• Title/Summary/Keyword: Rapid maxillary expansion

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Evaluation of Midpalatal Suture Maturation using Cone-Beam Computed Tomography in Children and Adolescents (CBCT를 이용한 소아청소년의 정중구개봉합 성숙도 평가)

  • Lee, Yeonju;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.2
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    • pp.139-146
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    • 2019
  • This study aimed to analyze the association of midpalatal suture (MPS) maturation stages with skeletal maturation and age and to obtain references for establishing a treatment plan for rapid maxillary expansion (RME). Cone-Beam Computed Tomography (CBCT) images from 480 children (240 boys, 240 girls) aged 7 - 15 years were obtained. MPS maturation stages and cervical vertebral maturation indicator (CVMI) were evaluated, and the correlations between MPS maturation stages, CVMI, and age were determined using the Spearman's correlation test. The positive likelihood ratio (LHR) of CVMI for MPS maturation stages was calculated. MPS maturation stages and CVMI showed a strong correlation. Especially, CVMI 1 - 3 showed positive LHR greater than 10 for the diagnosis of stages A - C. MPS maturation stages and age were correlated strongly in girls and moderately in boys. Conventional RME produces the most favorable skeletal effect at CVMI 1 - 3 or those up to 12 years of age and fewer skeletal effects at CVMI 4 or at 13 years of age in girls and 13 - 15 years in boys. It is recommended to evaluate MPS maturation stages using CBCT before RME application at CVMI 5, 6 or at 14, 15 years of age in girls.

Preliminary study of Korean orthodontic residents' current concepts and knowledge of cleft lip and palate management

  • Cho, Il-Sik;Shin, Hyo-Keun;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.42 no.3
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    • pp.100-109
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    • 2012
  • Objective: A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. Methods: A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. Results: All of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO. Conclusions: These findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.

Effectiveness of low-level laser therapy in facilitating maxillary expansion using bone-borne hyrax expander: A randomized clinical trial

  • Abdelwassie, Sara Hassan;Kaddah, Mohammed Amgad;El-Dakroury, Amr Emad;El-Boghdady, Dalia;Abd El-Ghafour, Mohamed;Seifeldin, Nouran Fouad
    • The korean journal of orthodontics
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    • v.52 no.6
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    • pp.399-411
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    • 2022
  • Objective: The objective of this randomized clinical trial was to study the skeletal and dental effects of low-level laser therapy (LLLT) along with a miniscrew-assisted expander (Hyrax) after six months of retention. Methods: After sequence generation, concealed allocation, and implementation, 24 female patients were randomly divided (1:1) into two-groups: bone-borne rapid palatal expansion (BBE) without LLLT (n = 12) and BBE with LLLT (n = 12). Eligibility criteria included female patients aged 10-13 years old with bilateral posterior crossbites. Intraoral and extraoral photographs, cone-beam computed tomography images, and digital study models were obtained before expansion and six months after retention. The 7 mm Hyrax appliance was anchored to four palatal mini-screws, which were activated twice daily for 15 days, then locked and kept in place as a retainer. LLLT was performed in the laser group during expansion and retention, according to the guidelines provided. Results: The records of 24 patients were analyzed. According to the post-retention measurements, both groups showed a significant increase in nasal and maxillary widths and total facial height. In the laser group, the Sella-Nasion-Point A and Point A-Nasion-Point B angles and the interpremolar apical distance were significantly increased. Conclusions: Within the limitations of this study, the results suggest that the parameters and protocol of LLLT do not clinically affect the efficiency of BBE in prepubertal and pubertal patients.

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

  • Huang, Xinyi;Han, Yu;Yang, Shuangyan
    • The korean journal of orthodontics
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    • v.52 no.5
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    • pp.334-344
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    • 2022
  • 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.

A case report of Angle's Class 3 malocclusion (Angle씨 제3급 부정교합의 치험예)

  • Baik, Hyoung-Soon;Hwang, Chung-Ju
    • The Journal of the Korean dental association
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    • v.23 no.7 s.194
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    • pp.625-630
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    • 1985
  • 11 years 7 months old female had a reverse object of anterior teeth and class III molar relationship. Maxillary right and left canines were erupted labially and lower left lateral incisor was congenitally missed. She was treated by rapid palatal expansion and full band technique with extraction of maxillary and mandibular second molars. The following results were obtained. 1. Maxilary arch was expanded. 2. Anterior cross-bite and crowding was corrected. 3. Molar relationship was corrected. 4. Profile was somewhat improved.

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Correction of late adolescent skeletal Class III using the Alt-RAMEC protocol and skeletal anchorage

  • Muhammed Hilmi Buyukcavus;Omer Faruk Sari;Yavuz Findik
    • The korean journal of orthodontics
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    • v.53 no.1
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    • pp.54-64
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    • 2023
  • This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (AltRAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

Maxillary protraction using customized mini-plates for anchorage in an adolescent girl with skeletal Class III malocclusion

  • Liang, Shuran;Xie, Xianju;Wang, Fan;Chang, Qiao;Wang, Hongmei;Bai, Yuxing
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.346-355
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    • 2020
  • The treatment of skeletal Class III malocclusion in adolescents is challenging. Maxillary protraction, particularly that using bone anchorage, has been proven to be an effective method for the stimulation of maxillary growth. However, the conventional procedure, which involves the surgical implantation of mini-plates, is traumatic and associated with a high risk. Three-dimensional (3D) digital technology offers the possibility of individualized treatment. Customized mini-plates can be designed according to the shape of the maxillary surface and the positions of the roots on cone-beam computed tomography scans; this reduces both the surgical risk and patient trauma. Here we report a case involving a 12-year-old adolescent girl with skeletal Class III malocclusion and midface deficiency that was treated in two phases. In phase 1, rapid maxillary expansion and protraction were performed using 3D-printed mini-plates for anchorage. The mini-plates exhibited better adaptation to the bone contour, and titanium screw implantation was safer because of the customized design. The orthopedic force applied to each mini-plate was approximately 400-500 g, and the plates remained stable during the maxillary protraction process, which exhibited efficacious orthopedic effects and significantly improved the facial profile and esthetics. In phase 2, fixed appliances were used for alignment and leveling of the maxillary and mandibular dentitions. The complete two-phase treatment lasted for 24 months. After 48 months of retention, the treatment outcomes remained stable.

Change of arch dimension using two different expansion modalities in adults-MARPE and continuous archwire: a pilot study (임상가를 위한 특집 4 - 성인에서 미니스크류 보강형 비수술적 구개확장장치와 연속호선에 의한 악궁확장 효과 비교)

  • Koo, Yun-Jin;Choi, Tae-Hyun;Jang, Ji-Sung;Lee, Kee-Joon
    • The Journal of the Korean dental association
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    • v.51 no.6
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    • pp.330-336
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    • 2013
  • Considering the high prevalence, transverse control in adult patients presenting relatively narrow maxillary width is a challenging issue. This study compared the pattern of arch expansion induced by either miniscrew-assisted rapid palatal expander (MARPE) or continuous archwire engaged on self-ligating brackets. Age-matched adults groups(N=15 each) were treated with respective appliance. In both groups, all intercanine, interpremolar, and intermolar widths increased, and significantly greater change was noted in the intermolar region. Buccal tipping was minimal in both groups. Subsequent arch length increase, lingual tipping of incisors and distal tipping of molars were also found in both groups. According to the results, it can be concluded that the MARPE induced generally more arch expansion, particularly in the intermolar width, indicating that the adults showing buccal crossbite of the molars may have to undergo expansion via MARPE prior to arch alignment using continuous archwire.

TREATMENT OF TRANSVERSE DEFICIENCY WITH SURGICALLY ASSISTED RAPID PALATAL EXPANSION IN AN OPEN BITE PATIENT SHOWING PSEUDOMACROGLOSSIA (상대적 거대설을 보이는 전치부 개방교합 환자의 외과적 급속 구개확장술을 통한 횡적 부조화의 치험례)

  • Kim, Yoon-Ji;Lee, Kyu-Hong;Park, Jun-Woo;Rhee, Gun-Joo;Cho, Hyung-Jun;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.376-382
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    • 2008
  • Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and Quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.

The effects of nasal breathing due to pediatric allergic rhinitis on dentofacial growth and its dental considerations (소아 알레르기 비염으로 인한 구호흡이 악안면 성장에 미치는 영향과 이에 대한 치과적 고려사항)

  • Ong, Seung-Hwan;Yoo, Seung-Hoon
    • The Journal of the Korean dental association
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    • v.58 no.9
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    • pp.546-555
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    • 2020
  • Allergic rhinitis is a specific IgE mediated inflammatory disease of the nasal mucosa, characterized by symptoms such as rhinorrhea, nasal congestion, nasal obstruction, nasal and eye itching, and sneezing. The prevalence of allergic rhinitis varies according to country, age, and surveying methods, but it seems to increase worldwide, also in Korea. Prolonged mouth breathing caused by allergic rhinitis can produce muscular and postural alterations, causing alterations on the morphology, position, growth direction of the jaws, and malocclusion. Also, mouth breathing leads to dryness of the mouth, causing various oral diseases; gingivitis, halitosis, inflammation of tonsil, increased risk of dental caries and dental erosion. In dental clinic, using rapid maxillary expansion to persistent allergic rhinitis patients with narrow maxilla can enlarge maxillary dental arch and nasal cavity anatomy, improving nasal breathing and reducing nasal cavity resistance. However, it is desirable to use along with otolaryngologic treatment. Dentists should be aware of the characteristics of allergic rhinitis and its effects on patients, and consider when planning dental treatment.

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