scholarly journals Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:

2020 ◽  
Vol 91 (1) ◽  
pp. 36-45
Author(s):  
Haichao Jia ◽  
Li Zhuang ◽  
Nan Zhang ◽  
Yuanyuan Bian ◽  
Song Li

ABSTRACT Objective To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage. Materials and Methods Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 ± 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 ± 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests. Results The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P < .01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P < .01). Conclusions MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage.

2020 ◽  
Vol 13 (52) ◽  
pp. 10-24
Author(s):  
Luciana Quintanilha Pires Fernandes ◽  
Jonas Capelli Junior ◽  
José Augusto Mendes Miguel

Rapid maxillary expansion (RME) is an orthodontic treatment alternative that aims to increase the transverse direction of the maxilla by separating the median palatine suture (MPS). miniscrew-assisted rapid palatal expansion (MARPE) aims to enhance the orthopedic effects of RME through skeletal anchorage. Thus, the aim of this article is to provide a guide for MARPE planning in cone beam computed tomography (CBCT) and for installation of the expander device with this technique. In addition, a case report of a Caucasian male patient, 16 years and 3 months old with Class II malocclusion, division 1 right subdivision, posterior crossbite of the right side and atresic upper arch in the post-pubertal growth spurt phase will be presented. The patient was treated with MARPE for a period of 5 weeks, when overcorrection of crossbite, correction of maxillary atresia, opening of MPS and creation of a transient diastema between the upper incisors were achieved, evidencing the success of the MARPE technique in a post-pubertal growth spurt patient.


2014 ◽  
Vol 24 (6) ◽  
pp. 1168-1174 ◽  
Author(s):  
Weijun Wang ◽  
Zhiwei Wang ◽  
Zhen Liu ◽  
Zezhang Zhu ◽  
Feng Zhu ◽  
...  

2017 ◽  
Vol 22 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Brian LaBlonde ◽  
Manuel Lagravere Vich ◽  
Paul Edwards ◽  
Katherine Kula ◽  
Ahmed Ghoneima

ABSTRACT Introduction: The aim of this multi-center retrospective study was to quantify the changes in alveolar bone height and thickness after using two different rapid palatal expansion (RPE) activation protocols, and to determine whether a more rapid rate of expansion is likely to cause more adverse effects, such as alveolar tipping, dental tipping, fenestration and dehiscence of anchorage teeth. Methods: The sample consisted of pre- and post-expansion records from 40 subjects (age 8-15 years) who underwent RPE using a 4-banded Hyrax appliance as part of their orthodontic treatment to correct posterior buccal crossbites. Subjects were divided into two groups according to their RPE activation rates (0.5 mm/day and 0.8 mm/day; n = 20 each group). Three-dimensional images for all included subjects were evaluated using Dolphin Imaging Software 11.7 Premium. Maxillary base width, buccal and palatal cortical bone thickness, alveolar bone height, and root angulation and length were measured. Significance of the changes in the measurements was evaluated using Wilcoxon signed-rank test and comparisons between groups were done using ANOVA. Significance was defined at p ≤ 0.05. Results: RPE activation rates of 0.5 mm per day (Group 1) and 0.8 mm per day (Group 2) caused significant increase in arch width following treatment; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Buccal alveolar height and width decreased significantly in both groups. Both treatment protocols resulted in significant increases in buccal-lingual angulation of teeth; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Conclusion: Both activation rates are associated with significant increase in intra-arch widths. However, 0.8 mm/day resulted in greater increases. The 0.8 mm/day activation rate also resulted in more increased dental tipping and decreased buccal alveolar bone thickness over 0.5 mm/day.


2019 ◽  
Vol 89 (5) ◽  
pp. 713-720 ◽  
Author(s):  
Camilla Juliana Storto ◽  
Aguinaldo Silva Garcez ◽  
Hideo Suzuki ◽  
Karla Garcez Cusmanich ◽  
Islam Elkenawy ◽  
...  

ABSTRACT Objectives: To assess alterations in respiratory muscle strength and inspiratory and expiratory peak flow, as well as skeletal and dental changes in patients diagnosed with transverse maxillary deficiency before and after microimplant-assisted rapid maxillary expansion (MARPE). Materials and Methods: Twenty patients (13 female and 7 male) were assessed by respiratory tests in three different periods: T0 initial, T1 immediately after expansion, and T2 after 5 months. Tests included: maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), oral expiratory peak flow, and inspiratory nasal flow. Cone-beam computed tomography measurements were performed in the maxillary arch, nasal cavity, and airway before and immediately after expansion. Results: There was a significant increase in MIP between T0 and T2 and MEP between T0 and T1 (P&lt;.05). Oral and nasal peak flow increased immediately after and 5 months later, especially in patients with initial signs of airway obstruction (P&lt;.05). In addition, after expansion there was a significant enlargement of the nasal cavity, alveolar bone, and interdental widths at the premolar and molar region. Molars tipped buccally (P&lt;.05) but no difference was found in premolar inclination. MARPE increased airway volume significantly. Conclusions: Skeletal changes promoted by MARPE directly affected airway volume, resulting in a significant improvement in muscle strength and nasal and oral peak flow.


2018 ◽  
Vol 8 ◽  
pp. 71-85 ◽  
Author(s):  
Peter Ngan ◽  
Uyen Kelly Nguyen ◽  
Tung Nguyen ◽  
Timothy Tremont ◽  
Chris Martin

Introduction Microimplant-assisted rapid palatal expansion (MARPE) has recently been offered to adult patients for correcting maxillary transverse deficiency. However, there is limited information in the literature on the success of this appliance and its skeletal and dental effects on skeletally matured patients. The purpose of this study was to investigate the immediate skeletal, dentoalveolar, and periodontal response to MARPE appliance using cone-beam computed tomography in a skeletally matured patient as assessed by the cervical vertebral maturation method. Materials and Methods Eight consecutively treated patients (2 females, 6 males; mean age of 21.9 ± 1.5 years) treated with a maxillary skeletal expander were included in the study. Measurements were taken before and after expansion to determine the amount of midpalatal suture opening, upper facial bony expansion, alveolar bone bending, dental tipping, and buccal bone thickness (BBT). Data were analyzed using a one-way ANOVA and matched-pair t-test (α = 0.05). Results Midpalatal suture separation was found in 100% of the patients with no dislodged microimplants. Total maxillary expansion was attributed to 41% skeletal, 12% alveolar bone bending, and 48% dental tipping. Pattern of midpalatal suture opening was found to be parallel in both the coronal and axial planes. On average, the absolute dental tipping ranged from 4.17° to 4.96° and the BBT was reduced by an average of 39% measured at the premolars and molars. Conclusions The MARPE appliance can be a clinically acceptable, nonsurgical treatment option for correcting mild to moderate maxillary transverse discrepancies for skeletally matured adult patients with a healthy periodontium.


Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 38
Author(s):  
Rosamaria Fastuca ◽  
Helga Turiaco ◽  
Fausto Assandri ◽  
Piero A. Zecca ◽  
Luca Levrini ◽  
...  

(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.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
V. Anusuya ◽  
Amit Nagar ◽  
Pradeep Tandon ◽  
G. K. Singh ◽  
Gyan Prakash Singh ◽  
...  

2010 ◽  
Vol 299 (6) ◽  
pp. E990-E997 ◽  
Author(s):  
Lijie Shi ◽  
Thomas Remer ◽  
Anette E. Buyken ◽  
Michaela F. Hartmann ◽  
Philipp Hoffmann ◽  
...  

Whether prepubertal estrogen production impacts on the timing of puberty is not clear. We aimed to investigate prepubertal 24-h estrogen excretion levels and their association with early and late pubertal markers. Daily urinary excretion rates of estrogens of 132 healthy children, who provided 24-h urine samples 1 and 2 yr before the start of the pubertal growth spurt [age at takeoff (ATO)], were quantified by stable isotope dilution/GC-MS. E-sum3 (estrone + estradiol + estriol) was used as a marker for potentially bioactive estrogen metabolites and E-sum5 (E-sum3 + 16-epiestriol + 16-ketoestradiol) for total estrogen production. Pubertal outcomes were ATO, age at peak height velocity (APHV), duration of pubertal growth acceleration (APHV-ATO), age at Tanner stage 2 for pubic hair (PH2), genital (G2, boys) and breast (B2, girls) development, and age at menarche. Prepubertal urinary estrogen excretions (E-sum3 and E-sum5) were not associated with ATO, APHV, and age at PH2 but with duration of pubertal growth acceleration ( P < 0.01) in both sexes. Girls with higher E-sum3 reached B2 0.9 yr ( P = 0.04) and menarche 0.3 yr earlier ( P = 0.04) than girls with lower E-sum3. E-sum3 was not associated with age at G2 in boys ( P = 0.6). For most pubertal variables, the associations with E-sum3 were stronger than with E-sum5. In conclusion, prepubertal estrogens may not be critical for the onset of the pubertal growth spurt but are correlated with its duration in both boys and girls. Prepubertal estrogen levels may already predict the timing of girls' menstruation and breast development but do not appear to affect sexual maturation in boys.


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