Analysis of the dentoalveolar effects of slow and rapid maxillary expansion in complete bilateral cleft lip and palate patients: a randomized clinical trial

Objective To verify the effects of rapid maxillary expansion performed after secondary alveolar bone graft in one patient. Setting Department of Orthodontics of the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo. Patient(s) The patient had bilateral cleft lip and palate, had already had a bone graft, and showed a relapsing maxillary constriction in need of correction. Intervention A fixed dental-mucous-bone-supported expander corrected the maxillary constriction. Main Outcome Measure(s) Measurements were obtained from dental casts, including transverse dimensions (intercanine distance [IC], interfirst premolar distance [IP], and interfirst molar distance [IM]) and measurements of the grafted area (interfirst premolar/central incisors [IPI] and interfirst premolar/canine [IPC]) to observe the changes. Clinical and radiographic analyses were done through direct view. Results The occlusal radiograph of the maxilla after expansion showed opening of the intermaxillary suture in the premaxillary area, which was clinically confirmed by the diastema between the maxillary central incisors. No radiographic alteration was observed in the grafted area. The transverse measurements of the dental casts (IC, IP, and IM) showed a significant increase. The measurements of the teeth adjacent to the grafted area, IPI and IPC, increased. Conclusions The orthopedic effect of rapid maxillary expansion after bone graft was verified. Nevertheless, additional studies are necessary to define any side effects in patients submitted to bone graft.

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Rapid Maxillary Expansion Increases Internal Nasal Dimensions of Children with Bilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/14-244 ◽

2016 ◽

Vol 53 (3) ◽

pp. 272-277 ◽

Cited By ~ 6

Author(s):

Ivy Kiemle Trindade-Suedam ◽

Ricardo Leão Castilho ◽

Ana Claudia Martins Sampaio-Teixeira ◽

Bruna Mara Adorno Marmotel Araújo ◽

Ana Paula Fukushiro ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Bilateral Cleft Lip

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Nasal Chamber Changes Following Rapid Maxillary Expansion in Children with Bilateral Cleft Lip and Palate

Egyptian Dental Journal ◽

10.21608/edj.2020.77502 ◽

2020 ◽

Vol 66 (1) ◽

pp. 45-50

Author(s):

Noha Abdelrahman ◽

Raghdaa Mostafa

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Bilateral Cleft Lip

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Treatment of Unilateral Cleft Lip and Palate Patient With Intraoral Tooth Tissue Borne Distractor and Facemask Therapy: A Case Report

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665621993366 ◽

2021 ◽

pp. 105566562199336

Author(s):

Akansha Bansal Agrawal ◽

Harshavardhan Kidiyoor ◽

Anand K. Patil Morth

Keyword(s):

Case Report ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Face Mask ◽

Rapid Maxillary Expansion ◽

Growth Potential ◽

Maxillary Expansion ◽

Long Term Stability ◽

Tooth Tissue

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.

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Description of transverse maxillary expansion in patients with bilateral cleft lip and palate undergoing gingivoperiosteoplasty with alveolar bone graft. A preliminary study

Journal of Dentofacial Anomalies and Orthodontics ◽

10.1051/odfen/2014030 ◽

2015 ◽

Vol 18 (1) ◽

pp. 108

Author(s):

N. Niez ◽

K. Nham ◽

B. Vi-Fane

Keyword(s):

Bone Graft ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Maxillary Expansion ◽

Bilateral Cleft Lip ◽

Preliminary Study

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Effects of rapid maxillary expansion in cleft patients resulting from the use of two different expanders

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.2016-001.aop ◽

2016 ◽

Vol 21 (6) ◽

pp. 82-90 ◽

Cited By ~ 1

Author(s):

Daniel Santos Fonseca Figueiredo ◽

Lucas Cardinal ◽

Flávia Uchôa Costa Bartolomeo ◽

Juan Martin Palomo ◽

Martinho Campolina Rebello Horta ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Rapid Maxillary Expansion ◽

Cone Beam ◽

Tomographic Image ◽

Maxillary Expansion ◽

Downward Movement ◽

Computed Tomographic ◽

Significant Difference ◽

Maxillary Region

ABSTRACT Objective: The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. Methods: Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). Results: In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p < 0.05) and no significant forward and/or downward movement of the maxilla (p > 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p < 0.05). Cleft and non-cleft sides were symmetrically expanded and there was no difference in dental tipping between both sides (p > 0.05). Conclusions: The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one.

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