Orthodontic Treatment of a Cleft Palate Patient with Surgically Assisted Rapid Maxillary Expansion

1996 ◽  
Vol 33 (5) ◽  
pp. 445-449 ◽  
Author(s):  
Takafumi Susami ◽  
Takayuki Kuroda ◽  
Teruo Amagasa
Keyword(s):  
Case Report ◽  
Cleft Palate ◽  
Orthodontic Treatment ◽  
Rapid Maxillary Expansion ◽  
Third Molars ◽  
Maxillary Expansion ◽  
Anterior Maxilla ◽  
Posterior Crossbite ◽  
Palate Patient ◽  
Suture Opening

Some adult cleft palate patients show severe maxillary transverse contraction and posterior crossbite. This case report demonstrates successful surgical-orthodontic treatment of such a patient. Surgically assisted rapid maxillary expansion (SA-RME) was completed prior to comprehensive orthodontic treatment. The osteotomy was performed on both the buccal and lingual aspects of the posterior maxillary alveolus. A Hyrax-type maxillary-expansion appliance was used, and the screw (0.2 mm, one quarter turn) was turned two or three times per day. Comprehensive orthodontic treatment was initiated after extraction of the mandibular first premolars and four third molars. The maxillary lateral incisors were also extracted after active orthodontic treatment. The amount of expansion achieved using SA-RME was greater at the posterior than at the anterior maxilla. Midpalatal suture opening occurred. After orthodontic treatment, occlusal stability was satisfactory. This case demonstrates the effectiveness of SA-RME in adult cleft palate patients with severe posterior crossbite.

scholarly journals Assessment of Immediate Skeletal Changes after Alternate Rapid Maxillary Expansion and Constriction – A Case Report

2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande
Keyword(s):  
Case Report ◽  
Rapid Maxillary Expansion ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Maxillary Expansion ◽  
Skeletal Class ◽  
Posterior Crossbite ◽  
Skeletal Changes ◽  
Before And After ◽  
Opening And Closing

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.

scholarly journals Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults

2016 ◽  
Vol 86 (5) ◽  
pp. 713-720 ◽  
Author(s):  
Sung-Hwan Choi ◽  
Kyung-Keun Shi ◽  
Jung-Yul Cha ◽  
Young-Chel Park ◽  
Kee-Joon Lee
Keyword(s):  
Young Adults ◽  
Treatment Modality ◽  
Orthodontic Treatment ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Initial Examination ◽  
The Stability ◽  
Maxillary Deficiency ◽  
Time Point

ABSTRACT Objective:  To evaluate the stability of nonsurgical miniscrew-assisted rapid maxillary expansion (MARME) in young adults with a transverse maxillary deficiency. Materials and Methods:  From a total of 69 adult patients who underwent MARME followed by orthodontic treatment with a straight-wire appliance, 20 patients (mean age, 20.9 ± 2.9 years) with follow-up records (mean, 30.2 ± 13.2 months) after debonding were selected. Posteroanterior cephalometric records and dental casts were obtained at the initial examination (T0), immediately after MARME removal (T1), immediately after debonding (T2), and at posttreatment follow-up (T3). Results:  Suture separation was observed in 86.96% of subjects (60/69). An increase in the maxillary width (J-J; 1.92 mm) accounted for 43.34% of the total expansion with regard to the intermolar width (IMW) increase (4.43 mm; P < .001) at T2. The amounts of J-J and IMW posttreatment changes were −0.07 mm (P > .05) and −0.42 mm (P  =  .01), respectively, during retention. The postexpansion change in middle alveolus width increased with age (P < .05). The postexpansion change of interpremolar width (IPMW) was positively correlated with the amount of IPMW expansion (P < .05) but not with IMW. The changes of the clinical crown heights in the maxillary canines, first premolars, and first molars were not significant at each time point. Conclusions:  Nonsurgical MARME can be a clinically acceptable and stable treatment modality for young adults with a transverse maxillary deficiency.

scholarly journals Condylar Changes in Children with Posterior Crossbite after Maxillary Expansion: Tridimensional Evaluation

Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 38
Author(s):  
Rosamaria Fastuca ◽  
Helga Turiaco ◽  
Fausto Assandri ◽  
Piero A. Zecca ◽  
Luca Levrini ◽  
...  
Keyword(s):  
Rapid Maxillary Expansion ◽  
3D Analysis ◽  
Maxillary Expansion ◽  
3D Slicer ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Rapid Palatal Expansion ◽  
Before And After ◽  
Condylar Position ◽  
Caucasian Patients

(1) Background: To investigate condylar position in subjects with functional posterior crossbite comparing findings before and after rapid maxillary expansion (RME) treatment through 3D analysis; (2) Methods: Thirty-two Caucasian patients (14 males, mean age 8 y 8 m ± 1 y 2 m; 18 females mean age 8 y 2 m ± 1 y 4 m) with functional posterior crossbite (FPXB) diagnosis underwent rapid palatal expansion with a Haas appliance banded on second deciduous upper molars. Patients’ underwent CBCT scans before rapid palatal expansion (T0) and after 12 months (T1). The images were processed through 3D slicer software; (3) Results: The condylar position changes between T1 and T0 among the crossbite and non-crossbite sides were not statistically significant, except for the transversal axis. At T1, the condyles moved forward (y axis) and laterally (x axis), they also moved downward (z axis) but not significantly; (4) Conclusions: Condilar position in growing patients with functional posterior crossbite did not change significantly after rapid maxillary expansion.

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 Changes in the Upper and Lower Pharyngeal Airway Spaces Associated with Rapid Maxillary Expansion

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Fitin Aloufi ◽  
Charles B. Preston ◽  
Khalid H. Zawawi
Keyword(s):  
Orthodontic Treatment ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Lower Airway ◽  
Control Group ◽  
Maxillary Expansion ◽  
Pharyngeal Airway ◽  
Significant Difference ◽  
And Gender ◽  
Maxillary Constriction

Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group ( mm) compared to the control group ( mm), . However, there was no significant difference in the lower pharyngeal airway measurement between the RME group () and the control group (), . There was no significant difference with respect to mode of breathing between the two groups (). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.

scholarly journals Prosthetic Rehabilitation of Cleft Lip Palate with Andrews Bridge Modified as Obturator Prosthesis: Case Report

2020 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Almina Murić ◽  
Demet Cagil Ayvalioglu ◽  
Bilge Gokcen Rohlig
Keyword(s):  
Case Report ◽  
Cleft Palate ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Radiographic Evaluation ◽  
Congenital Defects ◽  
Prosthetic Rehabilitation ◽  
Removable Partial Denture ◽  
Partial Denture ◽  
Cleft Lip Palate

SummaryBackground/Aim: Congenital defects such as cleft palate and lips require a long-lasting and multidisciplinary approach. In cases when surgical and orthodontic treatment is not feasible, prosthodontic management of these patients is advocated. Prosthetic rehabilitation of cleft palate in concerning of achieving aesthetic and function (such as swallowing and speech) outcomes is very demanding.Case report: Material and method: After performing the necessary surgical procedures and orthodontic treatment, 24-years-old male patient was sent to the Department for Maxillofacial Prosthetics of Istanbul University. Followed the clinical examination, the necessary periodontal and conservative therapy was performed. After radiographic evaluation and dental cast analysis prosthetic rehabilitation was performed. The prosthetic rehabilitation of cleft palate was accomplish with conventional fixed partial denture whose number of included abutment were defined by biomechanical principles. Additionally removable partial denture were manufactured for closing oro-nasal defects and lip supporting.Conclusions: The prosthetic rehabilitation resulted with functionally and aesthetically content prosthesis. With achieving proper swallowing Quality of Life of the patient was enormously enhanced.

scholarly journals Rapid maxillary expansion in the treatment of the functional posterior crossbite: joint noise and electromyographic activity analysis

2019 ◽  
Vol 48 ◽  
Author(s):  
Diego Jesus Brandariz PIMENTEL ◽  
Laís Valencise MAGRI ◽  
Melissa de Oliveira MELCHIOR ◽  
Guido Artemio MARAÑÓN-VÁSQUEZ ◽  
Mirian Aiko Nakane MATSUMOTO ◽  
...  
Keyword(s):  
Masticatory Muscles ◽  
Rapid Maxillary Expansion ◽  
Electromyographic Activity ◽  
Maxillary Expansion ◽  
Posterior Crossbite ◽  
Stomatognathic System ◽  
End Of Treatment ◽  
Before And After ◽  
Electromyographic Analysis ◽  
Level Of Significance

Abstract Introduction The rapid maxillary expansion (RME) reduces the risk of developing structural and functional disorders in the stomatognathic system. Objective To examine the effects of the RME as a treatment for the posterior crossbite, related with the electromyographic activity of the masticatory muscles and the TMJ noises in a population of children. Material and method 13 girls and 7 boys, regardless of the type of malocclusion, with a mean age of 9 years old (± 3), were treated with RME. The electrovibratography analyzed the TMJ noise, and the electromyography analyzed the masticatory muscles before treatment (T0) and after three months of a short-term follow-up (T1). The comparisons of the affected and unaffected sides by the crossbite were performed using Mann-Whitney’s test, and to compare data before and after treatment the Wilcoxon’s test was used (level of significance: 5%). Result No significant differences were found in the parameters of joint noise in comparison to the sides affected and unaffected by the crossbite, in both T0 and T1 (p>0.05); only the side without the crossbite observed decrease in the peak amplitude of the joint noises after treatment. In the static electromyographic analysis, inter-side differences were observed before and after treatment, since the deliberate unilateral chewing showed greater asymmetry activity in T0 for both sides, which has been corrected after treatment, improving the functional chewing. Conclusion The proposed treatment did not lead to the occurrence of joint noises and improved the functional pattern of electromyographic activity during chewing at the end of treatment.

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