates the successful treatment of an adult patient with a narrow maxilla and bilateral cross-bite using a nonsurgical, conservative treatment.
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Kim SY, Park YC, Lee KJ, Lintermann A, Han SS, Yu HS, Choi YJ. Assessment of changes in the nasal airway after nonsurgical miniscrew-assisted rapid maxillary expansion in young adults. Angle Orthod 2018; 88:435-441. [PMID: 29561652 DOI: 10.2319/092917-656.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To evaluate changes in the volume and cross-sectional area of the nasal airway before and 1 year after nonsurgical miniscrew-assisted rapid maxillary expansion (MARME) in young adults. MATERIALS AND METHODS Fourteen patients (mean age, 22.7 years; 10 women, four men) with a transverse discrepancy who underwent cone beam computed tomography before (T0), immediately after (T1), and 1 year after (T2) expansion were retrospectively included in this study. The volume of the nasal cavity and nasopharynx and the cross-sectional area of the anterior, middle, and posterior segments of the nasal airway were measured and compared among the three timepoints using paired t-tests. RESULTS The volume of the nasal cavity showed a significant increase at T1 and T2 ( P < .05), while that of the nasopharynx increased only at T2 ( P < .05). The anterior and middle cross-sectional areas significantly increased at T1 and T2 ( P < .05), while the posterior cross-sectional area showed no significant change throughout the observation period ( P > .05). CONCLUSIONS The results demonstrate that the volume and cross-sectional area of the nasal cavity increased after MARME and were maintained at 1 year after expansion. Therefore, MARME may be helpful in expanding the nasal airway.
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17
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Fukuyama E, Omura S, Fujita K, Soma K, Torikai K. Excessive Rapid Palatal Expansion with Latham Appliance for Distal Repositioning of Protruded Premaxilla in Bilateral Cleft Lip and Alveolus. Cleft Palate Craniofac J 2017; 43:673-7. [PMID: 17105324 DOI: 10.1597/05-109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: This article reports a case of bilateral cleft lip and alveolus (BCLA) for which excessive rapid palatal expansion with a Latham appliance was performed for preoperative alignment of the protruded premaxilla. Postoperative changes of maxillary width were investigated with serial plaster casts. Patient and Results: A 3-month-old girl presented with complete BCLA in which the premaxilla was markedly protruded. Preoperative alignment of the protruded premaxilla with a Latham appliance was planned to facilitate primary lip repair. The appliance was placed when the patient was 4.5 months old. The necessary palatal expansion was estimated to be 7.0 mm in order to move the premaxilla backward into the ideal position. After palatal expansion and posterior repositioning of the protruded premaxilla, the primary operation, including cheiloplasty and gingivoperiosteoplasty, was performed when the patient was 7 months old. Excessive maxillary expansion might be a cause of transverse maxillomandibular discrepancy. Measurement with serial plaster casts demonstrated that maxillary widths increased from 42.3 mm pretreatment to 49.0 mm after orthopedic treatment but relapsed markedly to 43.5 mm at 3 months after the primary operation. Therefore, the net change of maxillary widths was only 1.2 mm. After alignment of the protruded premaxilla, tension-free soft tissue repairs were performed, and a harmonious alveolar arch was obtained without change in maxillary width. Conclusion: These results indicate that this method is useful for preoperative management of BCLA with protruded premaxilla.
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Affiliation(s)
- Eiji Fukuyama
- Orthodontic Science, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
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Wang MH, Ge ZL, Tian L, Li PR, Che YQ. [Effect of three types of rapid maxillary expansion: a three-dimensional finite element study]. Zhonghua Kou Qiang Yi Xue Za Zhi 2017; 52:678-683. [PMID: 29972947 DOI: 10.3760/cma.j.issn.1002-0098.2017.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: To evaluate the transverse displacement, stress distribution and tendency of change in tooth, alveolar bone and mid-palatal suture using three kinds of rapid maxillary expansion methods. Methods: Cone-beam CT image data was obtained by scanning skulls of a volunteer. Three-dimensional models of maxillary complex were re-established using Mimics and Geomagic Studio and models of Hyrax expander, Haas expander and miniscrew-assisted rapid palatal expander (MARPE) were established using ANSYS Workbench. Stress distribution, displacement and tendency of change in tooth, alveolar bone and mid-palatal suture were evaluated. Results: Hyrax expander brought 0.105 mm lateral displacement of crown, 0.022 mm mid-palatal suture width increase, wedge opening and clockwise rotation tendency of maxilla. Haas expander created uniform stress distribution, 0.216 mm lateral displacement of crown, and 0.031 mm mid-palatal suture width increase. In MARPE model, the lateral displacement of crown was 0.267 mm, and mid-palatal suture width increased 0.315 mm. The maximum of mid-palatal suture expansion and stress distribution appeared in the middle region, and maxilla had tendency of counterclockwise rotation. Conclusions: The lateral changes of teeth and bones brought by MARPE were the most significant. Haas expander had some advantages in comparison with Hyrax.
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Affiliation(s)
- M H Wang
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Z L Ge
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - L Tian
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - P R Li
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Y Q Che
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou 730000, China
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Clarenbach TH, Wilmes B, Ihssen B, Vasudavan S, Drescher D. Hybrid hyrax distalizer and mentoplate for rapid palatal expansion, class III treatment, and upper molar distalization. J Clin Orthod 2017; 51:317-325. [PMID: 29059059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | | | | | - Sivabalan Vasudavan
- Department of Dentistry, Boston Children's Hospital, Boston, MA; Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Faculty of Science, University of Western Australia, Perth
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Elnagar MH, Elshourbagy E, Ghobashy S, Khedr M, Evans CA. Dentoalveolar and arch dimension changes in patients treated with miniplate-anchored maxillary protraction. Am J Orthod Dentofacial Orthop 2017; 151:1092-1106. [PMID: 28554455 DOI: 10.1016/j.ajodo.2016.10.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate dentoalveolar and arch dimension changes in 2 miniplate-anchored maxillary protraction protocols in relation to an untreated control group using 3-dimensional digital models. METHODS Thirty growing Class III subjects with maxillary deficiency in the late mixed or early permanent dentition phase were randomly divided into 3 groups. In group 1 (n = 10), patients were treated with skeletally anchored facemasks anchored with miniplates placed at the zygomatic buttress. In group 2 (n = 10), patients were treated with Class III elastics extending from infrazygomatic miniplates in the maxilla to symphyseal miniplates in the mandible. Group 3 (n = 10) was an untreated control group. The decision to discontinue orthopedic treatment was made when the patients had 3 to 4 mm of positive anterior overjet. Pretreatment, posttreatment, and observation 3-dimensional digital models were analyzed, superimposed, 3 dimensionally mapped, and sectioned. RESULTS In this study, there were no significant changes in maxillary arch depth and maxillary or mandibular intermolar width before and after maxillary protraction or after the observation period in the control group. The mandibular arch depth decreased by a small but statistically significant amount only in groups 1 and 3. Superimposition of the pretreatment and posttreatment or observation maxillary 3-dimensional digital models showed minimal clinically significant dentoalveolar changes. CONCLUSIONS Miniplate-anchored maxillary protraction protocols can accomplish maxillary advancement by eliminating movements of teeth and dentoalveolar changes. No spontaneous improvement in transverse deficiency was detected after correction of the anteroposterior deficiency at this age. Consequently, patients with transverse maxillary deficiency should have rapid maxillary expansion before or during the miniplate-anchored protraction period to improve the transverse deficiency.
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Affiliation(s)
- Mohammed H Elnagar
- Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt; Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Ill.
| | - Eman Elshourbagy
- Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Safaa Ghobashy
- Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Mohamed Khedr
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Carla A Evans
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
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da Cunha AC, Lee H, Nojima LI, Nojima MDCG, Lee KJ. Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient. Dental Press J Orthod 2017; 22:97-108. [PMID: 28746493 PMCID: PMC5525451 DOI: 10.1590/2177-6709.22.3.097-108.oar] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/11/2017] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION: Etiology of dental crowding may be related to arch constriction in diverse dimensions, and an appropriate manipulation of arch perimeter by intervening in basal bone discrepancies cases, may be a key for crowding relief, especially when incisors movement is limited due to underlying pathology, periodontal issues or restrictions related to soft tissue profile. OBJECTIVES: This case report illustrates a 24-year old woman, with maxillary transverse deficiency, upper and lower arches crowding, Class II, division 1, subdivision right relationship, previous upper incisors traumatic episode and straight profile. A non-surgical and non-extraction treatment approach was feasible due to the miniscrew-assisted rapid palatal expansion technique (MARPE). METHODS: The MARPE appliance consisted of a conventional Hyrax expander supported by four orthodontic miniscrews. A slow expansion protocol was adopted, with an overall of 40 days of activation and a 3-month retention period. Intrusive traction miniscrew-anchored mechanics were used for correcting the Class II subdivision relationship, managing lower arch perimeter and midline deviation before including the upper central incisors. RESULTS: Post-treatment records show an intermolar width increase of 5 mm, bilateral Class I molar and canine relationships, upper and lower crowding resolution, coincident dental midlines and proper intercuspation. CONCLUSIONS: The MARPE is an effective treatment approach for managing arch-perimeter deficiencies related to maxillary transverse discrepancies in adult patients.
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Affiliation(s)
- Amanda Carneiro da Cunha
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| | | | - Lincoln Issamu Nojima
- Universidade Federal do Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil)
| | | | - Kee-Joon Lee
- Yonsei University,Department of Orthodontics, Seoul, Korea
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Teeters CA. Simultaneous Phase I Expansion and Ectopic Molar Correction with a Hyrax-Halterman Appliance. J Clin Orthod 2017; 51:295-300. [PMID: 28668946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Cerruto C, Ugolini A, Di Vece L, Doldo T, Caprioglio A, Silvestrini-Biavati A. Cephalometric and dental arch changes to Haas-type rapid maxillary expander anchored to deciduous vs permanent molars: a multicenter, randomized controlled trial. J Orofac Orthop 2017; 78:385-393. [PMID: 28397083 DOI: 10.1007/s00056-017-0092-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/14/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess radiographic changes and dental arch changes with Haas-type rapid maxillary expansion (H-RME) anchored to deciduous versus permanent molars in children with unilateral posterior crossbite. METHODS In all, 70 patients with unilateral posterior crossbite were randomly allocated to group GrE (H-RME on second deciduous molars) or Gr6 (H-RME on first permanent molars) and compared between T0 (before treatment) and T1 (at the RME removal; i.e., 10 months after the end of the activation of the screw). At T0 and T1, cephalometric head films were digitally traced, dental casts were scanned, and rotations of the upper first molars, of the upper central, and of the upper lateral incisors on the models were measured. RESULTS Between T0 and T1, the cephalometric analysis showed a significant decrease of the angulation of the upper central incisors to the SN line and to the palatal plane in GrE together with a significant increase of the lower incisors to the mandibular plane (IMPA). The digital dental cast analysis showed that the central and lateral incisors mesiorotated significantly more in GrE than in Gr6. Patients in GrE also showed a statistically significant distorotation of the upper first permanent molars after RME. CONCLUSIONS GrE showed a significant and spontaneous retraction and alignment of the upper central and lateral incisors compared to Gr6. This is probably due to a more pronounced expansion in the anterior area and more accentuated pressure of the upper lip in GrE. IMPA increased significantly in GrE vs Gr6. GrE also showed a more significant distorotation of the upper first permanent molars compared to Gr6. This is probably due to the design of the H-RME in GrE, where the screw is more anteriorly positioned and the bands are absent on the upper first permanent molars which are, therefore, free to adapt to the best occlusal situation. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02798822.
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Affiliation(s)
| | - Alessandro Ugolini
- Division of Orthodontics, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy.
| | - Luca Di Vece
- Division of Orthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Tiziana Doldo
- Division of Orthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Alberto Caprioglio
- Division of Orthodontics, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
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Whetzel AG. Maxillary Expansion Biteplate. J Clin Orthod 2017; 51:46. [PMID: 28253490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Feldmann I, Bazargani F. Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: A randomized controlled trial. Angle Orthod 2016; 87:391-396. [PMID: 28029266 DOI: 10.2319/091216-686.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate and compare perceived pain intensity, discomfort, and jaw function impairment during the first week with tooth-borne or tooth-bone-borne rapid maxillary expansion (RME) appliances. MATERIALS AND METHODS Fifty-four patients (28 girls and 26 boys) with a mean age of 9.8 years (SD 1.28 years) were randomized into two groups. Group A received a conventional hyrax appliance and group B a hybrid hyrax appliance anchored on mini-implants in the anterior palate. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment on the first and fourth days after RME appliance insertion. RESULTS Fifty patients answered both questionnaires. Overall median pain on the first day in treatment was 13.0 (range 0-82) and 3.5 (0-78) for groups A and B, respectively, with no significant differences in pain, discomfort, analgesic consumption, or functional jaw impairment between groups. Overall median pain on the fourth day was 9.0 (0-90) and 2.0 (0-71) for groups A and B, respectively, with no significant differences between groups. There were also no significant differences in pain levels within group A, while group B scored significantly lower concerning pain from molars and incisors and tensions from the jaw on day 4 than on the first day in treatment. There was a significant positive correlation between age and pain and discomfort on the fourth day in treatment. No correlations were found between sex and pain and discomfort, analgesic consumption, and jaw function impairment. CONCLUSIONS Both tooth-borne and tooth-bone-borne RME were generally well tolerated by the patients during the first week of treatment.
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Garib D, Lauris RDCMC, Calil LR, Alves ACDM, Janson G, De Almeida AM, Cevidanes LHS, Lauris JRP. Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial. Am J Orthod Dentofacial Orthop 2016; 150:564-574. [PMID: 27692413 PMCID: PMC5495880 DOI: 10.1016/j.ajodo.2016.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 05/01/2016] [Accepted: 05/01/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The purpose of this 2-arm parallel study was to evaluate the dentoskeletal effects of rapid maxillary expansion with differential opening (EDO) compared with the hyrax expander in patients with complete bilateral cleft lip and palate. METHODS A sample of patients with complete bilateral cleft lip and palate was prospectively and consecutively recruited. Eligibility criteria included participants in the mixed dentition with lip and palate repair performed during early childhood and maxillary arch constriction with a need for maxillary expansion before the alveolar bone graft procedure. The participants were consecutively divided into 2 study groups. The experimental and control groups comprised patients treated with rapid maxillary expansion using EDO and the hyrax expander, respectively. Cone-beam computed tomography examinations and digital dental models of the maxillary dental arches were obtained before expansion and 6 months postexpansion. Standardized cone-beam computed tomography coronal sections were used for measuring maxillary transverse dimensions and posterior tooth inclinations. Digital dental models were used for assessing maxillary dental arch widths, arch perimeters, arch lengths, palatal depths, and posterior tooth inclinations. Blinding was used only during outcome assessment. The chi-square test was used to compare the sex ratios between groups (P <0.05). Intergroup comparisons were performed using independent t tests with the Bonferroni correction for multiple tests. RESULTS Fifty patients were recruited and analyzed in their respective groups. The experimental group comprised 25 patients (mean age, 8.8 years), and the control group comprised 25 patients (mean age, 8.6 years). No intergroup significant differences were found for age, sex ratio, and dentoskeletal variables before expansion. No significant differences were found between the EDO and the hyrax expander groups regarding skeletal changes. The EDO promoted significantly greater increases of intercanine width (difference, 3.63 mm) and smaller increases in canine buccal tipping than the conventional hyrax expander. No serious harm was observed other than transitory variable pressure sensations on the maxillary alveolar process in both groups. CONCLUSIONS The EDO produced skeletal changes similar to the conventional hyrax expander. The differential expander is an adequate alternative to conventional rapid maxillary expanders when there is need for greater expansion in the maxillary dental arch anterior region. REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement. FUNDING This study received financial support from FAPESP (process number 2009/17622-9). As a possible conflict of interest, a patent with an EDO was submitted in March 2011 to the National Institute of Industry Property and is still in process. However, we believe that this is a natural step of translational research (bench-to-bedside), and we guarantee that the scientific results are true.
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Affiliation(s)
- Daniela Garib
- Associate professor, Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
| | - Rita De Cássia Moura Carvalho Lauris
- Orthodontist, Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Louise Resti Calil
- Postgraduate student, Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Arthur César De Medeiros Alves
- Postgraduate student, Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Guilherme Janson
- Professor and head, Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Araci Malagodi De Almeida
- Orthodontist, Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - José Roberto Pereira Lauris
- Professor, Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
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Ishii T, Sakamoto T, Ishikawa M, Yasumura T, Miyazaki H, Sueishi K. Relationship between Orthodontic Treatment Plan and Goslon Yardstick Assessment in Japanese Patients with Unilateral Cleft Lip and Palate: One-stage vs. Two-stage Palatoplasty. Bull Tokyo Dent Coll 2016; 57:159-68. [PMID: 27665693 DOI: 10.2209/tdcpublication.2016-0700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present study targeted patients with unilateral cleft lip and palate (UCLP) undergoing either one - (Wardill technique) or two-stage palatoplasty (Perko technique). Correlations between Goslon Yardstick scores and orthodontic appliances used and whether an osteotomy was performed were investigated. No differences were observed between the two types of palatoplasty in terms of Goslon Yardstick scores. A palatal expander and protraction facemask were used in Phase I of orthodontic treatment. The palatal expander was selected for most patients with UCLP in Phase I, regardless of the surgical technique used. A protraction facemask was used in patients undergoing the Wardill procedure who had a Goslon Yardstick score placing them in Group 3 or 4. In contrast, a protraction facemask was used in patients undergoing the Perko procedure who had a Goslon Yardstick score placing them in Group 4. No significant differences were observed in the Goslon Yardstick scores yielded by either type of procedure. The Goslon Yardstick score in relation to whether an osteotomy was performed in Phase II as part of orthodontic treatment was determined, focusing on the relationship between that score and the palatoplasty method used. A protraction facemask was used in patients undergoing the Perko procedure, which eliminated the need for an osteotomy at a future date. However, a protraction facemask was also used in patients undergoing the Wardill option, and those patients were likely to require an osteotomy. In other words, the results suggest that the type of palatoplasty selected will determine the effectiveness of any orthodontic appliances used.
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Rogério de Mendonça M, Gonçales Verri AC, Pimenta Martins L, Aparecido Cuoghi O. Case Report of Posterior Crossbite: Description of an Effective Treatment Protocol. Compend Contin Educ Dent 2016; 37:e13-e16. [PMID: 27606565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Early treatment of functional unilateral posterior crossbite during the mixed dentition stage is extremely important, as it provides the correct positioning of osseous bases, teeth, and the temporomandibular joint when the stomatognathic system is in growth and development. This article reports on a 9-year-old patient who presented with functional unilateral posterior crossbite and was treated with a modified Hyrax expander. The case report highlights a simple, low-cost, effective treatment protocol. The malocclusion was corrected with 15 days of active use of the appliance, 5 months of use for retention purposes, and 5 years of post-treatment follow-up. The stability in the long-term treatment is highly dependent on early diagnosis by the clinician and the elimination of the etiological factor through use of the proper appliance.
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Affiliation(s)
- Marcos Rogério de Mendonça
- Adjunct Professor, Department of Pediatric and Community Dentistry, Dental School of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Ana Caroline Gonçales Verri
- PhD Student, Department of Pediatric and Community Dentistry, Dental School of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Lídia Pimenta Martins
- PhD Student, Department of Pediatric and Community Dentistry, Dental School of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Osmar Aparecido Cuoghi
- Adjunct Professor, Department of Pediatric and Community Dentistry, Dental School of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
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Lanteri C, Beretta M, Lanteri V, Gianolio A, Cherchi C, Franchi L. The Leaf Expander for Non-Compliance Treatment in the Mixed Dentition. J Clin Orthod 2016; 50:552-560. [PMID: 27809214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Claudio Lanteri
- Private Practice of Orthodontics in Alessandria, Italy; SIDO (Italian Society of Orthodontics)
| | - Matteo Beretta
- Private Practice of Orthodontics in Alessandria, Italy; University of Insubria, Varese, Italy.
| | - Valentina Lanteri
- Private Practice of Orthodontics in Alessandria, Italy; University of Milan, Milan, Italy
| | | | | | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy
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Ruellas ACDO, Huanca Ghislanzoni LT, Gomes MR, Danesi C, Lione R, Nguyen T, McNamara JA, Cozza P, Franchi L, Cevidanes LHS. Comparison and reproducibility of 2 regions of reference for maxillary regional registration with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2016; 149:533-42. [PMID: 27021458 DOI: 10.1016/j.ajodo.2015.09.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the differences between 2 regions of maxillary voxel-based registration and to test the reproducibility of the registration. METHODS Three-dimensional models were built for before-treatment (T1) and after-treatment (T2) based on cone-beam computed tomography images from 16 growing subjects. Landmarks were labeled in all T2 models of the maxilla, and voxel-based registrations were performed independently by 2 observers at 2 times using 2 reference regions. The first region, the maxillary region, included the maxillary bone clipped inferiorly at the dentoalveolar processes, superiorly at the plane passing through the right and left orbitale points, laterally at the zygomatic processes through the orbitale point, and posteriorly at a plane passing through the distal surface of the second molars. In the second region, the palate and infrazygomatic region had different posterior and anterior limits (at the plane passing through the distal aspects of the first molars and the canines, respectively). The differences between the registration regions were measured by comparing the distances between corresponding landmarks in the T2 registered models and comparing the corresponding x, y, and z coordinates from corresponding landmarks. Statistical analysis of the differences between the T2 surface models was performed by evaluating the means and standard deviations of the distances between landmarks and by testing the agreement between coordinates from corresponding landmarks (intraclass correlation coefficient and Bland-Altman method). RESULTS The means of the differences between landmarks from the palate and infrazygomatic region to the maxillary region 3-dimensional surface models at T2 for all regions of reference, times of registrations, and observer combinations were smaller than 0.5 mm. The intraclass correlation coefficient and the Bland-Altman plots indicated adequate concordance. CONCLUSIONS The 2 regions of regional maxillary registration showed similar results and adequate intraobserver and interobserver reproducibility values.
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Affiliation(s)
- Antonio Carlos de Oliveira Ruellas
- Associate professor, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Brazilian National Counsel of Technological and Scientific Development (CNPq) researcher and postdoctoral fellow, School of Dentistry, University of Michigan, Ann Arbor, Mich.
| | | | - Marcelo Regis Gomes
- Postgraduate student, Department of Prosthetics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Carlotta Danesi
- Postgraduate student, Department of Clinical Sciences and Translational Medicine, University of Rome, Rome, Italy
| | - Roberta Lione
- PhD fellow, Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Tung Nguyen
- Assistant professor, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Paola Cozza
- Professor and department chair, Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Lorenzo Franchi
- Research associate, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia Helena Soares Cevidanes
- Assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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Hourfar J, Ruff CJ, Wilmes B, Ludwig B, Kanavakis G. Rapid Maxillary Expansion and Upper-Molar Distalization with a Miniscrew-Supported Hybrid Appliance. J Clin Orthod 2016; 50:476-484. [PMID: 27710949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, University of Heidelberg, Heidelberg, Germany; Private practice of orthodontics in Reinheim, Germany
| | - Charles J Ruff
- Department of Orthodontics, Tufts University School of Dental Medicine, Boston; Private practice of orthodontics in Waterville, ME
| | - Benedict Wilmes
- Department of Orthodontics, University of Dusseldorf, Dusseldorf, Germany; Department of Orthodontics, University of Alabama at Birmingham School of Dentistry, Birmingham, AL
| | - Bjorn Ludwig
- Journal of Clinical Orthodontics; Department of Orthodontics, University of Homburg, Saar, Germany; Private practice of orthodontics in Traben-Trarbach, Germany
| | - Georgios Kanavakis
- Department of Orthodontics, Tufts University School of Dental Medicine, One Kneeland St. #1145, Boston, MA 02111.
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Itsuki Y, Imamura E, Sugawara J, Nanda R. A TAD-Based System for Camouflage Treatment of Severe Skeletal Class III Malocclusion. J Clin Orthod 2016; 50:401-412. [PMID: 27575884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
| | - Eisaku Imamura
- Department of Oral and Maxillofacial Surgery, Yokohama General Hospital, Yokohama, Japan; Biomedical Engineering, Toin University of Yokohama
| | - Junji Sugawara
- Department of Craniofacial Sciences, and Division of Orthodontics, University of Connecticut School of Dental Medicine, 263 Farmington Ave., MC 1725, Farmington, CT 06030; SAS Orthodontic Center, Ichiban-Cho Dental Clinic, Sendai, Japan
| | - Ravindra Nanda
- Department of Craniofacial Sciences, and Division of Orthodontics, University of Connecticut School of Dental Medicine, 263 Farmington Ave., MC 1725, Farmington, CT 06030; Journal of Clinical Orthodontics.
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de Almeida Cardoso M, Guedes FP, da Silva Goulart M, Martinex L, Squillace LH, Filho LC. Possibilities of Orthopedic Management of Pattern Ill Malocclusions During Growth. Int J Orthod Milwaukee 2016; 27:33-42. [PMID: 29799701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Consistently performed by most orthodontists, the orthopedic treatment involves rapid maxillary expansion (RME) combined with maxillary protraction (MP). When this treatment protocol is performed up to the intertransitional period of the mixed dentition (around 9 years of age), it allows a positive influence on the maxilla and zygomatic projection, even though there are also effects on the dentition. The ideal orthopedic treatment should influence the growth and spatial arrangement of bone bases (maxilla and mandible), so as to achieve balance and maintain it until growth completion. This goal may seem utopic, especially when the problem involves the mandible; and, assuming some genetic influence for such disorder, it is difficult to predict its future magnification during the growth period. Notwithstanding, despite the uncertain prognosis, the search for function and better facial esthetics, though temporary, should be considered This paper discusses this topic, based on the treatment progress of a youngpatient with Class III, with monitoring ofgrowth from the deciduous dentition up to adulthood, and treatment performed in two periods, using the RME and MPprotocol. Positive outcomes were achieved.
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Vishwanath EA, Pai SS, Tubaki RR, Beladi A, Nelivigi NS. Spring-Loaded Transpatatal Arch with Turbo-V Springs for Correction of Severe Torsiversion. Int J Orthod Milwaukee 2016; 27:15-19. [PMID: 29799697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aim of this case report is to introduce an appliance that can be used for correcting severe bilateral symmetric rotation (more than 900) ofsecondpremolars in adult patient. Appliance design and testing: This is a case report ofa 27-year-old female patient with permanent dentition having Class I malocclusion with bi-alveolar dentoalveolar protrusion defined by a severe bilateral rotation (more than 90-) of upper second premolars. Since it was a case of maximum anchorage, we decided to extract upper and lower arch first premolars, and the upper and lower arch were strapped with fixed orthodontic appliance with MBT 0.022 slot PEA brackets and then a spring-loaded transpalatal arch with turbo-Vsprings appliance used to correct severely rotated premolars. After 4 months, both the premolars were orthodontically brought into proper alignment. Circumferential supracrestalfibrotomy was planned to prevent relapse. CONCLUSION Spring-loaded transpalatal arch with turbo- Vsprings appliance can be very effective for correcting severe bilateral rotation (more than 900) of premolar teeth.
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Maspero C, Giannini L, Galbiati G, Feresini M, Farronato G. Effect of rapid palatal expansion in early tratment and spontaneous correction of maxillary canine-first premolar transposition. Minerva Stomatol 2016; 65:134-143. [PMID: 27075370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUD The aim of this study was to describe an experimental study carried out in a group of young patients with an early diagnosis of atypical eruption pattern of the maxillary canines and first premolars, identified and treated by rapid palatal expansion (RPE) interceptive therapy. METHODS This study involved 20 young patients aged between 8 and 12 years (mean age 10±0.3 years). Patients were randomly divided into two equal groups (10 patients in each group). The patients in the first group underwent a rapid palatal expansion with an hyrax-type expander. The appliance was activated twice a day for 15 days in order to obtain 7.5 mm of palatal expansion. Then, it was left in situ for six months. The second group was the control group and patients were not treated but only observed. The total number of dental transposition were 30 couple (15 in the first group and 15 in the control group). RESULTS Among the first group, 13 couple of dental transposition reached the right position in the arch. Two of them remained transposed. Among the control group, 12 of them remained transposed and 3 reached the right position. CONCLUSIONS Transpositions of the maxillary canines and first premolar is a common tooth malposition in children. Early diagnosis will permit to perform an interceptive treatment that will prevent the full development of transposition.
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Affiliation(s)
- Cinzia Maspero
- Fondazione IRCCS Cà Granda, Maggiore Policlinic Hospital, Milan, Italy -
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Paik CH, McComb R, Hong C. Differential Molar Intrusion with Skeletal Anchorage in Open-Bite Treatment. J Clin Orthod 2016; 50:276-289. [PMID: 27323270 PMCID: PMC5573189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Cheol-Ho Paik
- Department of Orthodontics, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ryan McComb
- Private Practice of Orthodontics in Los Angeles
| | - Christine Hong
- Department of Orthodontics, UCLA School of Dentistry, 10833 Le Conte Ave., Los Angeles, CA 90095.
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Katyal V, Wilmes B, Nienkemper M, Darendeliler MA, Sampson W, Drescher D. The efficacy of Hybrid Hyrax-Mentoplate combination in early Class III treatment: a novel approach and pilot study. Aust Orthod J 2016; 32:88-96. [PMID: 27468596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The aim of the present study was to assess the skeletal, dental and soft tissue effects of a specific treatment protocol in consecutively treated patients who presented with a Class III malocclusion. Treatment involved the use of a Hybrid Hyrax (HH) in the maxilla, a Mentoplate in the mandible and the application of continuous intra-oral Class III elastics. METHOD The treated group was comprised of seven males and seven females (mean pretreatment age 10.4 ± 1.7 yr, range 7.8-12.9 yr). Treatment changes were analysed on lateral cephalograms taken 6-12 months prior to commencing treatment (T1) and at the finish of the orthopaedic phase (T2). Where a normality assumption was met, a parametric paired-sample t-test was used to assess the change differences at T1 and T2. For non-normal data, a non-parametric Wilcoxon sign rank test for related samples was used to assess T1 and T2 differences. The level of statistical significance was set at p < 0.05 (2-tailed). RESULTS The average sagittal changes showed an improved SNA angle of 2.1 ± 2° (p = 0.002), an ANB angle of 1.9 ± 1.8° (p = 0.002), a Wits improvement of 3.4 ± 2.7 mm (p < 0.001) and an overjet reduction of 2.0 ± 2.2 mm (p = 0.005). There were no statistically significant correlations found between the age at T1, age at treatment start and age at T2 and the changes identified in the cephalometric variables (T2-T1). CONCLUSION The HH-Mentoplate Class III treatment protocol induced a mean Wits improvement of 3.4 mm in the maxillary and mandibular sagittal base relationship at the functional occlusal level. This was primarily achieved by sagittal maxillary skeletal protraction with negligible effects on the mandible, facial vertical dimension and the incisor angulations. A controlled clinical study with larger sample sizes and longer follow-up times is needed.
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Halicioğlu K, Yavuz I. A comparison of the sagittal and vertical dentofacial effects of maxillary expansion produced by a memory screw and a hyrax screw. Aust Orthod J 2016; 32:31-40. [PMID: 27468589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM The aim of the present study was to investigate and compare the cephalometric effects of a conventional Hyrax expansion screw and a memory screw on the skeletal and dentoalveolar structures and soft tissues of the face. METHODS Thirty-two patients with a maxillary transverse deficiency were divided into two groups. A memory-screw group included 17 patients (nine females and eight males), while a Hyrax-screw group was comprised of 15 patients (eight females and seven males). The mean ages of the subjects in the memory-screw and Hyrax-screw groups were 13.00 ± 1.29 and 12.58 ? 1.50 years, respectively. Lateral cephalograms were taken of the patients at the beginning of the treatment (T1), at the end of expansion (T2) and retention periods (T3). The mean expansion period was 7.76 ± 1.04 days in the memory-screw group and 35.46 ± 9.39 days in the Hyrax-screw group. The Shapiro-Wilk Normality test was used to determine whether the investigated parameters were homogeneous. To determine the treatment changes within the groups, a paired test and Wilcoxon Signed Rank test were applied to the homogeneous and non-homogeneous parameters, respectively. A comparison between the groups was carried out using the Student's t-test for homogeneous parameters and the Mann-Whitney U test for all others. RESULTS A results summary indicates that mid-palatal sutural opening and subsequent important skeletal and dental expansions were obtained in all patients. The maxilla moved anteriorly and inferiorly in both groups while the mandible rotated inferiorly and posteriorly but to a greater extent in the memory-screw group. CONCLUSION The newly-developed memory expansion screw takes advantage of rapid and slow maxillary expansion protocols. The suture is opened and the maxilla expanded with relatively lighter forces over a shorter time. The RME using the memory screw resulted in similar sagittal and vertical changes to those produced by the Hyrax screw.
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Carriére L. Nonsurgical Correction of Severe Skeletal Class III Malocclusion. J Clin Orthod 2016; 50:216-230. [PMID: 27223855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Luis Carriére
- Journal of Clinical Orthodontics; Private Practice of Orthodontics in Barcelona, Spain.
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40
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Porseo M, Monaco B, Festa F, Fiorillo G. A Vestibular Rapid Palatal Expander. J Clin Orthod 2016; 50:110-117. [PMID: 27017254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Mauro Porseo
- Studio Porseo Dental Centre, Via Giovan Battista Simoncelli 2, 03022 Boville Ernica, Frosinone, Italy; Inventor and Patent Owner of the Changing-P.
| | - Barbara Monaco
- Paediatric Dentistry Division, San Camillo Hospital of Rome; Private Practice of Orthodontics in Rome
| | - Felice Festa
- Graduate School of Orthodontics, Gabriele d'Annunzio University of Chieti-Pescara, Italy
| | - Gianluigi Fiorillo
- Graduate School of Orthodontics, Gabriele d'Annunzio University of Chieti-Pescara, Italy; Private Practice of Orthodontics in Rome
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Oliveira A, Amaral C. Rapid Maxillary Expansion without Posterior Anchorage. Int J Orthod Milwaukee 2016; 27:73-76. [PMID: 27319047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This work aimed to evaluate an alternative form of maxillary expansion anchored with mini-implants. A patient 12 years, class III in permanent canine teeth, with multiple agenesis of upper posterior teeth was treated with the aid of four mini-implants in the palate and Haas modified type appliance. During the period of expansion, an interincisal diastema was observed as the first clinical sign of disjunction of the sutures. After correction of cross bite, the expansion of the palate was confirmed by upper occlusal radiographs. Thus, the evaluations showed that the technique was effective and that new scientific studies should be conducted to further develop this subject. Keywords: Appliances; Biomechanics; Implants; Malocclusions
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Maino BG, Paoletto E, Lombardo L, Siciliani G. A Three-Dimensional Digital Insertion Guide for Palatal Miniscrew Placement. J Clin Orthod 2016; 50:12-22. [PMID: 26919634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- B Giuliano Maino
- Department of Orthodontics, University of Ferrara, Ferrara, and University of Insubria, Varese; Private Practice in Vicenza, Italy
| | | | - Luca Lombardo
- Department of Orthodontics, University of Ferrara, Via Montebello 31, Ferrara 44100, Italy.
| | - Giuseppe Siciliani
- Department of Orthodontics, University of Ferrara, Via Montebello 31, Ferrara 44100, Italy
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Akin M, Akgul YE, Ileri Z, Basciftci FA. Three-dimensional evaluation of hybrid expander appliances: A pilot study. Angle Orthod 2016; 86:81-86. [PMID: 25923245 PMCID: PMC8603971 DOI: 10.2319/121214-902.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/01/2015] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVE To evaluate transverse dimensional changes in dentoalveolar and skeletal structures caused by hybrid expander, using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT records of nine patients (five boys and four girls) (mean age 13.61 ± 0.72 years) treated with hybrid expander were examined. CBCT images were taken at pretreatment and after the expansion. ELSA (point equidistant to both foramina spinosa) was determined as a reference point to compare the distances in all three dimensions. Nineteen transversal dimensions and four angles were measured for both right and left sides. Wilcoxon signed rank test was used for statistical comparison at P < .05 levels. RESULTS A V-shaped expansion of suture was successfully achieved in all patients without teeth support. The amount of opening was greater in anterior than posterior and in inferior than superior. An 8.75-mm screw expansion was achieved for all patients. Expansion effects reverberated to maxillary central incisor, canine, first premolar, and first molar at 70%, 75%, 92%, and 89%, respectively. The molar teeth tipped buccally (right 3.06° and left 3.24°) as did premolars (right 2.88° and left 3.02°). CONCLUSION The hybrid expander, minimally invasive expansion appliance that protects teeth by including bone support, can be used easily for rapid maxillary expansion treatment.
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Affiliation(s)
- Mehmet Akin
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Yasin Erdem Akgul
- Research Assistant, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Zehra Ileri
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Faruk Ayhan Basciftci
- Professor, Department of Orthodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
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Fontana M, Cafagna A, Cozzani M. Modified Cast-Metal Haas-Type Expander for Correction of Impacted Upper First Molars in the Mixed Dentition. J Clin Orthod 2015; 49:770-775. [PMID: 26799998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Mattia Fontana
- Department of Orthodontics, University of Insubria, Varese, Italy; In the Private Practice of Orthodontics in Querceta, Italy.
| | | | - Mauro Cozzani
- Department of Orthodontics, School of Dental Medicine, University of Cagliari, Cagliari, Italy; Scientific Committee, Unita Operative Odontoiatria, IRCCS Istituto Giannina, Gaslini, Genoa, Italy; and In the Private Practice of Orthodontics in La Spezia, Italy
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Manasse RJ, Atsawasuwan P, Conroy C. Treatment of Labially Impacted Upper Central Incisors. J Clin Orthod 2015; 49:701-710. [PMID: 26684843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Robert J Manasse
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 S. Paulina St., Chicago, IL 60612; In the Private Practice of Orthodontics in Matteson, IL.
| | - Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 S. Paulina St., Chicago, IL 60612
| | - Cara Conroy
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 S. Paulina St., Chicago, IL 60612
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Kuijpers-Jagtman AM, Mink van der Molen AB, Bierenbroodspot F, Borstlap WA. [Interdisciplinary orthodontic surgical treatment of children with cleft lip and palate from 9 to 20 years of age]. Ned Tijdschr Tandheelkd 2015; 122:637-642. [PMID: 26569005 DOI: 10.5177/ntvt.2015.11.15212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cleft lip and palate is a common congenital malformation with a prevalence of 1:600 newborns. Children with orofacial clefts are treated by an interdisciplinary team of specialists while parents and child play a key role in their own care process. The orthodontic and facial orthopedic treatment of a child with a cleft takes many years. Children often get bored of the long treatment and this can cause problems with compliance and oral hygiene. Therefore it is advisable to distinguish 5 well-defined stages in the orthodontic treatment and to attempt to have some 'orthodontics free' time in between. The 3 orthodontic treatment phases between the age of 9 and 20 years consist of orthodontic treatment concerning the closing of the cleft with a bone transplant, the treatment of the permanent dentition and, finally, a possible combined orthodontic surgical treatment at the end of the period of growth. Good interdisciplinary collaboration among the different dental disciplines is essential in this regard.
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Nienkemper M, Wilmes B, Franchi L, Drescher D. Effectiveness of maxillary protraction using a hybrid hyrax-facemask combination: a controlled clinical study. Angle Orthod 2015; 85:764-70. [PMID: 25393800 PMCID: PMC8610391 DOI: 10.2319/071614-497.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/01/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the treatment effects of a hybrid hyrax-facemask (FM) combination in growing Class III patients. MATERIAL AND METHODS A sample of 16 prepubertal patients (mean age, 9.5 ± 1.6 years) was investigated by means of pre- and posttreatment cephalograms. The treatment comprised rapid palatal expansion with a hybrid hyrax, a bone- and toothborne device. Simultaneously, maxillary protraction using an FM was performed. Mean treatment duration was 5.8 ± 1.6 months. The treatment group was compared with a matched control group of 16 untreated Class III subjects. Statistical comparisons were performed with the Mann-Whitney U-test. RESULTS Significant improvement in skeletal sagittal values could be observed in the treatment group over controls: SNA: 2.4°, SNB: -1.7°, Co-Gn: -2.3 mm, Wits appraisal: 4.5 mm. Regarding vertical changes, maintenance of vertical growth was obtained as shown by a small nonsignificant increase of FMA and a small significant decrease of the Co-Go-Me angle. CONCLUSIONS The hybrid hyrax-FM combination was found to be effective for orthopedic treatment in growing Class III patients in the short term. Favorable skeletal changes were observed both in the maxilla and in the mandible. No dentoalveolar compensations were found.
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Affiliation(s)
- Manuel Nienkemper
- Instructor, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Benedict Wilmes
- Associate Professor, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Lorenzo Franchi
- Associate Professor, Department of Orthodontics, University of Firenze, Florence, Italy
| | - Dieter Drescher
- Professor and Department Chair, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
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Akin M, Baka ZM, Ileri Z, Basciftci FA. Alveolar bone changes after asymmetric rapid maxillary expansion. Angle Orthod 2015; 85:799-805. [PMID: 25478739 PMCID: PMC8610406 DOI: 10.2319/090214.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/01/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To quantitatively evaluate the effects of asymmetric rapid maxillary expansion (ARME) on cortical bone thickness and buccal alveolar bone height (BABH), and to determine the formation of dehiscence and fenestration in the alveolar bone surrounding the posterior teeth, using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT records of 23 patients with true unilateral posterior skeletal crossbite (10 boys, 14.06 ± 1.08 years old, and 13 girls, 13.64 ± 1.32 years old) who had undergone ARME were selected from our clinic archives. The bonded acrylic ARME appliance, including an occlusal stopper, was used on all patients. CBCT records had been taken before ARME (T1) and after the 3-month retention period (T2). Axial slices of the CBCT images at 3 vertical levels were used to evaluate the buccal and palatal aspects of the canines, first and second premolars, and first molars. Paired samples and independent sample t-tests were used for statistical comparison. RESULTS The results suggest that buccal cortical bone thickness of the affected side was significantly more affected by the expansion than was the unaffected side (P < .05). ARME significantly reduced the BABH of the canines (P < .01) and the first and second premolars (P < .05) on the affected side. ARME also increased the incidence of dehiscence and fenestration on the affected side. CONCLUSIONS ARME may quantitatively decrease buccal cortical bone thickness and height on the affected side.
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Affiliation(s)
- Mehmet Akin
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Zeliha Muge Baka
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Zehra Ileri
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Faruk Ayhan Basciftci
- Professor, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Orton-Gibbs S, Kim NY. Clinical experience with the use of pulsatile forces to accelerate treatment. J Clin Orthod 2015; 49:557-573. [PMID: 26457615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Sharon Orton-Gibbs
- Walpole-The Orthodontic Specialists, 15 St. Leonards Road, Thames Ditton, Surrey KT7 0RL, United Kingdom.
| | - Na Yeoun Kim
- Private Dental Practice in Clydach, Swansea, Wales
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Leyder P, Altounian G, Chardain J, Quilichini J. Adjustable selective maxillary expansion combined with maxillomandibular surgery: A case report. Int Orthod 2015; 13:320-31. [PMID: 26277457 DOI: 10.1016/j.ortho.2015.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Surgically assisted rapid maxillary expansion (SARME) is usually considered the gold standard for maxillary transverse expansion in adults. However, a second surgical procedure is needed in cases of associated sagittal or vertical discrepancies. We describe the use of two new innovative devices for the correction of discrepancies in all dimensions during a single surgical procedure, thus reducing treatment duration. MATERIAL We report the case of a 21-year-old female patient, referred to our department for skeletal Class III malocclusion associated with right-side laterognathism and transverse maxillary deficiency. The patient underwent one-stage surgery, using sliding osteosynthesis plates and an adjustable bone-borne distractor. Pre-surgical orthodontics consisted in leveling and aligning the mandibular arch; maxillary leveling was initiated 3 months before surgery. Postoperative palatal distraction combined with orthodontic finishing enabled complete correction of dental and bony discrepancies after 3 months. CONCLUSION In our experience, treatment of transverse, sagittal and vertical discrepancies has been possible in a single surgical procedure, using two innovative techniques: sliding osteosynthesis and an adjustable bone distractor. Two years post-surgery, the correction is stable in all dimensions.
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Affiliation(s)
- Patrick Leyder
- Department of maxillofacial and plastic surgery, Robert-Ballanger Hospital, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois, France.
| | - Gérard Altounian
- Private practice, 2, rue Malleville, 95880 Enghien-Les-Bains, France
| | - Jacques Chardain
- Department of maxillofacial and plastic surgery, Robert-Ballanger Hospital, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois, France
| | - Julien Quilichini
- Department of maxillofacial and plastic surgery, Robert-Ballanger Hospital, boulevard Robert-Ballanger, 93602 Aulnay-sous-Bois, France
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