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.

Efficacy of Rapid Maxillary Expansion Associated With Maxillary Protraction in Patients With Unilateral Complete Cleft Lip and Palate

2020 ◽  
Vol 57 (7) ◽  
pp. 872-876
Author(s):  
Okada Terumi Ozawa ◽  
Costa Daniela Salzedas ◽  
de Lima Beatriz Oliveira ◽  
Renata Sathler ◽  
Gleisieli Baessa ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Sample ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Maxillary Protraction ◽  
The Stability ◽  
In The Beginning ◽  
Dental Casts

Objective: To evaluate the efficacy of rapid maxillary expansion (RME) and maxillary protraction (MP) in patients with unilateral complete cleft lip and palate (UCLP) using the Goslon yardstick index. Design: Retrospective study. Patients: Dental casts of 34 Goslon 3 (G3) and Goslon 4 (G4) patients treated with RME and MP were evaluated which composed the treated sample (S1). The dental cast were taken before the RME (T1) and immediately after the use of face mask for MP was suspended (T2). In order to verify the stability of the treatment, dental casts of 17 of these patients were evaluated 1 year after the treatment was finished (T3). For the control sample (S2), dental casts of 20 untreated G3 and G4 patients were evaluated. Results: At T2, 85.7% of study sample patients initially G3 and 70% of patients initially G4 obtained improvement in occlusal index. At T3, the majority of patients initially classified as G3 and G4 returned to the same classification as in the beginning of the treatment. The evaluation of the control sample showed that patients initially classified as G3, 55.6% continued at this initial index, and 44.4% had it worsened. Those initially G4, 100%, continued at this initial index. Conclusion: The immediate result of RME and MP was satisfactory, and despite the instability of these results, the outcome of this treatment option was better than the untreated sample.

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.

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.

A New Protocol for Maxillary Protraction in Cleft Patients: Repetitive Weekly Protocol of Alternate Rapid Maxillary Expansions and Constrictions

2005 ◽  
Vol 42 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Eric Jein-Wein Liou ◽  
Wen-Ching Tsai
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Mixed Dentition ◽  
Prospective Clinical Study ◽  
Maxillary Expansion ◽  
Treatment Results ◽  
Maxillary Protraction ◽  
Maxillary Advancement

Objective It was hypothesized that, through a repetitive weekly protocol of Alternate Rapid Maxillary Expansions and Constrictions (Alt-RAMEC), the maxilla in cleft patients could be protracted more effectively than with a single course of rapid maxillary expansion (RME). Methods Twenty-six consecutive unilateral cleft lip and palate patients at the age of mixed dentition were included in this prospective clinical study. The rapid maxillary expansion group included the first 16 consecutive patients undergoing 1 week of rapid maxillary expansion (1 mm/day) followed by 5 months, 3 weeks of maxillary protraction. The Alternate Rapid Maxillary Expansions and Constrictions group included the next 10 consecutive patients undergoing 9 weeks of Alternate Rapid Maxillary Expansions and Constrictions followed by 3 months, 3 weeks of maxillary protraction. Daily activation of the weekly expansion or constriction was 1.0 mm. Two-hinged expanders and intraoral maxillary protraction springs were used in both groups. Treatment results were evaluated cephalometrically. Results The amount of maxillary anterior displacement by the 2-hinged expander in the Alternate Rapid Maxillary Expansions and Constrictions group was 3.0 ± 0.9 mm at A point, significantly greater than the 1.6 ± 1.0 mm in the rapid maxillary expansion group. The amount of maxillary advancement with intraoral protraction springs in the Alternate Rapid Maxillary Expansions and Constrictions group was 2.9 ± 1.9 mm at A point, significantly greater than the 0.9 ± 1.1 mm in the rapid maxillary expansion group. The overall amount of maxillary advancement in the Alternate Rapid Maxillary Expansions and Constrictions group was 5.8 ± 2.3 mm at A point. This result remained stable, without significant relapse after 2 years. Conclusions Maxillary protraction using the 2-hinged expander, a repetitive weekly protocol of Alternate Rapid Maxillary Expansions and Constrictions, and intraoral protraction springs is most effective, with stable results at 2-year follow-up.

scholarly journals Bone-anchored maxillary protraction in patients with unilateral cleft lip and palate:

2020 ◽  
Vol 90 (4) ◽  
pp. 539-547 ◽  
Author(s):  
Eman H. Elabbassy ◽  
Noha E. Sabet ◽  
Islam T. Hassan ◽  
Dina H. Elghoul ◽  
Marwa A. Elkassaby
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensions ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Forward Movement ◽  
Maxillary Protraction ◽  
Computed Tomography Images ◽  
Group I ◽  
Effective Treatment Modality

ABSTRACT Objectives To assess the effectiveness of bone-anchored maxillary protraction (BAMP) in patients with unilateral cleft lip and palate (UCLP) and whether it was enhanced when preceded by maxillary expansion. Materials and Methods The sample consisted of 28 growing children (9–13 years old) with UCLP and Class III malocclusion. They were divided into two equal groups. In group I, patients were treated with BAMP not preceded by maxillary expansion. In group II, patients were treated with BAMP preceded by maxillary expansion. To assess treatment changes in three dimensions, Cone-beam computed tomography images were taken 1 week after surgical placement of the miniplates (T1) and after 9 months of treatment (T2). Results BAMP produced forward movement of the maxilla in both groups (3.17 mm) and (3.37 mm) respectively, without significant differences between the two groups except for clockwise rotation of the palatal plane in group I (1.60). Conclusions BAMP is an effective treatment modality for correcting midface deficiency in patients with UCLP whether or not maxillary expansion was carried out.

Attitude of the Canine in Secondary Bone-Grafted and Nongrafted Patients with Cleft Lip and Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 679-686 ◽  
Author(s):  
Enkhtuvshin Gereltzul ◽  
Yoshiyuki Baba ◽  
Kimie Ohyama
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Panoramic Radiography ◽  
Control Groups ◽  
Significant Difference ◽  
Before And After ◽  
Group 2 ◽  
Two Stages ◽  
And Control ◽  
Group 1

Objective To investigate the eruption pattern of the cleft-side canine regarding its pre-eruption position relative to the cleft in bone-grafted (BG) and nongrafted (NonBG) patients with cleft lip and palate. Methods Fifty-three patients with cleft lip and palate (21 BG, 32 NonBG) were examined by panoramic radiography and posteroanterior cephalography taken before and after canine eruption. Subjects were categorized into BG, NonBG, and control groups. Canines at the pre-eruption stage were categorized as close to (group 1) or distant from (group 2) the cleft area. The canine angle and its change between the two stages were evaluated. Results No significant differences were noted between the initial canine angle of the BG and NonBG groups. Although canines in the BG group erupted without a significant change in angle, the canine angle increased significantly (p < .0001) in the NonBG and control groups. In group 1, a greater change in canine angle was noted in the NonBG (p < .05) and control (p < .01) groups than in the BG group. In group 2, no significant difference was noted among the three groups. Conclusions In BG patients, a canine located near the cleft appears to erupt at the same angle as it had before grafting. However, in NonBG patients, it erupts more vertically, guided by cortical bone. For canines distant from the cleft area, there is no significant difference in the change in angulation between NonBG and BG patients.

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

scholarly journals Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion

2010 ◽  
Vol 80 (5) ◽  
pp. 799-806 ◽  
Author(s):  
Lucia Cevidanes ◽  
Tiziano Baccetti ◽  
Lorenzo Franchi ◽  
James A. McNamara ◽  
Hugo De Clerck
Keyword(s):  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Maxillary Protraction ◽  
Bone Anchors

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 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.

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