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

2016 ◽  
Vol 21 (6) ◽  
pp. 82-90 ◽  
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.

scholarly journals Upper airway assessment using four different maxillary expanders in cleft patients: A cone-beam computed tomography study

2015 ◽  
Vol 86 (4) ◽  
pp. 617-624 ◽  
Author(s):  
Carolina Morsani Mordente ◽  
Juan Martin Palomo ◽  
Martinho Campolina Rebello Horta ◽  
Bernardo Quiroga Souki ◽  
Dauro Douglas Oliveira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cone Beam ◽  
Nasal Passage ◽  
Maxillary Expansion ◽  
Computed Tomography Images ◽  
Intergroup Comparison ◽  
Significant Difference

ABSTRACTObjective: To evaluate the anterior and posterior maxillary width, the nasal passage volume, the oropharyngeal minimum axial area, and volume changes in unilateral cleft lip and palate patients treated with one of the following four expanders: Hyrax, Fan-Type, inverted mini-hyrax supported on the first permanent molars (iMini-M), or inverted mini-hyrax supported on the first premolars (iMini-B).Materials and Methods: A total of 40 patients with transverse maxillary deficiency who were submitted for rapid maxillary expansion were divided in four groups according to type of expander used. Cone-beam computed tomography images were taken before and 3 months after expansion. One-way analysis of variance was used to analyze the differences among the groups, and paired t-tests were used to evaluate the changes in each group.Results: All groups showed a significant increase in the anterior maxillary width, with no intergroup differences. The iMini-B was the only group that did not show a significant increase in the posterior maxillary width. The intergroup comparison demonstrated differences among all groups except between Hyrax and iMini-M, which showed the greatest posterior expansions. The intragroup analysis showed a significant increase in the nasal passage volume in hyrax and inverted mini-hyrax on the molar groups, but the intergroup comparison revealed a significant difference only between Fan-Type and inverted mini-hyrax on the molars. None of the expanders caused significant changes in the oropharyngeal measurements.Conclusions: Only the Hyrax and inverted mini-hyrax on the molar expanders effectively increased the nasal passage volume, and none of the expanders evaluated in this study modified the oropharyngeal airway.

Dentoskeletal Effects of Maxillary Protraction in Cleft Patients with Repetitive Weekly Protocol of Alternate Rapid Maxillary Expansions and Constrictions

2009 ◽  
Vol 46 (4) ◽  
pp. 391-398 ◽  
Author(s):  
Gustavoda Luz Vieira ◽  
Luciane Macedo de Menezes ◽  
Eduardo Martinelli S. de Lima ◽  
Susana Rizzatto
Keyword(s):  
Repeated Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Covariance Structure ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Maxillary Protraction ◽  
Significant Difference ◽  
Group 2

Objective: To evaluate the amount of maxillary protraction with face mask in complete unilateral cleft lip and palate patients submitted to two distinct rapid maxillary expansion (RME) protocols. Material and Methods: The sample consisted of 20 individuals (nine boys and 11 girls; mean age of 10.4 ± 2.62 years) with unilateral complete cleft lip and palate who had a constricted maxilla in the vertical and transverse dimensions. Ten patients underwent 1 week of RME with screw activation of one complete turn per day, followed by 23 weeks of maxillary protraction (group 1). The other 10 patients underwent 7 weeks of alternate rapid maxillary expansion and constriction, with one complete turn per day, followed by 17 weeks of maxillary protraction (group 2); both groups underwent a total of 6 months of treatment. Cephalometric measurements were taken at different times: pretreatment (T1), soon after RME (T2), and after 6 months of treatment (T3). Each measurement was analyzed with mixed models for repeated measures, and the covariance structure chosen was compound symmetry. Results: The maxilla displaced slightly forward and downward with a counterclockwise rotation; the mandible rotated downward and backward, resulting in an increase in anterior facial height; the sagittal maxillomandibular relationship was improved; the maxillary molars and incisors were protruded and extruded; and the mandibular incisors were retroclined. Conclusion: There was no significant difference between the groups in evaluation time.

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

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.

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

2015 ◽  
Vol 20 (7) ◽  
pp. 1837-1847 ◽  
Author(s):  
Arthur César de Medeiros Alves ◽  
Daniela Gamba Garib ◽  
Guilherme Janson ◽  
Araci Malagodi de Almeida ◽  
Louise Resti Calil
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Bilateral Cleft Lip

An Improved Method of Differential Rapid Maxillary Expansion in Cleft Palate

1982 ◽  
Vol 9 (3) ◽  
pp. 129-131 ◽  
Author(s):  
E. A. Devenish ◽  
T.D. Foster ◽  
D. Chinn
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Improved Method ◽  
Maxillary Expansion ◽  
Concomitant Increase ◽  
Maxillary Growth

A system of differential rapid maxillary expansion is described. This method is particularly useful in patients with cleft lip and palate who have severe defects of lateral maxillary growth, since it enables the maxillary segments to be rotated so that intercanine width increases without a concomitant increase in the intermolar width.

scholarly journals Three-Dimensional Prospective Evaluation of Piezocision-Assisted and Conventional Rapid Maxillary Expansion: A Controlled Clinical Trial

2019 ◽  
Vol 7 (1) ◽  
pp. 127-133
Author(s):  
Ahmed I. Abdul-Aziz ◽  
Wael M. Refai
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Time ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Controlled Study ◽  
Controlled Clinical Trial ◽  
Maxillary Expansion ◽  
Posterior Crossbite ◽  
Significant Difference

BACKGROUND: Piezocision-assisted orthodontics (PAO) is considered one of the modern techniques aiming at reducing the treatment time and overcoming some limitations of orthodontic treatment. The use of piezocision as an adjunct in the treatment of posterior crossbite is limited, so additional research in this area is required. AIM: To three-dimensionally compare the skeletal and dental effects produced by piezocision-assisted rapid maxillary expansion (PARME) and conventional rapid maxillary expansion (RME) using cone beam computed tomography (CBCT). MATERIALS AND METHODS: This prospective controlled study comprised 14 consecutive non-syndromic patients with posterior crossbite. In 7 patients (mean age = 16.1 ± 0.3 years), PARME was used to correct the crossbite; whereas in the remaining 7 (mean age = 15.9 ± 0.5 years), RME was done. Cone beam computed tomography (CBCT) scans were performed before expansion (T1) and 3 months later after expansion (T2) to compare the skeletal and dental effects produced by the two expansion techniques. Transverse skeletal, dentolinear, and dentoangular variables at the level of maxillary first and second premolars and maxillary first molars were measured and compared within and between groups using the appropriate statistical test. RESULTS: For the transverse skeletal variables, PARME showed a non-significant increase; whereas, RME showed a significant increase. Regarding the dentolinear measurements, a significant increase in coronal widths and an insignificant increase in apical widths was seen in PARME, whereas, the RME showed a non-significant increase for both coronal and apical widths. Non-significant decreases (protrusion of teeth) in the dentoangular measurements were seen in both groups. Between-group comparisons showed a non-significant difference except for the dentolinear coronal widths. CONCLUSION: PARME is effective in treating posterior crossbite. Because of the more dental expansion produced by PARME as compared to the conventional RME, PARME should be limited only to mild or moderate not severe forms of palatal constriction. The available evidence regarding the effectiveness of corticotomy- and/or piezocision-assisted maxillary expansion for correction of posterior crossbite is limited and inadequate.

scholarly journals The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate

2021 ◽  
Vol 8 ◽  
Author(s):  
Richard Togbedji Dahoue ◽  
Abdelali Halimi ◽  
Médard Antah Gbètoho Dohou ◽  
Rajae Elhaddaoui ◽  
Fatima Zaoui
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Transverse Dimension ◽  
Cochrane Library ◽  
Maxillary Expansion ◽  
Case Control Studies ◽  
Randomized Controlled Clinical Trials ◽  
Significant Difference ◽  
Healthy Side

Introduction: Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol. Materials and methods: Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies. Results: Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation. Conclusion: The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.

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

2004 ◽  
Vol 41 (3) ◽  
pp. 332-339 ◽  
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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