Effects of rapid maxillary expansion on nasal cavity dimensions and airway resistance

Background: Rapid maxillary expansion is a common treatment for posterior cross-bites that has also shown to improve nasal breathing.Methods: Thirteen oral breather patients with posterior cross-bite were studied. Treatment consisted in rapid maxillary expansion with a fully bonded appliance including a bite-block and a hyrax expansion screw. Before and after treatment, CT scans and active anterior rhinomanometry were performed to each patient. Data was analyzed with the non-parametric Wilcoxon statistical test and correlation between palatal expansion and increase of airflow in each patient was assessed.Results: The CT scan showed that transversal dimensions were significantly increased (P<0.001) in most areas after treatment, considering the right and left side separately. Rhinomanometry also showed statistical differences (P<0.001) in all parameters studied when compared before and after treatment. Positive correlation was observed between palatal expansion and increase of airflow.Conclusions: All patients improved oral breathing habit clinically and there is also statistical evidence that the nasal cavity increased its transversal dimensions, measured by CT scan and that patients increased their airflow through the nasal cavity, measured by rhinomanometry.

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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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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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Periodontal clinical evaluation before and after surgically assisted rapid maxillary expansion

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.23.1.079-086.oar ◽

2018 ◽

Vol 23 (1) ◽

pp. 79-86 ◽

Cited By ~ 1

Author(s):

Michelle Sendyk ◽

Wilson Roberto Sendyk ◽

Débora Pallos ◽

Letícia Cristina Cidreira Boaro ◽

João Batista de Paiva ◽

...

Keyword(s):

Gingival Recession ◽

Rapid Maxillary Expansion ◽

Central Incisor ◽

Maxillary Expansion ◽

Clinical Attachment Level ◽

Posterior Crossbite ◽

Attached Gingiva ◽

Before And After ◽

The Right ◽

Attachment Level

ABSTRACT Introduction: The surgically assisted rapid maxillary expansion is a procedure that reduces the resistance of the sutures correcting the posterior crossbite in adults. Objective: The aim of this study was to evaluate the periodontal status of 17 adults submitted to this procedure. Methods: The clinical attachment level (CAL), gingival recession, attached gingiva and bleeding were evaluated in maxillary first premolars and molars, central and lateral incisors of right and left sides before surgery, 5 days and 6 months after. Means, standard deviation, medians, minimum and maximum values were compared among the evaluations using the Friedman and McNemar tests. Results: There was a statistically significant increase in CAL in the right central incisor, right and left premolars and right and left molars. There was a statistically significant increase in gingival recession in the right and left premolars and molars. The amount of attached gingiva significantly decreased in right premolars and right and left molars. There was increase in bleeding in most of the teeth. Conclusion: Results indicated that the surgically assisted rapid maxillary expansion might cause alterations in periodontal tissue.

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Assessment of respiratory muscle strength and airflow before and after microimplant-assisted rapid palatal expansion

The Angle Orthodontist ◽

10.2319/070518-504.1 ◽

2019 ◽

Vol 89 (5) ◽

pp. 713-720 ◽

Cited By ~ 6

Author(s):

Camilla Juliana Storto ◽

Aguinaldo Silva Garcez ◽

Hideo Suzuki ◽

Karla Garcez Cusmanich ◽

Islam Elkenawy ◽

...

Keyword(s):

Muscle Strength ◽

Nasal Cavity ◽

Respiratory Muscle ◽

Alveolar Bone ◽

Peak Flow ◽

Respiratory Muscle Strength ◽

Maxillary Expansion ◽

Palatal Expansion ◽

Rapid Palatal Expansion ◽

Before And After

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<.05). Oral and nasal peak flow increased immediately after and 5 months later, especially in patients with initial signs of airway obstruction (P<.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<.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.

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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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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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Rapid maxillary expansion in the treatment of the functional posterior crossbite: joint noise and electromyographic activity analysis

Revista de Odontologia da UNESP ◽

10.1590/1807-2577.03819 ◽

2019 ◽

Vol 48 ◽

Author(s):

Diego Jesus Brandariz PIMENTEL ◽

Laís Valencise MAGRI ◽

Melissa de Oliveira MELCHIOR ◽

Guido Artemio MARAÑÓN-VÁSQUEZ ◽

Mirian Aiko Nakane MATSUMOTO ◽

...

Keyword(s):

Masticatory Muscles ◽

Rapid Maxillary Expansion ◽

Electromyographic Activity ◽

Maxillary Expansion ◽

Posterior Crossbite ◽

Stomatognathic System ◽

End Of Treatment ◽

Before And After ◽

Electromyographic Analysis ◽

Level Of Significance

Abstract Introduction The rapid maxillary expansion (RME) reduces the risk of developing structural and functional disorders in the stomatognathic system. Objective To examine the effects of the RME as a treatment for the posterior crossbite, related with the electromyographic activity of the masticatory muscles and the TMJ noises in a population of children. Material and method 13 girls and 7 boys, regardless of the type of malocclusion, with a mean age of 9 years old (± 3), were treated with RME. The electrovibratography analyzed the TMJ noise, and the electromyography analyzed the masticatory muscles before treatment (T0) and after three months of a short-term follow-up (T1). The comparisons of the affected and unaffected sides by the crossbite were performed using Mann-Whitney’s test, and to compare data before and after treatment the Wilcoxon’s test was used (level of significance: 5%). Result No significant differences were found in the parameters of joint noise in comparison to the sides affected and unaffected by the crossbite, in both T0 and T1 (p>0.05); only the side without the crossbite observed decrease in the peak amplitude of the joint noises after treatment. In the static electromyographic analysis, inter-side differences were observed before and after treatment, since the deliberate unilateral chewing showed greater asymmetry activity in T0 for both sides, which has been corrected after treatment, improving the functional chewing. Conclusion The proposed treatment did not lead to the occurrence of joint noises and improved the functional pattern of electromyographic activity during chewing at the end of treatment.

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Assessment of Immediate Skeletal Changes after Alternate Rapid Maxillary Expansion and Constriction – A Case Report

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/604 ◽

2021 ◽

Vol 10 (34) ◽

pp. 2954-2959

Author(s):

Shilpa Venkatesh Pharande

Keyword(s):

Case Report ◽

Rapid Maxillary Expansion ◽

Class Iii ◽

Class Iii Malocclusion ◽

Maxillary Expansion ◽

Skeletal Class ◽

Posterior Crossbite ◽

Skeletal Changes ◽

Before And After ◽

Opening And Closing

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.

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Evaluation of signs and symptoms of temporomandibular disorders in children and adolescents, before and after rapid maxillary expansion

Journal of Interdisciplinary Dentistry ◽

10.4103/jid.jid_75_20 ◽

2021 ◽

Vol 11 (3) ◽

pp. 108

Author(s):

MarceloSoares Correa ◽

KarinaMaria Salvatore de Freitas ◽

MarcosRoberto de Freitas ◽

AntônioSergio Guimaraes ◽

Guilherme Janson

Keyword(s):

Children And Adolescents ◽

Temporomandibular Disorders ◽

Signs And Symptoms ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Before And After

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Long-Term Results of a Modified Removable Expansion Plate to Increase Arch Length: A Series of 10 Cases

The Journal of Indian Orthodontic Society ◽

10.1177/0301574220939493 ◽

2020 ◽

Vol 54 (4) ◽

pp. 374-381

Author(s):

Alka M. Banker ◽

Rahul P. Muchhadia ◽

Bhagyashree B. Desai ◽

Priyanka A. Shah

Keyword(s):

Transverse Dimension ◽

Rapid Maxillary Expansion ◽

Permanent Dentition ◽

Long Term Results ◽

Maxillary Expansion ◽

Fixed Appliance ◽

Palatal Expansion ◽

Fixed Appliances ◽

Complexity Cost

Crowding, protrusion, and class II or end-on occlusion are malocclusions frequently associated with a narrow transverse dimension. The goal of expansion is to reduce the need for extractions in permanent dentition through elimination of arch length discrepancies as well as correction of bony base imbalances. Gaining arch length makes the subsequent fixed appliance treatment easier and shorter. Palatal expansion is usually achieved by using fixed rapid maxillary expansion, but because of the complexity, cost, and increased laboratory steps, this step is sometimes omitted. We have modified the design and screw activation protocol of the removable Schwarz plate in such a way that it gives efficient and stable expansion as well as arch perimeter gain with simpler mechanics. We present the long-term results of 10 such cases treated with this modified expander followed by fixed appliances.

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