Buccal alveolar bone thickness changes after rapid maxillary expansion with tooth-borne and bone-borne expanders

ABSTRACT Objectives To assess factors that may be associated with buccal bone changes adjacent to maxillary first molars after rapid maxillary expansion (RME) and fixed appliance therapy. Materials and Methods Pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans were obtained from 45 patients treated with RME and preadjusted edgewise appliances. Buccal alveolar bone thickness was measured adjacent to the mesiobuccal root of the maxillary first molar 4 mm, 6 mm, and 8 mm apical to the cementoenamel junction, and anatomic defects were recorded. Paired and unpaired t-tests were used to compare alveolar bone thickness at T1 and T2 and to determine whether teeth with posttreatment anatomic defects had thinner initial bone. Correlation analyses were used to examine relationships between buccal alveolar bone thickness changes and amount of expansion, initial bone thickness, age at T1, postexpansion retention time, and treatment time. Results There was a statistically significant reduction in buccal alveolar bone thickness from T1 to T2. Approximately half (47.7%) of the teeth developed anatomic defects from T1 to T2. These teeth had significantly thinner buccal bone at T1. Reduction in alveolar bone thickness was correlated with only one tested variable: initial bone thickness. Conclusions RME and fixed-appliance therapy can be associated with significant reduction in buccal alveolar bone thickness and an increase in anatomic defects adjacent to the expander anchor teeth. Anchor teeth with greater initial buccal bone thickness have less reduction in buccal bone thickness and are less likely to develop posttreatment anatomic defects of buccal bone.

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Alveolar bone changes after asymmetric rapid maxillary expansion

The Angle Orthodontist ◽

10.2319/090214.1 ◽

2014 ◽

Vol 85 (5) ◽

pp. 799-805 ◽

Cited By ~ 6

Author(s):

Mehmet Akin ◽

Zeliha Muge Baka ◽

Zehra Ileri ◽

Faruk Ayhan Basciftci

Keyword(s):

Cortical Bone ◽

Alveolar Bone ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Bone Thickness ◽

Unaffected Side ◽

Posterior Teeth ◽

Cortical Bone Thickness ◽

Paired Samples ◽

Affected Side

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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Alveolar bone changes after rapid maxillary expansion with tooth-born appliances: a systematic review

European Journal of Orthodontics ◽

10.1093/ejo/cjx057 ◽

2017 ◽

Vol 40 (3) ◽

pp. 296-303 ◽

Cited By ~ 18

Author(s):

Antonino Lo Giudice ◽

Ersilia Barbato ◽

Leandro Cosentino ◽

Claudia Maria Ferraro ◽

Rosalia Leonardi

Keyword(s):

Systematic Review ◽

Alveolar Bone ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Bone Changes

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Rapid Maxillary Expansion after Secondary Alveolar Bone Grafting in Patients with Alveolar Cleft

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-205.1 ◽

2009 ◽

Vol 46 (3) ◽

pp. 331-338 ◽

Cited By ~ 18

Author(s):

Omar Gabriel da Silva Filho ◽

Elaine Boiani ◽

Arlete de Oliveira Cavassan ◽

Milton Santamaria

Keyword(s):

Bone Grafting ◽

Alveolar Bone ◽

Qualitative Evaluation ◽

Rapid Maxillary Expansion ◽

Dental Arch ◽

Sample Population ◽

Maxillary Expansion ◽

Alveolar Bone Grafting ◽

Before And After ◽

Secondary Alveolar Bone Grafting

Objective: To test the hypothesis that it is possible to perform rapid maxillary expansion (RME) after alveolar bone grafting in patients with clefts of the lip and palate (CLP) without compromising the final result of the bone graft. Design: Occlusal and periapical radiographs of the grafted area of 17 unilateral and 11 bilateral patients with CLP (n = 28) were obtained before and after RME. Setting and sample population: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo. Twenty-eighty patients with CLP who had undergone RME. Interventions: RME was performed in patients with CLP who had already undergone RME before secondary bone grafting but with relapse of the maxillary dental arch constriction, as well as in patients with CLP who had never undergone expansion before bone grafting. Outcome measure: Qualitative evaluation in occlusal and periapical radiographs after alveolar bone grafting. Results: Findings showed opening of the midpalatal suture in 42.8% of patients in this study. Regardless of the success rate of RME, the alveolar bone grafting was not affected when the procedures were inverted. Conclusion: The hypothesis was accepted. RME can be performed after secondary alveolar bone grafting without affecting it.

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Clinical effect on the alveolar bone of maxillary molar after rapid maxillary expansion: a systematic review and meta-analysis

10.21203/rs.3.rs-197503/v1 ◽

2021 ◽

Author(s):

Bowen Zhang ◽

Mengqiao Wang ◽

Fenglu Zhao ◽

Zijie Zhang ◽

Fulan Wei

Keyword(s):

Systematic Review ◽

Cortical Thickness ◽

Alveolar Bone ◽

Data Extraction ◽

Meta Analysis ◽

Rapid Maxillary Expansion ◽

Cochrane Central Register ◽

Maxillary Expansion ◽

Manual Search ◽

The Stability

Abstract Background This study assessed the effects of rapid maxillary expansion (RME) on alveolar bone cortical thickness and vertical bone level of maxillary first molar. Material and methods PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and a manual search in reference lists of the included studies were searched up to November 2020. The data extraction and risk of bias assessment were performed independently by two authors. Review Manager 5 was used for quantitative analysis. Results Eight studies were selected for the systematic review, and six studies were statistically selected in meta-analysis. The thickness of the distal buccal alveolar bone was significantly reduced of both left (MD 0.53;95% CI:0.15–0.90) and right (MD 0.61;95% CI:0.28–0.94) sides of the maxillary first molar after RME. The same was true for the left (MD 0.63;95% CI:0.28–0.98) and right (MD 0.63;95% CI:0.36–0.91) sides of the mesial buccal side. And the vertical distance between the cusp tip and the buccal alveolar crest increased significantly after RME (SMD − 0.92;95% CI: -1.20–0.64). However, the study of palatal cortical thickness of maxillary first molar needs more clinical trials because of its high heterogeneity (left: I2 = 92%; right: I2 = 86%). Conclusions According to current studies, RME can reduce the buccal cortical thickness of maxillary first molars and increase vertical bone loss. More research is needed to determine the stability of the results. However, it is advisable to evaluate the alveolar bone before treatment.

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Rapid Maxillary Expansion after Secondary Alveolar Bone Graft in a Patient with Bilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/02-099.1 ◽

2004 ◽

Vol 41 (3) ◽

pp. 332-339 ◽

Cited By ~ 14

Author(s):

Arlete de Oliveira Cavassan ◽

Marcelo D'Albuquerque de Albuquerque ◽

Leopoldino Capelozza Filho

Keyword(s):

Bone Graft ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Bilateral Cleft Lip ◽

Maxillary Constriction ◽

Intercanine Distance ◽

Dental Casts

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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