Soft Tissue Alterations Following Protraction Approaches with and without Rapid Maxillary Expansion

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.

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.


2013 ◽  
Vol 83 (5) ◽  
pp. 817-823 ◽  
Author(s):  
Davor Jokić ◽  
Dražen Jokić ◽  
Vedran Uglešić ◽  
Darko Macan ◽  
Predrag Knežević

ABSTRACT Objective: To evaluate the relationship between soft tissue and bone structure for Class III patients before and after bilateral sagittal split osteotomy (BSSO) and bimaxillary orthognathic surgery; to determine the impact of other factors on soft tissue change; and to evaluate correlations between thickness of tissue before surgery, SNA, SNB, and ANB angles, and soft tissue changes. Materials and Methods: The study included 78 Class III patients treated only with BSSO or with BSSO and Le Fort I osteotomy. Lateral cephalograms were taken before and 3 months to 1 year after surgery. After all points of the Zagreb82 and Legan and Burstone profile analysis were traced, the ratio of five soft tissue points before and after surgery was evaluated. Results: Soft tissue between points Sn and A and upper lip showed statistically significant changes for patients treated with bimaxillary surgery and BSSO. Only gender had an influence on soft tissue change. The correlation between soft tissue thickness and changes after surgery was significant. A change in SNB angle correlated with upper lip thickness for patients treated with BSSO but not for patients treated with BSSO and Le Fort I. SNA angle changes correlated with soft tissue changes between points Sn and A. Conclusion: Results of this study show soft tissue changes after BSSO and BSSO and Le Fort I and eliminate the deficiencies that were indicated in the meta-analysis of soft tissue changes from a previous study.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Nashid Fareen ◽  
Mohammad Khursheed Alam ◽  
Mohd Fadhli Khamis ◽  
Norehan Mokhtar

Objective. This study was focused on comparing and analyzing the soft tissue changes induced by Reverse Twin-Block (RTB) and Reverse Pull Face Mask (RPFM) in early and late mixed dentition Malay children having Class III malocclusion. Methods. This cross-sectional study includes a total sample of 95 Malay children of both early (8-9 years) and late (10-11 years) mixed dentition stages. The comparison was between 49 samples treated by RTB and 46 samples treated by RPFM. Both pre- and posttreatment changes were assessed with Holdaway’s analysis using the CASSOS software. In each cephalogram, 71 anatomic landmarks were traced. Descriptive and multiple regression analyses were performed for statistical evaluation. Results. Statistically significant changes were noticed in soft tissue facial angle, subnasale to H-line, skeletal profile convexity, upper lip strain, H-line angle, lower lip to H-line, and inferior sulcus to H-line measurements. Gender disparity was noticed in upper lip strain. Other significant changes were influenced by the type of appliance. However, the mean differences were minute to notice clinically. Age difference did not have any effect on the treatment changes. Conclusions. RPFM revealed treatment outcome with more protruded upper lip than RTB.


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.


Author(s):  
Ali Alkhayer ◽  
Roland Becsei ◽  
László Hegedűs ◽  
László Párkányi ◽  
József Piffkó ◽  
...  

Facial soft tissue esthetics is a priority in orthodontic treatment, and emerging of the digital technologies can offer new methods to help the orthodontist toward an esthetic outcome. This prospective study aimed to assess the soft tissue changes of the face after six months of retention following Rapid Maxillary Expansion (RME). The sample consisted of 25 patients (13 females, 12 males, mean age: 11.6 years) who presented with unilateral or bilateral posterior crossbite requiring RME, which was performed with a Hyrax expander. 3D facial images were obtained before treatment (T0) and at the end of a six-month retention period after the treatment (T1) using a structured-light 3D handheld scanner. Linear and angular measurements were performed and 3D deviation analyses were done for six morphological regions of the face. Significant changes in various areas of the nasal and the upper lip regions were observed. Based on the results of the study and within the limitations of the study, RME with a Hyrax expander results in significant morphological changes of the face after a six-month retention period.


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