Long-term follow-up of Liou-Alternate rapid maxillary expansion and constriction

Abstract Objective: To evaluate a 10-year follow-up of anteroposterior and vertical maxillary changes in skeletal Class II patients treated with slow and rapid maxillary expansion methods. Materials and Methods: The sample consisted of 70 patients divided into two groups: (1) treated with a cervical headgear with expansion of the inner bow (CHG) and (2) using a Haas-type rapid maxillary expansion appliance in conjunction with cervical headgear (RME-CHG). The CHG group consisted of 40 patients (18 males and 22 females; average age 10.6 years at pretreatment [T1], 13.6 years at posttreatment [T2], and 23.6 years at postretention [T3]). The RME-CHG group consisted of 30 patients (14 males and 16 females; average age 10.4 years at T1, 14.0 years at T2, and 24.6 years at T3). The profiles of SNA and SN-PP angles showed no significant differences in either group at T1, T2, and T3 phases. Results: For the entire sample, the profile analysis between the phases showed reduction in the SNA angle from T1–T2 and an increase from T2–T3. The SN-PP angle showed an increase from T1–T2 and a decrease from T2–T3. Treatment of skeletal Class II patients with slow and rapid maxillary expansions was efficient and stable over the long-term. Conclusions: The profiles of SNA and SN-PP at T1, T2, and T3 achieved with slow and rapid maxillary expansions were clinically equivalent.

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Rapid Maxillary Expansion Effects on Nocturnal Enuresis in Children

The Angle Orthodontist ◽

10.2319/021407-71.1 ◽

2008 ◽

Vol 78 (2) ◽

pp. 201-208 ◽

Cited By ~ 25

Author(s):

Ulrike Schütz-Fransson ◽

Jüri Kurol

Keyword(s):

School Performance ◽

Medical Therapy ◽

Nocturnal Enuresis ◽

Adverse Reactions ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Positive Effects ◽

Before And After

Abstract Objective: To assess the effects of 10–14 days of rapid maxillary expansion (RME) on nocturnal enuresis (NE) in children who have long-standing resistance to medical therapy and to evaluate the long-term success rate after 10 years. Materials and Methods: Twenty-three children with NE, aged 6–15 years old (mean age = 10), who wet their bed almost every night and had never been dry were referred from pediatric specialists. Mean RME was 6.5 mm (range = 5–8), but only 7 of the 23 patients had lateral crossbites. Rhinomanometric measurements were taken before and after RME, and patients were interviewed 10 years after treatment. Results: Positive effects of RME were observed in nearly 50% of the patients within 1 month of treatment: six were completely dry and five had notable improvements. Relapse in the overexpanded arches to a normal transversal occlusion was noted within 1 year. No correlation was found between success and improved airways, familial heritage, school performance, or other social factors. Younger children responded better to the treatment. Results were stable at the 10-year follow-up, and no adverse reactions were reported. Conclusion: Orthodontic RME is a new option for treating children with NE who are resistant to medical therapy; the treatment has no adverse side effects.

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Long-term maxillary anteroposterior changes following maxillary protraction with or without expansion: A meta-analysis and meta-regression

PLoS ONE ◽

10.1371/journal.pone.0247027 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247027

Author(s):

Wei-Cheng Lee ◽

Yi-Shing Shieh ◽

Yu-Fang Liao ◽

Cho-Hao Lee ◽

Chiung Shing Huang

Keyword(s):

Confidence Interval ◽

Meta Analysis ◽

Rapid Maxillary Expansion ◽

Mean Difference ◽

Class Iii ◽

Maxillary Expansion ◽

Maxillary Protraction ◽

Meta Regression

Background Maxillary protraction with or without expansion is a widely known orthopedic treatment modality in growing skeletal Class III patients. However, limited data are available regarding the outcomes of long-term changes in the maxilla. Aim of this meta-analysis was to assess the effectiveness of the long-term maxillary anteroposterior changes following a facemask therapy with or without rapid maxillary expansion in growing skeletal Class III patients. Methods A comprehensive literature search was conducted using the databases of PubMed, Science Direct, Web of Science, and Embase. Randomized controlled trials and cohort studies, published up to Sep. 2020, with maxillary protraction and/or expansion as keywords were included in this meta-analysis. Risk of bias within and across studies were assessed using the Cochrane tools (RoB2.0 and ROBINS-I) and GRADE approach. Overall and subgroup comparisons with the random-effect model were performed in this meta-analysis. Meta-regression models were designed to determine potential heterogeneity. Results There was a statistically significant increase (Mean difference, 2.29°; 95% confidence interval, 1.86–2.73; and p < 0.001 after facemask (FM) protraction. Mean difference, 1.73°; 95% confidence interval, 1.36–2.11; and p < 0.001 after rapid maxillary expansion(RME) and facemask protraction) in the Sella-Nasion-A point (SNA) angle in the treatment groups as compared with the control groups, when measured during the less than 3-year follow-up period. However, no statistically significant changes (Mean difference, 0.28°; 95% confidence interval, -0.57–1.13; and p = 0.52 after facemask protraction. Mean difference, 0.34°; 95% confidence interval, -0.64–1.33; and p = 0.50 after rapid maxillary expansion and facemask protraction) were observed in the SNA angle in the groups, when measured after 3 years of follow-up. Meta-regression analysis also showed that with increased follow-up duration, the effectiveness of maxillary protraction decreased. Conclusion This meta-analysis revealed that maxillary protraction therapy could be effective for a short-term in correcting maxillary hypoplasia and the treatment result was not affected by mean age and sex. However, with increased follow-up duration, the sagittal maxillary changes gradually decreased. Limitations on this review were only the SNA angle was used and clinical heterogeneity was not discussed. The quality of evidence was moderate. Further long-term observational studies are necessary for a comprehensive evaluation of the effects on maxillary skeletal changes.

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Long-Term Effects of Rapid Maxillary Expansion Followed by Fixed Appliances

The Angle Orthodontist ◽

10.2319/011209-22.1 ◽

2010 ◽

Vol 80 (1) ◽

pp. 5-9 ◽

Cited By ~ 46

Author(s):

Hakan Gurcan Gurel ◽

Badel Memili ◽

Mustafa Erkan ◽

Yusuf Sukurica

Keyword(s):

Rapid Maxillary Expansion ◽

Long Term Effects ◽

Maxillary Expansion ◽

Long Term Changes ◽

Fixed Appliances ◽

Relapse Rates ◽

Maxillary Arch

Abstract Objective: To evaluate the long-term changes in maxillary arch widths, overjet, and overbite in patients who were treated with rapid maxillary expansion (RME) followed by edgewise appliances. Materials and Methods: The material for the study consisted of study casts taken from 41 patients (19 males, 22 females) on four different occasions (before treatment, T1; after RME, T2; after treatment, T3; and during follow-up period, T4). The upper intercanine, interpremolar, and intermolar widths and overjet and overbite were measured on each set of study casts. Mean age of the subjects was 13.2 ± 1.3 years (range, 11.2–16.9 years) at T1, 13.3 ± 1.3 years (range, 11.3–17 years) at T2, 15.5 ± 1.4 years (range, 13.1–18.8 years) at T3, and 20.4 ± 1.6 years (range, 17.9–24.8 years) at T4. Results: The net increase in intercanine width, interpremolar width, intermolar width, overjet, and overbite was 1.4 ± 2.4 mm, 4.6 ± 2.6 mm, 4.3 ± 2.5 mm, 0.1 ± 0.6 mm, and 0.2 ± 0.6 mm, respectively, and the relapse rates were 37% for intercanine width, 19% for interpremolar width, and 17% for intermolar width at the end of the follow-up period. Conclusions: A significant amount of relapse occurred in maxillary arch widths at the postretention assessment, the greatest being in intercanine width. RME significantly decreased overbite and increased overjet, and a statistically significant decrease was observed in both overbite and overjet at the postretention assessment.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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