scholarly journals Short-term skeletal and dentoalveolar effects of overexpansion:

2021 ◽  
Author(s):  
Arun K. Bala ◽  
Phillip M. Campbell ◽  
Larry P. Tadlock ◽  
Emet D. Schneiderman ◽  
Peter H. Buschang

ABSTRACT Objectives To evaluate whether the amount of rapid maxillary expansion differentially affects the skeletal and dentoalveolar changes that occur. Materials and Methods This randomized controlled trial included 23 patients who had rapid maxillary expansion (RME). Subjects were randomly assigned to a conventional expansion control group (n = 12) or an overexpansion group (n = 11), who started treatment at 13.2 ± 1.5 and 13.8 ± 1 years of age, respectively. Cone beam computed tomography scans (11 cm) were obtained prior to rapid maxillary expander (RME) delivery and approximately 3.7 months later. Initial hand-wrist radiographs were used to determine the participants' skeletal maturity. Results The RME screws were activated 5.6 ± 1.2 mm and 10.1 ± 0.6 mm in the conventional and overexpansion groups, respectively. Overexpansion produced significantly greater expansion of the nasal cavity (2.1X–2.5X), maxillary base (2.3X), buccal alveolar crest (1.4X), and greater palatine foramina (1.9X). Significantly greater intermolar width increases (1.8X) and molar inclination (2.8X) changes were also produced. The nasal cavity and maxillary base expanded 23%–32% as much as the screws were activated. Skeletal expansion was positively correlated with RME screw activation (R = 0.61 to 0.70) and negatively correlated (R = −0.56 to −0.64) with the patients' skeletal maturation indicators (SMIs). Together, screw activation and the patients' SMI scores explained 48%–66% of the variation in skeletal expansion. Conclusions This pilot study shows that overexpansion produces greater changes than conventional expansion, with greater skeletal effects among less mature patients.

2013 ◽  
Vol 83 (5) ◽  
pp. 851-857 ◽  
Author(s):  
Ryuzo Kanomi ◽  
Toru Deguchi ◽  
Eriko Kakuno ◽  
Teruko Takano-Yamamoto ◽  
W. Eugene Roberts

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.


2017 ◽  
Vol 88 (2) ◽  
pp. 202-207 ◽  
Author(s):  
Fundagül Bilgiç ◽  
İbrahim Damlar ◽  
Özgür Sürmelioğlu ◽  
Özlem Akıncı Sözer ◽  
Ufuk Tatlı

ABSTRACT Objective: To evaluate the effects of rapid maxillary expansion (RME) on the vocal quality, maxillary central incisors, midpalatal suture, and nasal cavity in patients with maxillary crossbite. Materials and Methods: Coronal CT scans of 30 subjects (14 boys, 16 girls; mean age, 12.01 ± 0.75) were taken before RME (T0), and at the end of the expansion phase (T1). Voice samples of all patients were recorded with a high-quality condenser microphone (RODE NT2-A) on a desktop computer at T0 and T1. Statistical analyses were performed using a paired-sample t-test. The degree of association between the changes in the voice parameters and nasal width was assessed with Pearson's correlation. Results: RME treatment produced a significant increase in the transverse dimensions of the midpalatal suture and nasal cavity between T0 and T1 (P < .05). The maximum F0 and jitter (%) results were shown to decrease statistically significantly from T0 to T1 (P < .001 and P = .042, respectively). Between T0 and T1, shimmer (%) and shimmer (dB) exhibited statistically significant increases (P = .037 and P = .019, respectively). Conclusions: After RME therapy, voice quality differences were found to be associated with increases in nasal width.


2014 ◽  
Vol 19 (5) ◽  
pp. 79-87 ◽  
Author(s):  
Carolina da Luz Baratieri ◽  
Maheus Alves Jr ◽  
Claudia Trindade Mattos ◽  
Geórgia Wain Thi Lau ◽  
Lincoln Issamu Nojima ◽  
...  

The aim of this study was to assess by means of cone-beam computed tomography (CBCT) scans the transverse effects on the nasomaxillary complex in patients submitted to rapid maxillary expansion (RME) using Haas expander in comparison to untreated individuals. This prospective controlled clinical study assessed 30 subjects (18 boys and 12 girls) with mixed dentition and during pubertal growth. The treated group was submitted to RME with Haas expander, retention for six months and a six-month follow-up after removal. The control group matched the treated group in terms of age and sex distribution. CBCT scans were taken at treatment onset and one year after the expander was activated. Maxillary first molars (U6) width, right and left U6 angulation, maxillary alveolar width, maxillary basal width, palatal alveolar width, palatal base width, right and left alveolar angulation, palatal area, nasal base width, nasal cavity width and inferior nasal cavity area on the posterior, middle and anterior coronal slices were measured with Dolphin Imaging Software(r) 11.5, except for the first two variables which were performed only on the posterior slice. All transverse dimensions increased significantly (P < 0.05) in the treated group in comparison to the control, except for alveolar angulation and inferior nasal cavity area (P > 0.05). Results suggest that increase of molar, maxillary, palatal and nasal transverse dimensions was stable in comparison to the control group one year after treatment with RME.


2020 ◽  
Vol 90 (3) ◽  
pp. 432-441 ◽  
Author(s):  
Qiming Li ◽  
Hongyi Tang ◽  
Xueye Liu ◽  
Qing Luo ◽  
Zhe Jiang ◽  
...  

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 &lt; .05). Enlarged nasopharyngeal volume correlated with increased nasal width at the PNS plane (P &lt; .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 &lt; .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.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Fitin Aloufi ◽  
Charles B. Preston ◽  
Khalid H. Zawawi

Objectives. The primary objectives of this retrospective study were first to compare the upper and lower pharyngeal airway spaces between orthodontic patients with and without maxillary constriction and second to evaluate the effect of rapid maxillary expansion (RME) on these airway spaces. A secondary objective was to compare the mode of breathing between groups. Materials and Methods. The experimental (RME) group consisted of 30 patients (mean age, years, 16 boys and 14 girls) with maxillary constriction who were treated with hyrax-type RME. The control group comprised the records of age- and gender matched patients (mean age, years, 16 boys and 14 girls) with no maxillary constriction but requiring nonextraction comprehensive orthodontic treatment. Cephalometric measurements in the sagittal dimension of upper and lower airway spaces for the initial and final records were recorded. Mode of breathing and length of treatment were also compared. Results. The sagittal dimension of the upper airway increased significantly in the RME group ( mm) compared to the control group ( mm), . However, there was no significant difference in the lower pharyngeal airway measurement between the RME group () and the control group (), . There was no significant difference with respect to mode of breathing between the two groups (). Conclusion. Rapid maxillary expansion (RME) during orthodontic treatment may have a positive effect on the upper pharyngeal airway, with no significant change on the lower pharyngeal airway.


2011 ◽  
Vol 22 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Moara de Rossi ◽  
Andiara de Rossi ◽  
Jorge Abrão

Bonded maxillary expansion appliances have been suggested to control increases in the vertical dimension of the face after rapid maxillary expansion (RME). However, there is still no consensus in the literature about its real skeletal effects. The purpose of this prospective study was to evaluate, longitudinally, the vertical and sagittal cephalometric alterations after RME performed with bonded maxillary expansion appliance. The sample consisted of 26 children, with a mean age of 8.7 years (range: 6.9-10.9 years), with posterior skeletal crossbite and indication for RME. After maxillary expansion, the bonded appliance was used as a fixed retention for 3.4 months, being replaced by a removable retention subsequently. The cephalometric study was performed onto lateral radiographs, taken before treatment was started, and again 6.3 months after removing the bonded appliance. Intra-group comparison was made using paired t test. The results showed that there were no significant sagittal skeletal changes at the end of treatment. There was a small vertical skeletal increase in five of the eleven evaluated cephalometric measures. The maxilla displaced downward, but it did not modify the facial growth patterns or the direction of the mandible growth. Under the specific conditions of this research, it may be concluded that RME with acrylic bonded maxillary expansion appliance did promote signifciant vertical or sagittal cephalometric alterations. The vertical changes found with the use of the bonded appliance were small and probably transitory, similar to those occurred with the use of banded expansion appliances.


2015 ◽  
Vol 86 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Débora C Martins ◽  
Bernardo Q Souki ◽  
Paula L Cheib ◽  
Gerluza A.B Silva ◽  
Igor D.G Reis ◽  
...  

ABSTRACT Objective:  To compare external root resorption (ERR) when bands and wires are used as orthodontic anchorage during rapid maxillary expansion (RME). Materials and Methods:  Histologic analysis was performed on 108 sites from 18 maxillary first premolars and on 36 sites from six mandibular first premolars in nine subjects (mean age = 15.2 ± 1.4 years) 3 months after RME. Maxillary teeth were pooled into two groups (n = 54 each) according to the type of orthodontic anchorage (band group [BG] vs wire group [WG]). Anchorage type was randomly chosen in a split-mouth design. Mandibular first premolars, which were not subjected to orthodontic forces, were used as the control group (CG). Results:  All premolars in the BG and WG showed ERR at the level of the cementum and dentin. Repair with cementum cells was observed in all resorption areas, but complete repair was rarely found. No statistically significant difference was found between the BG and WG with regard to the ERR. No association was found between the root height position (middle or cervical third) and the incidence of ERR. Buccal root surfaces showed a higher amount of ERR compared with the palatal and interproximal surfaces. ERR was not found in any teeth in the CG. Conclusion:  All maxillary first premolars subjected to RME showed ERR and partial cementum repair. Banded teeth did not develop more ERR than nonbanded anchorage teeth.


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 ◽  
...  

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 &lt; .05. No extrusion of first permanent molar occurred in either group (P &gt; .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.


2012 ◽  
Vol 17 (4) ◽  
pp. 129-133 ◽  
Author(s):  
Carla Enoki Itikawa ◽  
Fabiana Cardoso Pereira Valera ◽  
Mírian Aiko Nakane Matsumoto ◽  
Wilma Terezinha Anselmo Lima

OBJECTIVE: To assess the effects of rapid maxillary expansion on facial morphology and on nasal cavity dimensions of mouth breathing children by acoustic rhinometry and computed rhinomanometry. METHODS: Cohort; 29 mouth breathing children with posterior crossbite were evaluated. Orthodontic and otorhinolaryngologic documentation were performed at three different times, i.e., before expansion, immediately after and 90 days following expansion. RESULTS: The expansion was accompanied by an increase of the maxillary and nasal bone transversal width. However, there were no significant differences in relation to mucosal area of the nose. Acoustic rhinometry showed no difference in the minimal cross-sectional area at the level of the valve and inferior turbinate between the periods analyzed, although rhinomanometry showed a statistically significant reduction in nasal resistance right after expansion, but were similar to pre-treatment values 90 days after expansion. CONCLUSION: The maxillary expansion increased the maxilla and nasal bony area, but was inefficient to increase the nasal mucosal area, and may lessen the nasal resistance, although there was no difference in nasal geometry. Significance: Nasal bony expansion is followed by a mucosal compensation.


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