Dentoskeletal effects of a temporary skeletal anchorage device–supported rapid maxillary expansion appliance (TSADRME): A pilot study

ABSTRACT Objective: To quantitatively evaluate maxillary skeletal expansion using cone-beam computed tomography (CBCT) images and propose a novel way to quantify the dental tipping effects of temporary skeletal anchorage device–supported rapid maxillary expansion appliance (TSADRME). Materials and Methods: Images from 25 patients receiving rapid maxillary expansion with incorporated temporary skeletal anchorage devices (TSADs) before activation (T1) and after removal (T2) were analyzed to detect dentoskeletal changes. Results: A significant increase from T1 to T2 was found for all linear measurements except buccal maxillary width at the canines. The greatest buccal expansion was at the first molar, decreasing anteriorly. However, the greatest palatal expansion was at the first premolar. All younger subjects (8–16 years old) exhibited less dental tipping and greater expansion overall compared with the older subjects. There was great variability in dental tipping of first molars (mean = 4.31°), with some subjects demonstrating mild uprighting of these teeth. Conclusions: The TSADRME appliance is an effective, clinically useful device that results in mild molar tipping and may positively affect expansion in the area of TSAD placement.

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MODERN PERSPECTIVES ON RAPID PALATAL EXPANSION

International Journal of Advanced Research ◽

10.21474/ijar01/12864 ◽

2021 ◽

Vol 9 (5) ◽

pp. 497-500

Author(s):

Kinnari Markana ◽

Keyword(s):

Transverse Dimension ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Negative Effects ◽

Palatal Expansion ◽

Beneficial Effects ◽

Rapid Palatal Expansion ◽

Mini Implants ◽

Maxillary Deficiency ◽

Skeletal Expansion

Maxillary deficiency in the transverse dimension is a common problem in children. The conventional management of such malocclusion is with conventional rapid maxillary expansion. The beneficial effects of such an orthodontic therapy are explained in detail in the literature. But there are also negative effects of conventional rapid maxillary expansion. Thus, the improvements in the methods of expansion has led to discovery of miniscrew assisted rapid palatal expansion. The miniscrew assisted rapid palatal expansion are supported by mini implants and thus enable better skeletal expansion of maxilla. This article will discuss the favourable effects, negative effects, and clinical uses of conventional and miniscrew assisted rapid palatal expansion.

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

The Angle Orthodontist ◽

10.2319/082012-669.1 ◽

2013 ◽

Vol 83 (5) ◽

pp. 851-857 ◽

Cited By ~ 20

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 (>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.

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Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study

Children ◽

10.3390/children8010033 ◽

2021 ◽

Vol 8 (1) ◽

pp. 33

Author(s):

Andrea Abate ◽

Davide Cavagnetto ◽

Francesca Maria Emilia Rusconi ◽

Paolo Cressoni ◽

Luca Esposito

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Nasal Cavity ◽

Rapid Maxillary Expansion ◽

T Test ◽

Maxillary Expansion ◽

Retrospective Case ◽

Linear Measurements ◽

Palatal Expansion ◽

Mandibular Hypoplasia ◽

Before And After

Background: In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects and the safety of rapid maxillary expansion (RME) in growing patients affected by JIA. It was evaluated whether RME could be performed without complications on TMJs of JIA patients using DC/TMD protocol, and naso-maxillary transversal parameters were compared with the ones obtained on healthy patients. Methods: Twenty-five patients affected by JIA that ceased to manifest TMJ (Temporo-Mandibular Joint) symptoms in the previous year were treated with RME to solve the maxillary transverse hypoplasia. Postero-anterior cephalometric tracings were collected before and after treatment; linear measurements were obtained to study maxillary and nasal cavity modifications. Data were compared to those of a similar group of twenty-five healthy patients. Paired t-test and Independent t-test were used to evaluate changes before and after treatment in each group and to perform a comparison between the groups. Results: All patients demonstrated a statistically significant increase in nasal cavity width, maxillary width and upper and lower intermolar width. No patients presented a worsening of their TMJs condition. Intragroup comparisons revealed significant changes of cephalometric measurements, but no difference was found when comparing JIA and healthy patients. Conclusions: Growing patients with JIA that ceased to show signs of active TMJ involvement for at least one year could be safely treated with RME, expecting similar benefits to those of healthy patients. Dentists and rheumatologists should be informed of safety and potential benefits of palatal expansion in JIA patients in order to improve the outcome of orthodontic treatment and reduce the indication for more invasive procedures (i.e., Surgical Assisted Rapid Maxillary Expansion).

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Evaluation of palate area before and after rapid maxillary expansion, using cone-beam computed tomography

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.24.5.040-045.oar ◽

2019 ◽

Vol 24 (5) ◽

pp. 40-45

Author(s):

Carolina Bruder ◽

Cristina Lucia Feijó Ortolani ◽

Tatiana Araújo de Lima ◽

Flavia Artese ◽

Kurt Faltin Junior

Keyword(s):

Computed Tomography ◽

Surface Area ◽

Cone Beam Computed Tomography ◽

Repeated Measures ◽

Rapid Maxillary Expansion ◽

Cone Beam ◽

P Value ◽

Maxillary Expansion ◽

Linear Measurements ◽

Retention Period

ABSTRACT Objective: The aim of this study was to estimate the changes in the palate area after rapid maxillary expansion (RME) with the Hyrax expander in growing subjects, using cone beam computed tomography (CBCT). Methods: Fourteen patients (9 girls and 5 boys; mean age = 11.7 ± 2.4 years) who required RME as part of their orthodontic treatment were included in this study. CBCT records had been taken before RME treatment (T0), at the end of active expansion (T1) and after a 6-month retention period (T2). The CBCT scans were manipulated with Dolphin Imaging® version 11.7 Premium software, in which landmarks were positioned and measured in relation to sagittal, coronal and axial planes, to verify the palate surface area. In addition, linear measurements of the palatal depth and width were assessed. These measurements were compared by using analysis of variance (ANOVA) for repeated measures. A p-value smaller than 0.05 was considered statistically significant. Results: The palatal surface area and width significantly increased from T0 to T1, respectively by 9.27% and 9.71%, and both decreased in a non-significant manner from T1 to T2. The palatal depth had non-significant differences at T0, T1 and T2. Conclusions: RME promotes a significant gain in the surface area of the palate and an increase in intermolar width. The Hyrax appliance was effective for the treatment of maxillary atresia in growing patients. There was no vertical alteration of the palate. After a 6-month retention period, the maxilla transverse dimension and the surface area of the palate remained stable.

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Comparison of dimensions and volume of upper airway before and after mini-implant assisted rapid maxillary expansion

The Angle Orthodontist ◽

10.2319/080919-522.1 ◽

2020 ◽

Vol 90 (3) ◽

pp. 432-441 ◽

Cited By ~ 1

Author(s):

Qiming Li ◽

Hongyi Tang ◽

Xueye Liu ◽

Qing Luo ◽

Zhe Jiang ◽

...

Keyword(s):

Nasal Cavity ◽

Upper Airway ◽

Rapid Maxillary Expansion ◽

Cone Beam ◽

Complex Structures ◽

Direct Relation ◽

Maxillary Expansion ◽

Before And After ◽

Skeletal Pattern ◽

Skeletal Expansion

ABSTRACT Objectives To evaluate changes in dimensions and volume of upper airway before and after mini-implant assisted rapid maxillary expansion (MARME) and observe correlations between changes of upper airway and vertical skeletal pattern in young adults. Materials and Methods In this retrospective study, 22 patients (mean age, 22.6 ± 4.5 years; 4 male 18 female) with transverse discrepancy underwent MARME. Cone beam computed tomography was taken before and 3 months after expansion. Vertical and horizontal dimensions and volume of the nasal cavity, nasopharyngeal, retropalatal, retroglossal and hypopharyngeal airway were compared before and after MARME. Correlations between changed volume and dimensions were explored, as well as the vertical skeletal pattern. Results Nasal osseous width, maxillary width, volume of the nasal cavity and nasopharynx increased significantly (P < .05). Enlarged nasopharyngeal volume correlated with increased nasal width at the PNS plane (P < .05). There were no correlations between expanded volume and maxillary width. No measurements except nasal cavity volume had a correlation with Sum angle. Increased maxillary width correlated negatively with hard palate thickness (P < .05). Conclusions (1) MARME caused an increase in volume of the nasal cavity and nasopharynx, with expansion of nasal osseous width and maxillary width. (2) Enlarged nasal width at the PNS plane contributed to the increase in nasopharynx volume. Enlarged maxillary width showed no direct relation with increased volume. (3) In this study, it was unclear about the association between changes of the upper airway and vertical skeletal pattern because of complex structures. (4) Palate thickness affected skeletal expansion of the maxilla in MARME.

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Effect of rapid maxillary expansion on nasal cavity assessed with cone-beam computed tomography

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.25.3.039-045.oar ◽

2020 ◽

Vol 25 (3) ◽

pp. 39-45

Author(s):

Luciana Duarte Caldas ◽

Wilton M. Takeshita ◽

André Wilson Machado ◽

Marcos Alan Vieira Bittencourt

Keyword(s):

Computed Tomography ◽

Nasal Cavity ◽

Cone Beam Computed Tomography ◽

Rapid Maxillary Expansion ◽

Cone Beam ◽

Maxillary Expansion ◽

Linear Measurements ◽

Skeletal Deformity ◽

Anterior Portion ◽

Posterior Portion

ABSTRACT Introduction: Rapid maxillary expansion (RME) is assumed as a well established procedure; although, some effects on facial complex are not yet fully understood. Objective: The aim of this research was to verify, using cone-beam computed tomography, the effect on linear dimensions of the nasal cavity. Methods: Sample consisted of twenty patients aged 7 to 16 years, with skeletal deformity that justified the use of CT scans, and who required the RME as part of the orthodontic treatment planning. Scans were taken before clinical procedures were performed (T0) and after stabilizing the expander screw (T1). Dolphin Imaging v. 11.5 3D software was used to measure six areas on nasal cavity: three at the anterior portion (upper, middle, and lower) and other three at the posterior portion (also upper, middle, and lower). Data were statistically treated using Shapiro-Wilk test to verify normality. Differences between T0 and T1 were calculated using the Spearman correlation and paired Student’s t-test, with a significance level of 5%. Results: All linear measurements presented a significant increase (p< 0.05) after RME, both in the anterior and posterior regions, suggesting some parallelism on the opening pattern, especially at the lower portion (p< 0.001). Conclusions: RME was able to significantly modify the internal dimensions of the nasal cavity.

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RAPID PALATAL EXPANSION AND ITS FEATURES

ASJ. ◽

10.31618/asj.2707-9864.2020.2.40.23 ◽

2020 ◽

Vol 2 (40) ◽

pp. 20-22

Author(s):

A.K. Al Dzhafari ◽

S.A. Ulyanovskaya

Keyword(s):

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Maxillofacial Region ◽

Posterior Teeth ◽

Anatomical Features ◽

Palatal Expansion ◽

Rapid Palatal Expansion ◽

Congenital Deformities ◽

Upper Jaw ◽

Mid Palatal Suture

Rapid Maxillary expansion or palatal expansion as it is sometimes called, occupies unique niche in dentofacial therapy. Rapid Maxillary expansion (RME) is a skeletal type of expansion that involves the separation of the mid-palatal suture and movement of the maxillary shelves away from each other. RME effects the maxillary complex, palatal vaults, maxillary anterior and posterior teeth, adjacent periodontal structures to bring about an expansion in the maxillary arch. Morphogenesis and anatomical features of the upper jaw determine the choice of the method of rapid palatal expansion with narrowing of the upper dentition, as an effective method for eliminating congenital deformities of the maxillofacial region. The majority of dental transverse measurements changed significantly as a result of RME. The maturity of the maxillofacial structures determines the timing and degree of success of rapid palatal dilatation treatment.

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

Children ◽

10.3390/children8010038 ◽

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.

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