DOI QR코드

DOI QR Code

Effect and stability of miniscrew-assisted rapid palatal expansion: A systematic review and meta-analysis

  • Huang, Xinyi (Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration) ;
  • Han, Yu (Department of Orthodontics, Hangzhou Dental Hospital) ;
  • Yang, Shuangyan (Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration)
  • Received : 2021.12.16
  • Accepted : 2022.03.25
  • Published : 2022.09.25

Abstract

Objective: This study aimed to systematically analyze the effect and stability of miniscrew-assisted rapid palatal expansion (MARPE) to provide a reference for the clinical treatment of patients with maxillary transverse deficiency (MTD). Methods: We searched PubMed, Science Direct, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Database for relevant studies published before February 18, 2021 and selected them according to the eligibility criteria. The Cochrane Handbook for Systematic Reviews (version 5.1.0) criteria were used for the quality assessment of randomized controlled trials, while the scoring protocol of the methodological index for non-randomized studies was used for non-randomized controlled trials. Statistical analysis was performed using the RevMan5.3 software. Results: All the included studies showed a relatively high success rate of expansion. The changes in both the intermolar and alveolar widths after MARPE were statistically significant. MARPE exhibited greater skeletal expansion effects than did conventional RPE. The midpalatal suture was opened in parallel after MARPE. A small amount of relapse was observed 1 year after expansion. MARPE caused tooth inclination and a decrease in alveolar height, but it was less significant than in conventional RPE. Conclusions: MARPE may be an effective treatment modality for patients with MTD. It causes great transverse skeletal expansion in late adolescence. In comparison to conventional RPE, MARPE has lower detrimental periodontal effects and has certain clinical advantages.

Keywords

Acknowledgement

This study was supported by the National Natural Science Foundation of China (Grant Nos. 81800926).

References

  1. Proffit WR, Fields HW Jr, Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg 1998;13:97-106.
  2. Angell EH. Treatment of irregularity of the permanent or adult teeth. Dental Cosmos 1860;1:540-4.
  3. Melsen B, Melsen F. The postnatal development of the palatomaxillary region studied on human autopsy material. Am J Orthod 1982;82:329-42. https://doi.org/10.1016/0002-9416(82)90467-5
  4. Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 1977;72:42-52. https://doi.org/10.1016/0002-9416(77)90123-3
  5. Cao Y, Zhou Y, Song Y, Vanarsdall RL Jr. Cephalometric study of slow maxillary expansion in adults. Am J Orthod Dentofacial Orthop 2009;136:348-54. Erratum in: Am J Orthod Dentofacial Orthop 2009;136:760.
  6. Betts NJ, Vanarsdall RL, Barber HD, Higgins-Barber K, Fonseca RJ. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg 1995;10:75-96.
  7. Cureton SL, Cuenin M. Surgically assisted rapid palatal expansion: orthodontic preparation for clinical success. Am J Orthod Dentofacial Orthop 1999;116:46-59. https://doi.org/10.1016/S0889-5406(99)70302-1
  8. Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod 2016;86:713-20. https://doi.org/10.2319/101415-689.1
  9. Lee SR, Lee JW, Chung DH, Lee SM. Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: a threedimensional stereophotogrammetry study. Korean J Orthod 2020;50:75-85. https://doi.org/10.4041/kjod.2020.50.2.75
  10. Lim HM, Park YC, Lee KJ, Kim KH, Choi YJ. Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion. Korean J Orthod 2017;47:313-22. https://doi.org/10.4041/kjod.2017.47.5.313
  11. Oliveira CB, Ayub P, Angelieri F, Murata WH, Suzuki SS, Ravelli DB, et al. Evaluation of factors related to the success of miniscrew-assisted rapid palatal expansion. Angle Orthod 2021;91:187-94. https://doi.org/10.2319/051420-436.1
  12. Park JJ, Park YC, Lee KJ, Cha JY, Tahk JH, Choi YJ. Skeletal and dentoalveolar changes after miniscrewassisted rapid palatal expansion in young adults: a cone-beam computed tomography study. Korean J Orthod 2017;47:77-86. https://doi.org/10.4041/kjod.2017.47.2.77
  13. Jia H, Zhuang L, Zhang N, Bian Y, Li S. Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage. Angle Orthod 2021;91:36-45. https://doi.org/10.2319/041920-332.1
  14. Ngan P, Nguyen UK, Nguyen T, Tremont T, Martin C. Skeletal, dentoalveolar, and periodontal changes of skeletally matured patients with maxillary deficiency treated with microimplant-assisted rapid palatal expansion appliances: a pilot study. APOS Trends Orthod 2018;8:71-85. https://doi.org/10.4103/apos.apos_27_18
  15. Yilmaz A, Arman-Ozcirpici A, Erken S, Polat-Ozsoy O. Comparison of short-term effects of mini-implantsupported maxillary expansion appliance with two conventional expansion protocols. Eur J Orthod 2015;37:556-64. https://doi.org/10.1093/ejo/cju094
  16. Cantarella D, Dominguez-Mompell R, Mallya SM, Moschik C, Pan HC, Miller J, et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging. Prog Orthod 2017;18:34.
  17. Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod 2015;85:253-62. https://doi.org/10.2319/030514-156.1
  18. Lagravere MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2010;137:304.e1-12; discussion 304-5. https://doi.org/10.1016/j.ajodo.2009.10.004
  19. Akin M, Akgul YE, Ileri Z, Basciftci FA. Three-dimensional evaluation of hybrid expander appliances: a pilot study. Angle Orthod 2016;86:81-6. https://doi.org/10.2319/121214-902.1
  20. Celenk-Koca T, Erdinc AE, Hazar S, Harris L, English JD, Akyalcin S. Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: a prospective randomized clinical trial. Angle Orthod 2018;88:702-9. https://doi.org/10.2319/011518-42.1
  21. Stuart DA, Wiltshire WA. Rapid palatal expansion in the young adult: time for a paradigm shift? J Can Dent Assoc 2003;69:374-7.
  22. Bishara SE, Staley RN. Maxillary expansion: clinical implications. Am J Orthod Dentofacial Orthop 1987;91:3-14. https://doi.org/10.1016/0889-5406(87)90202-2
  23. Cohen MM Jr. Sutural biology and the correlates of craniosynostosis. Am J Med Genet 1993;47:581-616. https://doi.org/10.1002/ajmg.1320470507
  24. Handelman CS, Wang L, BeGole EA, Haas AJ. Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander. Angle Orthod 2000;70:129-44.
  25. Braun S, Bottrel JA, Lee KG, Lunazzi JJ, Legan HL. The biomechanics of rapid maxillary sutural expansion. Am J Orthod Dentofacial Orthop 2000;118: 257-61. https://doi.org/10.1067/mod.2000.108254
  26. Gauthier C, Voyer R, Paquette M, Rompre P, Papadakis A. Periodontal effects of surgically assisted rapid palatal expansion evaluated clinically and with cone-beam computerized tomography: 6-month preliminary results. Am J Orthod Dentofacial Orthop 2011;139(4 Suppl):S117-28. https://doi.org/10.1016/j.ajodo.2010.06.022
  27. Kanzaki R, Daimaruya T, Takahashi I, Mitani H, Sugawara J. Remodeling of alveolar bone crest after molar intrusion with skeletal anchorage system in dogs. Am J Orthod Dentofacial Orthop 2007;131:343-51. https://doi.org/10.1016/j.ajodo.2006.04.025
  28. Storey E. Tissue response to the movement of bones. Am J Orthod 1973;64:229-47. https://doi.org/10.1016/0002-9416(73)90017-1
  29. Hou B, Fukai N, Olsen BR. Mechanical force-induced midpalatal suture remodeling in mice. Bone 2007;40:1483-93. https://doi.org/10.1016/j.bone.2007.01.019
  30. Ma J, Wu Y, Zhang W, Smales RJ, Huang Y, Pan Y, et al. Up-regulation of multiple proteins and biological processes during maxillary expansion in rats. BMC Musculoskelet Disord 2008;9:37.
  31. Garib DG, Henriques JF, Janson G, Freitas MR, Coelho RA. Rapid maxillary expansion--tooth tissueborne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects. Angle Orthod 2005;75:548-57.
  32. Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with conebeam computed tomography. Am J Orthod Dentofacial Orthop 2008;134:8-9. https://doi.org/10.1016/j.ajodo.2008.06.004
  33. Lione R, Ballanti F, Franchi L, Baccetti T, Cozza P. Treatment and posttreatment skeletal effects of rapid maxillary expansion studied with low-dose computed tomography in growing subjects. Am J Orthod Dentofacial Orthop 2008;134:389-92. https://doi.org/10.1016/j.ajodo.2008.05.011
  34. Weissheimer A, de Menezes LM, Mezomo M, Dias DM, de Lima EM, Rizzatto SM. Immediate effects of rapid maxillary expansion with Haas-type and hyrax-type expanders: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2011;140:366-76. https://doi.org/10.1016/j.ajodo.2010.07.025
  35. Seong EH, Choi SH, Kim HJ, Yu HS, Park YC, Lee KJ. Evaluation of the effects of miniscrew incorporation in palatal expanders for young adults using finite element analysis. Korean J Orthod 2018;48:81-9. https://doi.org/10.4041/kjod.2018.48.2.81
  36. Koo YJ, Choi SH, Keum BT, Yu HS, Hwang CJ, Melsen B, et al. Maxillomandibular arch width differences at estimated centers of resistance: comparison between normal occlusion and skeletal Class III malocclusion. Korean J Orthod 2017;47:167-75. https://doi.org/10.4041/kjod.2017.47.3.167
  37. Thilander B, Nyman S, Karring T, Magnusson I. Bone regeneration in alveolar bone dehiscences related to orthodontic tooth movements. Eur J Orthod 1983;5:105-14. https://doi.org/10.1093/ejo/5.2.105
  38. Tian YL, Liu F, Sun HJ, Lv P, Cao YM, Yu M, et al. Alveolar bone thickness around maxillary central incisors of different inclination assessed with conebeam computed tomography. Korean J Orthod 2015;45:245-52. https://doi.org/10.4041/kjod.2015.45.5.245
  39. Garib DG, Henriques JF, Janson G, de Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofacial Orthop 2006;129:749-58. https://doi.org/10.1016/j.ajodo.2006.02.021
  40. Rungcharassaeng K, Caruso JM, Kan JY, Kim J, Taylor G. Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2007;132:428.e1-8.