scholarly journals Stability in Dental Changes in RME and SARME: A 2-Year Follow-up

2009 ◽  
Vol 79 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Oral Sokucu ◽  
H. Huseyin Kosger ◽  
A. Altug Bıcakci ◽  
Hasan Babacan
Keyword(s):  
Orthodontic Treatment ◽  
Rapid Maxillary Expansion ◽  
Study Group ◽  
Maxillary Expansion ◽  
Patient Groups ◽  
Group 2 ◽  
Maxillary Arch ◽  
Group 1 ◽  
Dental Casts

Abstract Objective: To compare the effects of rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME) on dentoalveolar structures following orthodontic treatment, as well as stability at 2-year follow-up. Materials and Methods: Two groups of subjects were used in the study. Group 1 consisted of 14 subjects (mean age, 12.7 ± 1.4 years) who were treated with RME, and Group 2 consisted of 13 subjects (mean age, 18.5 ± 2.3 years) who were treated with SARME. In both groups, all cases had a maxillary width deficiency with bilateral crossbites. Maxillary dental casts were available at three different intervals: pretreatment (T1), after orthodontic treatment (T2), and at follow-up recall (T3). Intermolar and interpremolar width, palatal height, and maxillary arch depth and length were assessed from maxillary dental casts. Results: Treatment by RME and SARME produced significant increases in intermolar and interpremolar width and maxillary arch length after expansion (T2) (P < .05). The amount of relapse was not significantly different 2 years after treatment (P > .05). Conclusions: Although age ranges of the patient groups are different, the dentoalveolar responses of RME and SARME were similar after orthodontic treatment. (Angle Orthod. 2009:79; )

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 Molar Changes with Cervical Headgear Alone or in Combination with Rapid Maxillary Expansion

2008 ◽  
Vol 78 (5) ◽  
pp. 847-851 ◽  
Author(s):  
Marcel Marchiori Farret ◽  
Eduardo Martinelli S. de Lima ◽  
Vanessa Pereira Araújo ◽  
Susana Maria Deon Rizzatto ◽  
Luciane Macedo de Menezes ◽  
...  
Keyword(s):  
Class Ii ◽  
Rapid Maxillary Expansion ◽  
Control Group ◽  
Maxillary Expansion ◽  
Lateral Cephalograms ◽  
Cervical Traction ◽  
Permanent Molars ◽  
Group 2 ◽  
First Permanent Molars ◽  
Group 1

Abstract Objective: To test the hypothesis that there is no difference in the distal movement of the maxillary first permanent molars when cervical headgear is used alone or in combination with rapid maxillary expansion. Materials and Methods: The sample was composed of 36 subjects (aged 9 to 13 years), treated in the Faculty of Dentistry, Pontifícia Universidade Cat;aaolica, Rio Grande do Sul, Brazil. The individuals were in good health and in their pubertal growth period. All had Class II division 1 malocclusion. The patients were divided into two groups: group 1 (22 subjects), Class II, with a normal transverse maxilla treated with cervical traction headgear (HG) 400 g 12 h/d, and group 2 (14 subjects), Class II maxillary transverse deficiency treated with rapid maxillary expansion plus cervical traction headgear (RME + HG). An additional group 3 (17 subjects) served as a control group and included individuals with the same characteristics. All subjects had two lateral cephalograms: initial (T1) and progress (T2), taken 6 months later. Differences between T1 and T2 were compared with the Student's t-test, and three groups were compared by the analysis of variance and Tukey multiple comparison test. Results: Results showed greater distal tipping and greater distal movement of the first permanent molars in group 1 (HG) than in group 2 (RME + HG), P < .05. No extrusion of first permanent molar occurred in either group (P > .05). Conclusion: The hypothesis was rejected. Cervical traction headgear alone produced greater distal movement effects in maxillary first permanent molars when compared with rapid maxillary expansion associated with cervical headgear.

scholarly journals Stability of orthodontic treatment outcomes after 1-year treatment with the eruption guidance appliance in the early mixed dentition: A follow-up study

2018 ◽  
Vol 89 (2) ◽  
pp. 206-213 ◽  
Author(s):  
Rita Myrlund ◽  
Katri Keski-Nisula ◽  
Heidi Kerosuo
Keyword(s):  
Orthodontic Treatment ◽  
Permanent Dentition ◽  
Mixed Dentition ◽  
Retention Period ◽  
Anterior Crowding ◽  
Follow Up Study ◽  
Early Correction ◽  
Group 2 ◽  
Group 1

ABSTRACT Objectives: To investigate occlusal stability from the early mixed to the permanent dentition in children after early treatment with the eruption guidance appliance (EGA). Materials and Methods: Of 46 participants who received 1-year early EGA treatment, 35 attended a follow-up examination at age 12. Group 1 (n = 21) started their EGA treatment at mean age 7.7 years, and group 2 at 9.1 years. Following 1-year treatment, the EGA was used as a retainer. Changes in overjet, overbite, sagittal molar relationship, and anterior crowding were measured on casts obtained before EGA treatment, after EGA treatment, and at follow-up to evaluate occlusal stability. Results: Mean overjet, overbite, sagittal molar relation, and mandibular crowding improved significantly during the study period. Participants with good compliance during the retention period had significantly smaller overjet and overbite values than those with poor compliance. Conclusions: Early correction of increased overjet, overbite, and class II molar relation with the EGA is maintainable and can also be effective in the permanent dentition, provided the EGA is worn regularly as a retainer.

scholarly journals Dental and skeletal effects of combined headgear used alone or in association with rapid maxillary expansion

2015 ◽  
Vol 20 (5) ◽  
pp. 43-49
Author(s):  
Milton Meri Benitez Farret ◽  
Eduardo Martinelli de Lima ◽  
Marcel M. Farret ◽  
Laura Lutz de Araújo
Keyword(s):  
Side Effects ◽  
Rapid Maxillary Expansion ◽  
Class Ii Malocclusion ◽  
Maxillary Expansion ◽  
Clockwise Rotation ◽  
Maxillary Molars ◽  
Skeletal Effects ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: The aim of this study was to assess the effects of combined headgear used alone or in association with rapid maxillary expansion, as the first step for Class II malocclusion treatment.Methods:The sample comprised 61 patients divided into three groups: Group 1, combined headgear (CH); Group 2, CH + rapid maxillary expansion (CH + RME); and Group 3, control (CG). In Group 1, patients were treated with combined headgear until Class I molar relationship was achieved. In Group 2, the protocol for headgear was the same; however, patients were previously subject to rapid maxillary expansion.Results:Results showed distal displacement of maxillary molars for both experimental groups (p < 0.001), with distal tipping only in Group 1 (CH) (p < 0.001). There was restriction of forward maxillary growth in Group 2 (CH + RME) (p < 0.05) and clockwise rotation of the maxilla in Group 1 (CH) (p < 0.05).Conclusion: Based on the results, it is possible to suggest that treatment with both protocols was efficient; however, results were more significant for Group 2 (CH + RME) with less side effects.

scholarly journals The Effect of Rapid Maxillary Expansion on the Upper Airway’s Aerodynamic Characteristics

2020 ◽  
Author(s):  
Xin Feng ◽  
Yicheng Chen ◽  
Kristina Halme ◽  
Weihua Cai ◽  
Xie-Qi Shi
Keyword(s):  
Pressure Drop ◽  
Cfd Simulation ◽  
Maximum Velocity ◽  
Upper Airway ◽  
Aerodynamic Characteristics ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Airway Function ◽  
Group 2 ◽  
Group 1

Abstract Background: The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the upper airway function in terms of airflow resistance by applying a computational fluid dynamics (CFD) simulation.Methods: This retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three - dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop, midsagittal maximum velocity, and maximum wall shear stress were compared by independent samples t-test between the two groups at T0 and T1. Results: At T0, the pressure drop at expiration was significantly higher in group 2 compared to group 1, whereas the difference between the two groups was not significant at T1. The midsagittal maximum velocity of the two groups decreased to some extent at expiration, but without significant difference. The midsagittal maximum velocity of group 2 was at inspiration significantly higher than that of group 1 at T0 and T1. Conclusion: RME had a positive effect on UA airflow resistance in patients with an AN ratio ≥ 0.6. The findings provide positive evidence of RME in airway function and should thus be recommended to patients with both a narrow maxilla and enlarged adenoid.

scholarly journals Long-Term Effects of Rapid Maxillary Expansion Followed by Fixed Appliances

2010 ◽  
Vol 80 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Hakan Gurcan Gurel ◽  
Badel Memili ◽  
Mustafa Erkan ◽  
Yusuf Sukurica
Keyword(s):  
Rapid Maxillary Expansion ◽  
Long Term Effects ◽  
Maxillary Expansion ◽  
Long Term Changes ◽  
Fixed Appliances ◽  
Relapse Rates ◽  
Maxillary Arch

Abstract Objective: To evaluate the long-term changes in maxillary arch widths, overjet, and overbite in patients who were treated with rapid maxillary expansion (RME) followed by edgewise appliances. Materials and Methods: The material for the study consisted of study casts taken from 41 patients (19 males, 22 females) on four different occasions (before treatment, T1; after RME, T2; after treatment, T3; and during follow-up period, T4). The upper intercanine, interpremolar, and intermolar widths and overjet and overbite were measured on each set of study casts. Mean age of the subjects was 13.2 ± 1.3 years (range, 11.2–16.9 years) at T1, 13.3 ± 1.3 years (range, 11.3–17 years) at T2, 15.5 ± 1.4 years (range, 13.1–18.8 years) at T3, and 20.4 ± 1.6 years (range, 17.9–24.8 years) at T4. Results: The net increase in intercanine width, interpremolar width, intermolar width, overjet, and overbite was 1.4 ± 2.4 mm, 4.6 ± 2.6 mm, 4.3 ± 2.5 mm, 0.1 ± 0.6 mm, and 0.2 ± 0.6 mm, respectively, and the relapse rates were 37% for intercanine width, 19% for interpremolar width, and 17% for intermolar width at the end of the follow-up period. Conclusions: A significant amount of relapse occurred in maxillary arch widths at the postretention assessment, the greatest being in intercanine width. RME significantly decreased overbite and increased overjet, and a statistically significant decrease was observed in both overbite and overjet at the postretention assessment.

Effect of Rapid Maxillary Expansion on Upper Airway Morphology: A Retrospective Comparison of Normal Patients versus Patients with Enlarged Adenoid Tissue.

2021 ◽  
Vol 45 (3) ◽  
pp. 208-215
Author(s):  
Xin Feng ◽  
Stein Atle Lie ◽  
Kristina Hellén-Halme ◽  
Xie-Qi Shi
Keyword(s):  
Nasal Obstruction ◽  
Upper Airway ◽  
3D Models ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Objectives The present study evaluated the effect of rapid maxillary expansion (RME) on the morphology of the upper airway (UA) by calculating cross-sectional areas and volumes and comparing the effect in patients with a normal-sized adenoid with the effect in patients with an enlarged adenoid. Study design: Seventeen patients met the inclusion criteria. We constructed 3D models of the UA on cone-beam computed tomography images to calculate cross-sectional areas and volumes at the levels of the nasopharyngeal, retropalatal, and retroglossal airways. Patients were divided into two groups: group 1 was comprised of patients with an adenoidal nasopharyngeal (AN) ratio &lt; 0.6 and group 2 with an AN ratio ≥ 0.6. Paired samples t-tests assessed any area and volumetric changes of the UA after RME. Changes in degree of nasal obstruction, calculated as the AN ratio, was then compared for the two groups. An independent samples t-test compared volumetric changes in the nasopharynx between the two groups before and after RME. Results Changes in cross-sectional areas and volumes of the UA due to RME were not significant. The effects of RME on AN ratio (11 % vs 0 %) and nasopharyngeal volume (36.8 % vs 5.97%) were somewhat larger in group 2 patients who had adenoid-associated nasal obstruction compared with group 1 patients with a normal-sized adenoid; however, the differences were not significant. Conclusions After RME, the patients with an enlarged adenoid had more increases in nasopharyngeal volume compared with those with normal adenoid, despite there was no significant difference.

Teeth movement 12 years after orthodontic treatment with and without retainer: relapse or usual changes?

2019 ◽  
Author(s):  
Salem Abdulraheem ◽  
Ulrike Schütz-Fransson ◽  
Krister Bjerklin
Keyword(s):  
Orthodontic Treatment ◽  
Natural Growth ◽  
Lower Incisor ◽  
Irregularity Index ◽  
Lower Jaw ◽  
Group 3 ◽  
Group 2 ◽  
Growth Changes ◽  
Group 1

Summary Aims To identify if lower incisor movements after orthodontic treatment are due to the relapse of the orthodontic treatment or due to natural growth. Subjects and methods The subjects consisted of 92 patients who have had orthodontic treatment, divided into three groups, group 1: 38 individuals had no retainer in the lower jaw. Group 2: 24 individuals had a retainer 0.028 inch, a spring hard wire bonded to the mandibular canines only. Group 3: 30 individuals had a 0.0195-inch Twist-Flex wire, bonded to all mandibular incisors and canines. Study models before orthodontic treatment (T0), immediately after orthodontic treatment (T1), 6 years after orthodontic treatment (T2), and 12 years after orthodontic treatment (T3) were used for the measurements. The wires in groups 2 and 3 were removed after mean 2.6 years (SD 1.49). Little Irregularity Index (LII), inter-canine distance, available mandibular anterior space, and number of crowded incisors were registered. A Tooth Displacement Index (TDI) was developed to measure the tooth displacement directions at T0 and T3. Results The LII showed equal values before treatment (T0) and at the follow-up registrations (T2 and T3). But about 25 per cent of the tooth displacements at T2 and T3 did not exist before treatment, at T0. This indicates usual growth changes and not relapse of the orthodontic treatment. Conclusion As about 25 per cent of the displaced incisors can be considered as an effect of natural growth, not a relapse of the orthodontic treatment, it is valuable to use a displacement index in combination with other variables for investigations of stability after orthodontic treatment. Importance of the present study is that it is possible to differ between relapse and usual growth changes.

Augmented trabeculectomy-outcomes of first hundred versus second hundred surgeries of a fellowship-trained glaucoma surgeon

2021 ◽  
pp. 112067212199827
Author(s):  
Pornjittra Rattanasirivilai ◽  
Zaria Christine Ali ◽  
Dawnn Ira Khoo ◽  
Vikas Shankar
Keyword(s):  
Statistical Difference ◽  
Secondary Outcome ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Patient Groups ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose: We aim to compare the outcomes of trabeculectomy with mitomycin-C by a fellowship-trained glaucoma surgeon in the first hundred compared to second hundred surgeries. Patients and methods: Retrospective review of 200 consecutive surgeries from May 2015 to January 2017. Primary outcomes were intraocular pressure (IOP) control and use of IOP-lowering medications. Success between first hundred (Group 1) and second hundred (Group 2) patients were reported using World Glaucoma Association guidelines. Kaplan-Meier survival demonstrated complete success and qualified success. Secondary outcome measures were postoperative complications, bleb interventions and additional procedures. Results: We found no statistical difference between the first hundred and second hundred patient’s postoperative IOP at week 4 ( p = 0.17), 3 months ( p = 0.74), 6 months ( p = 0.46), 12 months ( p = 0.47), 18 months ( p = 0.13) or at final follow up ( p = 0.53). The mean final follow up period was 3.6 ± 0.7 years. Mean IOP reduction in Group 1 was from 27.1 ± 10.8 to 12.6 ± 7.1 ( p < 0.0001) and Group 2 from 22.8 ± 8.4 to 11.3 ± 4.2 ( p < 0.0001). Kaplan-Meier graphs showed no significant difference in complete success ( p = 0.0693) or qualified success ( p = 0.0866) between Group 1 and Group 2. Bleb interventions were not statistically significant between two groups. There was a significantly higher rate of complications with the first hundred patients ( p < 0.0001). Conclusion: Both first hundred and second hundred patient groups achieved statistically similar outcomes in long term IOP control. Significant reduction of complications was achieved in the second group of patients.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

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