Evaluation of Palatal Rugae Following Orthopedic Treatment Using Rapid Maxillary Expander and Facemask

The purpose of this study was to determine whether the palatal rugae could be used as an appropriate reference area for serial model superimposition following Rapid maxillary expansion(RME) and facemask treatment.<br/>A total of 52 pediatric patients who had undergone RME and facemask treatment were selected. Palate and palatal rugae in the pre- and post- treatment casts from the patients were measured.<br/>In spite of dentoalveolar changes occurred by RME and facemask, anteroposterior changes in palate and palatal rugae were not significant. Anatomical changes of palate and palatal rugae were mostly shown in the transverse dimension. The soft tissue of the palatal rugae stretches in adaptation to hard tissue movement. Among the evaluated landmarks, the medial point of the third palatal rugae seemed to be the most stable.<br/>The observed alterations in the palatal rugae demonstrated the potential of medial points of third palatal rugae as a reference point in model superimpositions to evaluate dental movement within the maxillary arch following RME and facemask treatment.

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Analysis of the Morphological Characteristics of the Palatal Rugae for Three-Dimensional Superimposition of Digital Models in Korean Subjects

BioMed Research International ◽

10.1155/2018/3936918 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Sung-Hwan Choi ◽

Kyongmin Koh ◽

Kee-Joon Lee ◽

Chung-Ju Hwang ◽

Jung-Yul Cha

Keyword(s):

Orthodontic Treatment ◽

Three Dimensional ◽

Morphological Characteristics ◽

Digital Model ◽

Initial Visit ◽

Reference Area ◽

The Third ◽

Palatal Rugae ◽

Before And After ◽

Left And Right

Objective. The aim of this study was to evaluate the morphological characteristics of the palatal rugae in Korean subjects to determine whether the palatal rugae can be used as an appropriate reference area for three-dimensional digital model superimpositions. Materials and Methods. In total, 343 patients (110 men, 233 women; mean age, 25.6±8.2 years) who had a digital model taken at their initial visit were included, and the numbers and types of right and left palatal rugae were investigated according to the primary, secondary, and fragmentary rugae. Finally, the differences in the positions of the third primary ruga were investigated according to the presence of additional rugae posterior to the third primary ruga. Results. The number of primary palatal rugae ranged from one to six, with 43.5% of the subjects having three primary rugae and 36.1% having four primary rugae; there were no significant differences between sexes. Except for the fragment rugae, the numbers of primary and secondary rugae were not significantly different between the left and right sides. The third primary ruga was located more significantly anteriorly when there was an additional ruga posterior to the third primary ruga (P < 0.001). Conclusions. The numbers of the palatal rugae vary greatly among individuals, and this affects the anteroposterior position of the third primary ruga. When the third primary ruga is located anteriorly, care should be taken when using it as a reference area for superimposition with a digital model before and after orthodontic treatment.

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Case Study Comparison: Limitations in Telehealth Relating to Poverty and Family Support

Seminars in Hearing ◽

10.1055/s-0041-1731696 ◽

2021 ◽

Vol 42 (02) ◽

pp. 158-164

Author(s):

Lindsey E. Jorgensen ◽

Rachel E. Barrett

Keyword(s):

Family Support ◽

Pediatric Patients ◽

Internet Access ◽

Smart Devices ◽

Internet Connection ◽

The Third ◽

Global Pandemic ◽

Internet Connections ◽

Made In

AbstractTelehealth appointments have grown in popularity due to the COVID-19 global pandemic. Three cases presented in this article show several different perspectives where telehealth was utilized. For the first patient, appointments were successfully completed via telehealth; however, the patient's family opted to continue with an unsecure internet connection at a local laundromat. For the second patient, a stable internet connection could not be obtained in his home, thus making telehealth appointments unavailable. The caregiver of this patient ended up driving to the clinic to have adjustments made in person. For the third patient, telehealth appointments were unavailable due to unstable internet connections as well as difficulty setting up video interpreting services. These cases highlight the idea that telehealth can be incredibly beneficial, when used correctly. For some, the option to attend appointments virtually gives them access to specialists that otherwise may not be available. For other patients, aspects such as access to smart devices and steady internet access must be considered to ensure a successful connection. The hope is that this article sheds light on some of the potential setbacks that can come from the use of telehealth appointments in a practice and provides discussion regarding for whom telehealth may be appropriate, even in pediatric patients. After reading this article, readers should be able to discuss ways in which there could be solutions for these barriers that may prevent some patients from utilizing these types of virtual appointments.

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Orthopedic Treatment of Maxillary Expansion: A Review of the Literature

International Journal of Dentistry and Oral Science ◽

10.19070/2377-8075-150009 ◽

2015 ◽

pp. 39-41

Author(s):

Yanqi Yang ◽

◽

Sylvia Ng ◽

Minjie Li

Keyword(s):

Review Of The Literature ◽

Maxillary Expansion ◽

Orthopedic Treatment

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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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Early timely orthodontic treatment: Treatment of unerupted maxillary laterals

APOS Trends in Orthodontics ◽

10.25259/apos_27_2021 ◽

2021 ◽

Vol 11 ◽

pp. 4-13

Author(s):

Peter Ngan ◽

Mohamad Sarraj ◽

Ghaddy AlSaty

Keyword(s):

Early Intervention ◽

Orthodontic Treatment ◽

Case Reports ◽

Young Patients ◽

Mixed Dentition ◽

Maxillary Expansion ◽

Orthopedic Treatment ◽

Maxillary Protraction ◽

Posterior Crossbite ◽

Timely Treatment

There is no universal agreement as to which type of orthodontic or orthopedic treatment deserves early intervention. In addition, there is a need for more information as to which treatments are the most effective and less costly if they are initiated timely in the mixed dentition. Early timely treatment may benefit young patients with a maxillary transverse deficiency with or without a posterior crossbite that requires maxillary expansion. It may also be indicated in children with anteroposterior jaw discrepancy that requires chin cup or maxillary protraction. In this paper, the authors will focus on early maxillary expansion to facilitate the eruption of maxillary laterals. In specific, the authors will present a contemporary protocol using a bonded maxillary expander as anchorage for treatment of unerupted maxillary laterals. The use of this protocol was illustrated with two case reports to enable clinicians to routinely achieve a beautiful smile on a young patient by timely alignment of the maxillary incisors.

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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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Three-dimensional evaluation of mid-facial soft tissue changes after expansion using micro-implant-supported maxillary skeletal expander

10.21203/rs.3.rs-18883/v1 ◽

2020 ◽

Author(s):

Hieu Nguyen ◽

Jeong Won Shin ◽

Hai-Van Giap ◽

Ki Beom Kim ◽

Hwa Sung Chae ◽

...

Keyword(s):

Soft Tissue ◽

Computerized Tomography ◽

Soft Tissues ◽

Cone Beam ◽

Maxillary Expansion ◽

Hard Tissue ◽

Facial Soft Tissue ◽

Tissue Changes ◽

Cone Beam Computerized Tomography ◽

Soft Tissue Changes

Abstract Background The aim of this study was to assess the mid-facial soft tissue changes induced by a micro-implant-supported maxillary skeletal expander in late adolescents and young adults by cone-beam computerized tomography and the correlations between hard and soft tissue changes after expansion with maxillary skeletal expander.Subjects and methods Twenty patients with maxillary transverse deficiency treated with maxillary skeletal expander were selected. Cone-beam computerized tomography images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks.Results Anterior nasal spine, posterior nasal spine, and alveolar bone width were significantly increased after expansion with maxillary skeletal expander (p < 0.05). The average lateral movement of the cheek points was 1.13 ± 0.33 mm (left) and 1.41 ± 0.39 mm (right), while that of the alar curvature points was 1.07 ± 0.72 mm (left) and 1.06 ± 0.68 (right) (p < 0.05). The average forward displacement of the cheek points was 0.42 ± 0.66 mm (left) and 0.60 ± 0.58 mm (right), whereas that of the alar curvature points was 0.80 ± 0.67 mm (left) and 0.68 ± 0.56 mm (right) side (p < 0.05). The average downward movement of the subnasale was 0.40 ± 0.37 mm (p < 0.05). The changes in cheek points and alar curvature points on both sides significantly correlated with hard-tissue changes (p < 0.05).Conclusions Maxillary expansion using maxillary skeletal expander resulted in significant lateral and forward movement of soft tissues of the cheek and alar curvature points on both sides and correlated with the maxillary suture opening at the anterior and posterior nasal spines.

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The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.432 ◽

2021 ◽

Vol 8 ◽

Author(s):

Richard Togbedji Dahoue ◽

Abdelali Halimi ◽

Médard Antah Gbètoho Dohou ◽

Rajae Elhaddaoui ◽

Fatima Zaoui

Keyword(s):

Systematic Review ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Transverse Dimension ◽

Cochrane Library ◽

Maxillary Expansion ◽

Case Control Studies ◽

Randomized Controlled Clinical Trials ◽

Significant Difference ◽

Healthy Side

Introduction: Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol. Materials and methods: Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies. Results: Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation. Conclusion: The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.

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Early experience of pump-controlled retrograde trial off for weaning from veno-arterial extracorporeal membrane oxygenation in adult patients with cardiogenic shock

Perfusion ◽

10.1177/0267659120941328 ◽

2020 ◽

pp. 026765912094132

Author(s):

Min Ho Ju ◽

Mi Hee Lim ◽

Soo Yong Lee ◽

Chee-Hoon Lee ◽

Hyung Gon Je

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Pediatric Patients ◽

Early Experience ◽

Adult Patients ◽

Invasive Procedures ◽

The Third ◽

Membrane Oxygenation ◽

Hospital Deaths ◽

Venovenous Extracorporeal Membrane Oxygenation

Introduction: Pump-controlled retrograde trial off has recently been introduced as an effective method for weaning from veno-arterial extracorporeal membrane oxygenation in pediatric patients. However, studies on pump-controlled retrograde trial off in adults are still lacking. Thus, this study aimed to examine the outcomes of pump-controlled retrograde trial off for weaning from veno-arterial extracorporeal membrane oxygenation in adult patients. Methods: Between January 2018 and July 2019, 87 consecutive adult patients underwent veno-arterial extracorporeal membrane oxygenation support, of whom 47 (54.0%) underwent pump-controlled retrograde trial off for weaning from extracorporeal membrane oxygenation and were enrolled in this study. The pump-controlled retrograde trial off results, extracorporeal membrane oxygenation reapplication rate, and clinical outcomes were analyzed. Results: Of the 47 patients, 38 (80.9%) were weaned from veno-arterial extracorporeal membrane oxygenation on the first attempt of pump-controlled retrograde trial off, 5 (10.6%) on the second attempt, and 4 (8.5%) on the third attempt. Three patients were converted to venovenous extracorporeal membrane oxygenation by desaturation but had stable blood pressure during pump-controlled retrograde trial off. No extracorporeal membrane oxygenation reapplication was performed within 3 days after removal, and two patients underwent veno-arterial extracorporeal membrane oxygenation during follow-up. No complications associated with pump-controlled retrograde trial off occurred during the weaning process, including thromboembolic events. Five in-hospital deaths (10.6%) occurred after weaning from extracorporeal membrane oxygenation. Conclusion: Pump-controlled retrograde trial off is an effective method to safely wean from veno-arterial extracorporeal membrane oxygenation in adult patients. It is simple and can be easily implemented without additional invasive procedures and may help prevent deterioration of the cardiovascular system after weaning from veno-arterial extracorporeal membrane oxygenation.

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