Effects of Combined Rapid Maxillary Expansion and Facemask Therapy on the Mandibular Dental Arch in Mixed Dentition

2020 ◽  
Vol 44 (6) ◽  
pp. 459-463
Author(s):  
Fatma Deniz Uzuner ◽  
Tuba Tortop ◽  
Şenol Gülşen ◽  
Selin Kale Varlık

Objective: The aim of this study was to evaluate changes in the mandibular dental arch and incisor alignment induced by combined bonded Rapid Maxillary Expansion (RME) and Face Mask (FM) therapy in the mixed dentition stage in which leeway space was used throughout the treatment. Study Design: This retrospective study evaluates pretreatment (T0) and posttreatment (T1) cephalometric radiographs and orthodontic models of 25 patients (mean age: 10.75±2.64), in mixed dentition, having skeletal Class 3 anomaly (ANB<0) with maxillary retrognatism (SNA=77.2±0.68) and bilateral posterior crossbite treated with bonded Hyrax RME-FM. Mean treatment duration was 10.4 months. Dental model measurements were performed using the 3Shape OrthoAnalyzerTM 2013-1 program. Changes in the mandibular incisor and first molar positions were determined on cephalometric radiographs. Statistical evaluation was done with a paired t-test. Results: A significant increase of 1.2 mm was found in intermolar width (p<0.001) in the mandibular dental arch. There was a significant decrease (1.4 mm) (p<0.001) in arch depth and an increase in arch length discrepancy (1.7mm)(p<0.01). There was a significant increase (0.8mm) (p<0.05) in the incisors’ irregularity score (LII). IMPA showed a significant decrease (p<0.05). Conclusion: Clinicians should be aware that mandibular crowding tends to increase during this type of combined therapy.

2017 ◽  
Vol 41 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Fatma Deniz Uzuner ◽  
Duygu Öztürk ◽  
Selin Kale Varlık

Objective: To evaluate the effects of combined rapid maxillary expansion (RME) and face mask (FM) therapy during the mixed dentition period on the dental arch length in patients with skeletal Class III malocclusion. Study Design: We evaluated pre- and post-treatment orthodontic models of 52 patients (25 girls, 27 boys) aged 8–12 years with skeletal Class III malocclusion(ANB<0) accompanied by maxillary transverse deficiency and retrognatism treated by bonded RME-FM therapy for a mean duration of 8 months. Palatal rugae, the cusp tips of permanent first molars, deciduous molars/permanent premolars, deciduous canines and the incisal edges of permanent central incisors were marked on orthodontic models, which were then photocopied. Inter-molar, inter-premolar and inter-canine widths; the arch length; the arch depth and molar and incisor sagittal movements were measured on these photocopies. Statistical comparisons were made using paired t-tests. Results: Inter-molar, inter-premolar and inter-canine widths and the arch length showed significant increases after treatment, while the arch depth showed a significant decrease (p<0.001 for all). Conclusions: With the study limitations, our results suggest that combined RME-FM therapy increases the arch length in the mixed dentition of patients with skeletal Class III malocclusion.


2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

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.


2014 ◽  
Vol 85 (4) ◽  
pp. 570-576 ◽  
Author(s):  
Alessandro Ugolini ◽  
Carmen Cerruto ◽  
Luca Di Vece ◽  
Luis Huanca Ghislanzoni ◽  
Chiarella Sforza ◽  
...  

ABSTRACT Objective:  To assess maxilla and mandibular arch widths' response to Haas-type rapid maxillary expansion (RME) anchored to deciduous vs permanent molars on children with unilateral posterior crossbite. Materials and Methods:  Seventy patients with unilateral posterior crossbite recruited at the Universities of Genova, Siena, and Insubria (Varese) were randomly located into GrE (RME on second deciduous molars) or Gr6 (RME on first permanent molars) and compared. Results:  Upper intermolar distance and permanent molar angulation increased significantly in Gr6 vs GrE at T1. Upper intercanine distance increased significantly in GrE vs Gr6 at T1 and T2. GrE showed significant increases for upper intermolar and upper intercanine widths. Gr6 showed statistically significant increases for upper intermolar widths, for upper and lower intercanine widths, and for increases of angulation of upper and lower permanent molars. Conclusions:  GrE showed reduced molar angulation increases at T1 and reduced molar angulation decreases at T2 when compared with Gr6. At T2, the net increase of the upper intercanine distance in GrE was still significant compared with Gr6, indicating a more stable expansion in the anterior area.


2018 ◽  
Vol 20 (2) ◽  
pp. 31-37
Author(s):  
Hilda Alejandra Bedolla-Gaxiola DDS ◽  
David Garrigós-Esparza DDS ◽  
Juan Carlos Hernández-Cabanillas DDS, MS ◽  
Miguel Ángel Rosales-Berber DDS ◽  
Amaury Pozos-Guillén DDS, PhD ◽  
...  

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.


2018 ◽  
Vol 20 (2) ◽  
pp. 31-37
Author(s):  
Hilda Alejandra Bedolla-Gaxiola DDS ◽  
David Garrigós-Esparza DDS ◽  
Juan Carlos Hernández-Cabanillas DDS, MS ◽  
Miguel Ángel Rosales-Berber DDS ◽  
Amaury Pozos-Guillén DDS, PhD ◽  
...  

Skeletal Class III is a malocclusion characterized by anterior crossbite as a result of an abnormal skeletal maxillary and mandibular base discrepancy, which involves disharmony of craneofacial skeleton and profile. The preferred management for children having skeletal Class III malocclusion with retruded maxilla and/or prognathic mandible is the use of devices that encourage the growth and anterior movement of the maxilla bone and/or restrict the exessive mandible growth. The orthopedic treatment consisting of a face mask with rapid maxillary expansion (RME) produces the most dramatic results in the shortest period of time. The purpose of this article is to review a quick correction of skeletal class III maloclussion in the primary dentition through a case example with use of a face mask plus rapid maxillary expansion therapy in a 5 year-old male patient due to a combination of retruded maxilla and protruded mandible, in primary dentition, who was treated with a Petit face mask in conjunction with a bonded RME intraoral appliance added with bite blocks. The first evident occlusal outcomes were a clockwise rotation of the mandible, a positive overjet of 3 mm, a correct overbite, a canine Class I relationship, and a bilateral flush terminal plane. After discussing the present clinical case report and the related published literature, we concluded that skeletal class III malocclusions should be treated as soon as the first clinical signs of abnormal craniofacial growth are recognized, during the first years of life.


2015 ◽  
Vol 20 (1) ◽  
pp. 85-96 ◽  
Author(s):  
Daniele Nóbrega Nardoni ◽  
Danilo Furquim Siqueira ◽  
Mauricio de Almeida Cardoso ◽  
Leopoldino Capelozza Filho

INTRODUCTION: Prognosis is the main limitation of interceptive treatment of Class III malocclusions. The interceptive procedures of rapid maxillary expansion (RME) and face mask therapy performed in early mixed dentition are capable of achieving immediate overcorrection and maintenance of facial and occlusal morphology for a few years. Individuals presenting minimal acceptable faces at growth completion are potential candidates for compensatory orthodontic treatment, while those with facial involvement should be submitted to orthodontic decompensation for orthognathic surgery. OBJECTIVES: To investigate cephalometric variables that might predict the outcomes of orthopedic treatment with RME and face mask therapy (FM). METHODS: Cephalometric analysis of 26 Class III patients (mean age of 8 years and 4 months) was performed at treatment onset and after a mean period of 6 years and 10 months at pubertal growth completion, including a subjective facial analysis. Patients was divided into two groups: success group (21 individuals) and failure group (5 individuals). Discriminant analysis was applied to the cephalometric values at treatment onset. Two predictor variables were found by stepwise procedure. RESULTS: Orthopedic treatment of Class III malocclusion may have unfavorable prognosis at growth completion whenever initial cephalometric analysis reveals increased lower anterior facial height (LAFH) combined with reduced angle between the condylar axis and the mandibular plane (CondAx.MP). CONCLUSION: The results of treatment with RME and face mask therapy at growth completion in Class III patients could be predicted with a probability of 88.5%.


2019 ◽  
Vol 22 (4) ◽  
pp. 467-474
Author(s):  
Ana de Lourdes Sá De Lira ◽  
Igo Rafael Costa Araújo

Aim: To demonstrate the main effects on maxillary and facial profile after treatment with expansion and face mask therapy in patients pattern III Class III. Material and Method: A cross-sectional study of maxillary expansion and reverse traction performed in 4 patients with maxillary deficiency, in the pre-peak pubertal growth stage and in the mixed dentition, with cephalograms before and after treatment, using angular measurements (SNA, SNENA, ANL and 1NA) and linear (S’-ENA, S’-A, 1-NA, OVERJET, S-LS and S-LI) and plot overlays. Results: Improvement in overjet was observed, going from negative to positive in all cases treated with incisor uncrossing, although it was not statistically significant. The upper and lower labial posture with respect to the base of the nose and the ment improved significantly, represented by the measurements S-LS and S-LI, with a change from the concave profile to slightly convex. Conclusion: Class III malocclusion with maxillary deficiency treated with rapid maxillary disjunction and reverse traction with facial mask was effective in both groups, with maxillary protraction and shifting in the concave to slightly convex profile.KeywordsFacial Mask; Rapid maxillary expansion; Class III.


2016 ◽  
Vol 6 ◽  
pp. 129-136
Author(s):  
Sabrina Mutinelli ◽  
Mauro Cozzani

We have reviewed our retrospective research about rapid maxillary expansion performed in the early mixed dentition to summarize the results of different studies regarding maxillary dental arch width variation and crowding improvement in light of contemporary literature. The aim is to define the effects of treatments followed until the end of dental arch growth. In all studies, a Haas expander anchored to the deciduous dentition was used. The samples consisted of treated patients with and without a lateral crossbite and homogeneous untreated individuals as controls. Two additional control groups of adolescents and adults in dental Class 1 were also compared. As a result of the analysis, rapid maxillary expansion with anchorage to the deciduous dentition was found to be effective in increasing transverse width in intermolar and intercanine areas, and the change was preserved until the full permanent dentition stage. When performed before maxillary lateral incisors have fully erupted, this procedure allows for a rapid increase in the arch length in the anterior area and consequently, in the space available for permanent incisors with a stable reduction in crowding over time.


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