scholarly journals Comparison of dentoskeletal and soft tissue changes between tooth-borne and tooth-bone-borne hybrid nonsurgical rapid maxillary expansions in adults: a retrospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jung-Sub An ◽  
Bo-Yeon Seo ◽  
Sug-Joon Ahn

Abstract Background Despite the gradual increase in the use of rapid maxillary expansion (RME), specifically RME with the aid of skeletal anchorage in adults, there have been no reports comparing dentoskeletal and soft tissue changes between nonsurgical tooth-borne and tooth-bone-borne RMEs in adults. This study aimed to analyse differences in dentoskeletal and soft tissue changes between tooth-borne and tooth-bone-borne RMEs using a similar appliance design and the same expansion protocol in adult patients. Methods Twenty-one patients with tooth-borne expansion (a conventional expansion screw with two premolars and two molar bands for dental anchorage [T-RME]) and the same number of patients with tooth-bone-borne hybrid expansion (a conventional expansion screw with two premolar and two molar bands for dental anchorage and four mini-implants in the palate for skeletal anchorage [H-RME]) were included. Dentoskeletal and soft tissue variables at pretreatment (T1) and after expansion (T2) were measured using posteroanterior and lateral cephalograms and frontal photographs. The sex distribution of the two groups was analysed using the chi-square test, and the change after RME in each group was evaluated using the Wilcoxon signed-rank test. Differences in pretreatment age, expansion duration, post-expansion duration, and dentoskeletal and soft tissue changes after RME between the two groups were determined using the Mann–Whitney U test. Results There were no significant differences in the expansion protocol, pretreatment conditions, and sex distribution between the two groups. Despite similar degrees of dental expansion at the crown level between the two groups, H-RME induced increased skeletal and parallel expansion of the maxilla compared to T-RME. After expansion, H-RME demonstrated increased forward displacement of the maxilla without significant changes in the vertical dimension, while T-RME exhibited increased backward displacement of the mandible, increased vertical dimension, and decreased overbite. Both groups showed significant retroclination and extrusion of the maxillary incisors without significant intergroup differences. There were no significant soft tissue changes between the two groups. Conclusion This study suggests that using skeletal anchorage in RME may induce increased skeletal and parallel expansion of the maxilla without significant effects on the vertical dimension.

2021 ◽  
Author(s):  
Jung-Sub An ◽  
Bo-Yeon Seo ◽  
Sug-Joon Ahn

Abstract Background Despite the gradual increase in the use of rapid maxillary expansion (RME), specifically RME with the aid of skeletal anchorage in adults, there have been no reports comparing dentoskeletal and soft tissue changes between nonsurgical tooth-borne and tooth-bone-borne RMEs in adults. This study aimed to analyse differences in dentoskeletal and soft tissue changes between tooth-borne and tooth-bone-borne RMEs using a similar appliance design and the same expansion protocol in adult patients. Methods Twenty-one patients with tooth-borne expansion (a conventional expansion screw with two premolars and two molar bands for dental anchorage [T-RME]) and the same number of patients with tooth-bone-borne hybrid expansion (a conventional expansion screw with two premolar and two molar bands for dental anchorage and four mini-implants in the palate for skeletal anchorage [H-RME]) were included. Dentoskeletal and soft tissue variables at pretreatment (T1) and after expansion (T2) were measured using posteroanterior and lateral cephalograms and frontal photographs. The sex distribution of the two groups was analysed using the chi-square test, and the change after RME in each group was evaluated using the Wilcoxon signed-rank test. Differences in pretreatment age, expansion duration, post-expansion duration, and dentoskeletal and soft tissue changes after RME between the two groups were determined using the Mann–Whitney U test. Results There were no significant differences in the expansion protocol, pretreatment conditions, and sex distribution between the two groups. Despite similar degrees of dental expansion at the crown level between the two groups, H-RME induced increased skeletal and parallel expansion of the maxilla compared to T-RME. After expansion, H-RME demonstrated increased forward displacement of the maxilla without significant changes in the vertical dimension, while T-RME exhibited increased backward displacement of the mandible, increased vertical dimension, and decreased overbite. Both groups showed significant retroclination and extrusion of the maxillary incisors without significant intergroup differences. There were no significant soft tissue changes between the two groups. Conclusion This study suggests that using skeletal anchorage in RME may induce increased skeletal and parallel expansion of the maxilla without significant effects on the vertical dimension.


2014 ◽  
Vol 38 (3) ◽  
pp. 277-283 ◽  
Author(s):  
N Canigur Bavbek ◽  
B Balos Tuncer ◽  
T Tortop

The aim of this study was to compare the soft tissue changes influenced by reverse headgear therapy with (RHg+RME) or without (RHg) rapid maxillary expansion with each other and with an untreated Class III control group (C). Study design: RHg group (10 girls, 6 boys, mean chronological age 11.1 years), RHg+RME group (12 girls, 4 boys, mean chronological age 10.8 years) and C group (7 girls, 11 boys, mean chronological age 10.2 years) comprised skeletally Class III patients with maxillary deficiency. Soft tissue measurements were made on lateral cephalograms at the beginning and at the end of the treatment and observation periods. Changes within each group and the differences between the groups were analyzed by paired t-test; the differences between the groups were determined by variance analysis and Duncan test with a significance level p<0.05. Results: The sagittal depth of nose and maxilla, upper lip height and protrusion were significantly increased in treatment groups and the differences were significant when compared to control group (p<0.05). Conclusion: Forward movement of upper lip was more prominent in RHg group. Reverse headgear treatment with or without RME revealed significant soft tissue changes when compared with a growing Class III control group with the same skeletal characteristics.


2020 ◽  
Author(s):  
Hieu Nguyen ◽  
Jeong Won Shin ◽  
Hai-Van Giap ◽  
Ki Beom Kim ◽  
Hwa Sung Chae ◽  
...  

Abstract Background The aim of this study was to assess the mid-facial soft tissue changes induced by a micro-implant-supported maxillary skeletal expander in late adolescents and young adults by cone-beam computerized tomography and the correlations between hard and soft tissue changes after expansion with maxillary skeletal expander.Subjects and methods Twenty patients with maxillary transverse deficiency treated with maxillary skeletal expander were selected. Cone-beam computerized tomography images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks.Results Anterior nasal spine, posterior nasal spine, and alveolar bone width were significantly increased after expansion with maxillary skeletal expander (p < 0.05). The average lateral movement of the cheek points was 1.13 ± 0.33 mm (left) and 1.41 ± 0.39 mm (right), while that of the alar curvature points was 1.07 ± 0.72 mm (left) and 1.06 ± 0.68 (right) (p < 0.05). The average forward displacement of the cheek points was 0.42 ± 0.66 mm (left) and 0.60 ± 0.58 mm (right), whereas that of the alar curvature points was 0.80 ± 0.67 mm (left) and 0.68 ± 0.56 mm (right) side (p < 0.05). The average downward movement of the subnasale was 0.40 ± 0.37 mm (p < 0.05). The changes in cheek points and alar curvature points on both sides significantly correlated with hard-tissue changes (p < 0.05).Conclusions Maxillary expansion using maxillary skeletal expander resulted in significant lateral and forward movement of soft tissues of the cheek and alar curvature points on both sides and correlated with the maxillary suture opening at the anterior and posterior nasal spines.


2018 ◽  
Vol 23 (3) ◽  
pp. 63-72 ◽  
Author(s):  
Bruno D’Aurea Furquim ◽  
Guilherme Janson ◽  
Laura de Castro Cabrera Cope ◽  
Karina Maria Salvatore Freitas ◽  
José Fernando Castanha Henriques

ABSTRACT Objective: The aim of this study was to compare the skeletal, dental, and soft tissue effects of the Mandibular Protraction Appliance (MPA) application in adolescent and adult Class II malocclusion patients. Methods: The sample comprised the pretreatment and posttreatment lateral cephalograms of 39 subjects presenting Class II malocclusion treated with the MPA and fixed appliances. Sample was divided into two groups: Group 1 comprised 23 subjects (10 male; 13 female), at a mean pretreatment age of 11.75 years, with a mean treatment time of 3.32 years; Group 2 included 16 subjects (7 male; 9 female), at a mean pretreatment age of 22.41 years, with a mean treatment time of 4.24 years. Intergroup comparison of the initial and final stages and treatment changes between the groups was performed with t tests, at p< 0.05. Results: The adults showed less significant amounts of skeletal, dentoalveolar and soft tissue changes than the adolescents. There was significantly greater palatal tipping of the maxillary incisors and retrusion of the upper lip in the adolescents. The adult group showed greater mandibular incisor proclination in the posttreatment stage. Conclusion: Adult patients treated with MPA showed less significant amounts of skeletal, dentoalveolar and soft tissue changes than adolescents.


2016 ◽  
Vol 86 (6) ◽  
pp. 934-942 ◽  
Author(s):  
Asli Baysal ◽  
Mehmet Ali Ozturk ◽  
Ahmet Oguz Sahan ◽  
Tancan Uysal

ABSTRACT Objective: To evaluate three-dimensional (3-D) soft tissue facial changes following rapid maxillary expansion (RME) and to compare these changes with an untreated control group. Materials and Methods: Patients who need RME as a part of their orthodontic treatment were randomly divided into two groups of 17 patients each. Eligibility criteria included having maxillary transverse deficiency with crossbite, and to be in the normal range according to body mass index. In the first group (mean age  =  13.4 ± 1.2 years), expansion was performed. The second group received no treatment initially and served as untreated control (mean age  =  12.8 ± 1.3 years). Skeletal and soft tissue changes were evaluated using posteroanterior cephalograms and 3-D facial images. The primary outcome of this study was to assess the soft tissue changes. The secondary outcomes were evaluation hard tissue and soft tissue relations. Randomization was done with preprepared random number tables. Blinding was applicable for outcome assessment only. MANOVA, t-test, and correlation analyses were used (P  =  .05). Results: In both groups, there was a general trend of increase for the transverse skeletal measurements, but these increases were more limited in the control group. Alar base width was greater in the treatment group (P  =  .002). Pogonion soft tissue point (P  =  .022) was located more posteriorly in the expansion group compared with the control group. Conclusions: Soft tissue changes between groups were similar, except for the alar base, which became wider in the treatment group. Weak correlations were found between the skeletal and soft tissue changes.


Author(s):  
Lorenz Moser ◽  
Enrica Di Lorenzo ◽  
Marco Serafin ◽  
Giuliano Maino ◽  
Ute Schneider-Moser ◽  
...  

Introduction: Problem solving in Class II malocclusion treatment performed with premolars extractions or distalizing techniques in relation to the profile modification. Aim: To cephalometrically compare soft tissue changes produced either by maxillary premolar extraction, tooth-borne Pendulum appliance or bone-borne MGBM appliance. Materials and Methods: Both pre- (T1) and post-treatment (T2) lateral cephalograms of 89 skeletal Class II patients (36 M, 53 F), treated during pubertal growth spurt, were retrospectively selected. Three groups were formed based on the therapy performed: 30 patients had been treated with maxillary first premolars extraction (U4), 31 patients with a conventional tooth-borne distalizing with Pendulum appliance (PA), and 28 patients with a skeletally anchored distalizing appliance (MGBM). Soft tissue was analyzed comparing upper (UL) and lower (LL) lip’s points with regard to True Vertical Line (TVL) and Esthetic plane (E-plane). Skeletal and dental values have been recorded in order to cephalometrically compare ΔT2-T1 changes among groups and to correlate dental and skeletal changes to profile modifications. One-way ANOVA was employed to compare groups at T1. Paired sample t-tests were employed to assess significant intra- and intergroup differences between T2 and T1. Significance level was set at 0.05 Results: UL and LL showed a slight but not significant retrusion relative to TVL in all three groups. UL and LL distances to E-plane were not statistically significant among U4, PA, and MGBM groups. Independently of the treatment, UL was tangent to TVL in all groups. No statistically significant differences have been shown in skeletal records. Significant differences were recorded in Overjet among U4 than PA and MGBM groups. Conclusions: Class II malocclusion treatment with maxillary first premolar extraction, conventional or skeletal distalization did not significantly affect the profile producing similar changes in the soft tissue.


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