scholarly journals Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial

2018 ◽  
Vol 88 (6) ◽  
pp. 702-709 ◽  
Author(s):  
Tugce Celenk-Koca ◽  
Aslihan Ertan Erdinc ◽  
Serpil Hazar ◽  
Lacey Harris ◽  
Jeryl D. English ◽  
...  
Keyword(s):  
Root Length ◽  
Cone Beam ◽  
Maxillary Expansion ◽  
Bone Thickness ◽  
Prospective Randomized Clinical Trial ◽  
Adolescent Population ◽  
Skeletal Changes ◽  
Computed Tomography Images ◽  
Length Measurements ◽  
Tooth Inclination

ABSTRACT Objectives: To evaluate and compare the dental and skeletal changes with conventional and miniscrew-supported maxillary expansion appliances in adolescents. Materials and Methods: Forty patients were divided into two groups, with one group receiving a tooth-borne expander and the other group receiving an expander supported by four miniscrews (bone-borne). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images were used to measure the changes in transverse skeletal widths, buccal bone thickness, tooth inclination, and root length. Paired t-tests and independent-sample t-tests were used to compare the two expansion methods. Results: Bone-borne expansion increased the maxillary suture opening more than 2.5 times than tooth-borne expansion both anteriorly and posteriorly. Between the maxillary first premolars, sutural expansion accounted for 28% and 70% of the total transverse width increase in the tooth-borne and bone-borne expander groups, respectively. Similarly, 26% and 68% of the total expansion was of skeletal nature in the tooth-borne and bone-borne expander groups between the maxillary first molars. The pattern of expansion was variable, with most of the patients in both groups demonstrating a triangular-shaped sutural opening that was wider anteriorly. Subjects in the conventional group experienced significantly more buccal bone reduction and greater buccal inclination of the teeth. No significant differences were observed for root length measurements between the two groups. Conclusion: Use of bone-borne expansion in the adolescent population increased the extent of skeletal changes in the range of 1.5 to 2.8 times that of tooth-borne expansion and did not result in any dental side effects.

scholarly journals A 3-D evaluation of transverse dentoalveolar changes and maxillary first molar root length after rapid or slow maxillary expansion in children

2019 ◽  
Vol 24 (3) ◽  
pp. 79-87 ◽  
Author(s):  
Helder Baldi Jacob ◽  
Gerson Luiz Ulema Ribeiro ◽  
Jeryl D. English ◽  
Juliana da Silva Pereira ◽  
Mauricio Brunetto
Keyword(s):  
Root Length ◽  
Root Formation ◽  
Tooth Movement ◽  
Root Resorption ◽  
Root Apex ◽  
Cone Beam ◽  
Maxillary Expansion ◽  
Bone Thickness ◽  
Significant Difference ◽  
Bone Changes

ABSTRACT Objective: The objective of the present study was to conduct a randomized clinical trial comparing the effects of rapid maxillary expansion (RME) and slow maxillary expansion (SME). Maxillary permanent first molar root length and tooth movement through the alveolus were studied using cone-beam computed tomography (CBCT). Methods: Subjects with maxillary transverse deficiencies between 7 and 10 years of age were included. Using Haas-type expanders, children were randomly assigned to two groups: RME (19 subjects, mean age of 8.60 years) and SME (13 subjects, mean age of 8.70 years). Results: Buccal cortical, buccal bone thicknesses and dentoalveolar width decreased in both groups. In the RME group the greatest decrease was related to distal bone thickness (1.26 mm), followed by mesial bone thickness (1.09 mm), alveolar width (0.57 mm), and the buccal cortical (0.19 mm). In the SME group the mesial bone thickness decreased the most (0.87 mm) and the buccal cortical decreased the least (0.22 mm). The lingual bone thickness increased in the RME and SME groups (0.56 mm and 0.42 mm, respectively). The mesial root significantly increased in the RME group (0.52 mm) and in the SME group (0.40 mm), possibly due to incomplete root apex formation at T1 (prior to installation of expanders). Conclusions: Maxillary expansion (RME and SME) does not interrupt root formation neither shows first molar apical root resorption in juvenile patients. Although slightly larger in the RME group than SME group, both activation protocols showed similar buccal bone thickness and lingual bone thickness changes, without significant difference; and RME presented similar buccal cortical bone changes to SME.

scholarly journals Planning orthodontic frontal teeth inclination and estimating bone thickness from cone-beam computed tomography images

2021 ◽  
Author(s):  
IS Kopetskiy ◽  
NG Meskhiya ◽  
AI Kopetskaya ◽  
DA Eremin ◽  
DD Orekhova
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Cone Beam ◽  
Bone Thickness ◽  
Computed Tomography Images ◽  
Positive Treatment ◽  
Tooth Inclination ◽  
Different Levels

Changing the vestibulo-oral inclination (torque) of the frontal teeth is an important component of orthodontic treatment. Cone-beam computed tomography is recommended as an accurate diagnostic tool allowing the orthodontist to estimate the safety of frontal tooth movement and inclination. This tool is helpful in measuring bone thickness at different levels of the tooth root and estimating incisal inclination and position. The aim of our study was to analyze bone thickness in patients with pathologically and normally inclined teeth using CT images and to create a universal table that will provide useful information about the thickness of the bone around different segment of the root required for a safe change in tooth inclination. Using the proposed table, the orthodontist can assess the feasibility of the planned tooth movement in the setting of changed tooth inclination, with due account of critical bone deficit regions. This will ensure the safety of tooth movement, stable retention and a positive treatment outcome.

scholarly journals Evaluation of transverse maxillary growth on cone-beam computed tomography images

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Brandon J. Seubert ◽  
Laurence Gaalaas ◽  
Brent E. Larson ◽  
Thorsten Grünheid
Keyword(s):  
Computed Tomography ◽  
Nasal Cavity ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Long Term Effects ◽  
Maxillary Expansion ◽  
Computed Tomography Images ◽  
Before And After ◽  
Annual Changes ◽  
Lateral Walls

AbstractThis study aimed at quantifying the annual transverse growth of the maxilla using skeletal landmarks in three different regions on cone-beam computed tomography (CBCT) scans. CBCT scans taken before and after orthodontic treatment of 100 child and adolescent patients (50 male, 50 female) without maxillary transverse deficiencies were used to determine the transverse linear distances between the greater palatine foramina (GPFd), the lateral walls of the nasal cavity (NCd), and the infraorbital foramina (IOFd). We found that all distances increased significantly with growth in both genders (p < 0.001). The overall average annual change was 0.5 mm for GPFd, 0.3 mm for NCd, and 0.7 mm for IOFd. Males generally had greater annual changes than females for GPFd and IOFd, but not NCd. There were weak, statistically not significant (p > 0.05) correlations between patient age and the annual changes in GPFd, NCd, and IOFd. These results suggest that the positions of the greater palatine foramina, the lateral walls of the nasal cavity, and the infraorbital foramina change consistently with maxillary transverse growth. Clinicians can use the growth rates as population averages to more confidently estimate the amount of skeletal transverse deficiency or evaluate the long-term effects of maxillary expansion treatment.

scholarly journals Evaluation of alveolar bone support around incisors in patients with unilateral cleft lip, alveolus, and palate in late mixed dentition using cone beam computed tomography

2018 ◽  
Vol 88 (3) ◽  
pp. 299-305 ◽  
Author(s):  
Yingdan Pan ◽  
Yunting Zeng ◽  
Zeyu Zhang ◽  
Yiqin Liu ◽  
Yi Jing ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Cone Beam ◽  
Bone Thickness ◽  
Computed Tomography Scans ◽  
Tooth Inclination ◽  
Bone Height

ABSTRACT Objectives: To evaluate alveolar bone support around cleft-adjacent maxillary central incisors (U1) in patients with unilateral cleft lip, alveolus and palate (UCLAP) in the late mixed dentition and to investigate the correlation between the alveolar bone thickness (ABT) and tooth inclination. Materials and Methods: Cone beam computed tomography scans of 45 subjects with UCLAP (29 boys, 16 girls; mean age = 10.74 ± 1.08 years) were assessed. The distance between the cementoenamel junction (CEJ) and alveolar bone crest (AC), and the ABTs at 3 mm, 6 mm, and the apex were measured on the labial, lingual and distal surfaces of U1. The cleft and normal sides were compared using a paired t-test and Pearson's χ2 test. Pearson's correlation was used to explore the association between the ABT and tooth inclination of cleft-adjacent U1 in the labiolingual and mesiodistal dimensions. Results: The CEJ-AC distances were significantly greater in cleft-adjacent U1 (P &lt; .01), with more bone height reduction observed labially and distally (P &lt; .001). The labial, lingual, and apico-distal ABTs were decreased on the cleft side (P &lt; .01). A positive correlation was found between the apico-labial ABT and the labiolingual inclination (r = 0.568, P &lt; .01). Conclusions: Patients with UCLAP have reduced alveolar bone support around the cleft-adjacent U1, and the apico-labial ABT tends to decrease with increasing lingual tooth inclination; however, the correlation was weak.

scholarly journals CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance

2013 ◽  
Vol 83 (5) ◽  
pp. 851-857 ◽  
Author(s):  
Ryuzo Kanomi ◽  
Toru Deguchi ◽  
Eriko Kakuno ◽  
Teruko Takano-Yamamoto ◽  
W. Eugene Roberts
Keyword(s):  
Three Dimensional ◽  
Pediatric Dentistry ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Older Children ◽  
Maxillary Expansion ◽  
Skeletal Changes ◽  
Skeletal Effects ◽  
3D Evaluation ◽  
Skeletal Expansion

ABSTRACT Objective: To assess the three-dimensional (3D) skeletal response to a standardized 5 mm of rapid maxillary expansion (RME) in growing children (6–15 years) with maxillary width deficiency and crowding. Materials and Methods: A bonded appliance was used prior to the eruption of the maxillary first premolars (Mx4s), and a banded appliance was used thereafter. A consecutive sample of 89 patients (29 boys and 60 girls) from a large pediatric dentistry and orthodontics practice was divided into four groups: 1) 6–8 years old (n  =  26), 2) 9–11 years old with unerupted Mx4s (n  =  21), 3) 9–11 years with erupted Mx4s (n  =  23), and 4) 12–15 years (n  =  19). For all patients, the 3D evaluation of dental and skeletal effects was performed with cone-beam computed tomography (CBCT). Results: For both appliances in all patients, CBCT confirmed a triangular pattern of expansion in both the frontal and sagittal planes. Overall, both appliances produced significant maxillary expansion (&gt;80% of the 5-mm activation), but older children showed a progressively more dental (less skeletal) response. Comparison of the two types of expanders in the crossover sample, children aged 9–11 years, showed that the bonded RME produced the most efficient skeletal expansion in the preadolescent sample. Increased maxillary width at the level of the zygomaticomaxillary suture was the best indicator for development of maxillary arch circumference. Conclusion: Development-dependent appliances (bonded RPE before Mx4s erupt, and a banded device thereafter) provided optimal RME treatment for all children from age 6–15 years.

scholarly journals Buccal alveolar bone changes following rapid maxillary expansion and fixed appliance therapy

2020 ◽  
Author(s):  
Adam Sperl ◽  
Laurence Gaalaas ◽  
John Beyer ◽  
Thorsten Grünheid
Keyword(s):  
Computed Tomography ◽  
Alveolar Bone ◽  
Treatment Time ◽  
Rapid Maxillary Expansion ◽  
Cone Beam ◽  
Maxillary Expansion ◽  
Bone Thickness ◽  
Fixed Appliance ◽  
Computed Tomography Scans ◽  
Bone Changes

ABSTRACT Objectives To assess factors that may be associated with buccal bone changes adjacent to maxillary first molars after rapid maxillary expansion (RME) and fixed appliance therapy. Materials and Methods Pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans were obtained from 45 patients treated with RME and preadjusted edgewise appliances. Buccal alveolar bone thickness was measured adjacent to the mesiobuccal root of the maxillary first molar 4 mm, 6 mm, and 8 mm apical to the cementoenamel junction, and anatomic defects were recorded. Paired and unpaired t-tests were used to compare alveolar bone thickness at T1 and T2 and to determine whether teeth with posttreatment anatomic defects had thinner initial bone. Correlation analyses were used to examine relationships between buccal alveolar bone thickness changes and amount of expansion, initial bone thickness, age at T1, postexpansion retention time, and treatment time. Results There was a statistically significant reduction in buccal alveolar bone thickness from T1 to T2. Approximately half (47.7%) of the teeth developed anatomic defects from T1 to T2. These teeth had significantly thinner buccal bone at T1. Reduction in alveolar bone thickness was correlated with only one tested variable: initial bone thickness. Conclusions RME and fixed-appliance therapy can be associated with significant reduction in buccal alveolar bone thickness and an increase in anatomic defects adjacent to the expander anchor teeth. Anchor teeth with greater initial buccal bone thickness have less reduction in buccal bone thickness and are less likely to develop posttreatment anatomic defects of buccal bone.

scholarly journals Skeletal and Alveolar Changes in Conventional Rapid Palatal Expansion (RPE) and Miniscrew-assisted RPE(MARPE): a Prospective Randomized Clinical Trial Using Low-dose CBCT

2022 ◽  
Author(s):  
Joo-Hee Chun ◽  
Amanda Cunha Regal Castro ◽  
Sunmee Oh ◽  
Kyung-Ho Kim ◽  
Sung-Hwan Choi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Low Dose ◽  
Adolescent And Young Adult ◽  
Maxillary Expansion ◽  
Prospective Randomized Clinical Trial ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Computed Tomography Images ◽  
Basal Bone

Abstract Background: This prospective randomized clinical trial aimed to evaluate the short-term effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) on skeletal, dentoalveolar, and periodontal structures in adolescent and young adult patients. Methods: Thirty-six patients (12 men and 24 women) requiring maxillary expansion were randomly allocated to RPE (n=17) or MARPE (n=19) groups. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). Skeletal, dentoalveolar, and periodontal measurements were performed at each time point. Results: A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after expansion (T1-T0) and consolidation periods (T2-T0) in MARPE group (P<0.05). MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW) (P<0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT) (P<0.05).Conclusions: Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. This evidence can help clinicians decide the appliance design for maxillary expansion, while preventing periodontal side effects, such as buccal bone dehiscence Trial registration: WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration Date 27/12/2021)

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.

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