scholarly journals Buccal alveolar bone changes following rapid maxillary expansion and fixed appliance therapy

2020 ◽  
Author(s):  
Adam Sperl ◽  
Laurence Gaalaas ◽  
John Beyer ◽  
Thorsten Grünheid

ABSTRACT Objectives To assess factors that may be associated with buccal bone changes adjacent to maxillary first molars after rapid maxillary expansion (RME) and fixed appliance therapy. Materials and Methods Pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans were obtained from 45 patients treated with RME and preadjusted edgewise appliances. Buccal alveolar bone thickness was measured adjacent to the mesiobuccal root of the maxillary first molar 4 mm, 6 mm, and 8 mm apical to the cementoenamel junction, and anatomic defects were recorded. Paired and unpaired t-tests were used to compare alveolar bone thickness at T1 and T2 and to determine whether teeth with posttreatment anatomic defects had thinner initial bone. Correlation analyses were used to examine relationships between buccal alveolar bone thickness changes and amount of expansion, initial bone thickness, age at T1, postexpansion retention time, and treatment time. Results There was a statistically significant reduction in buccal alveolar bone thickness from T1 to T2. Approximately half (47.7%) of the teeth developed anatomic defects from T1 to T2. These teeth had significantly thinner buccal bone at T1. Reduction in alveolar bone thickness was correlated with only one tested variable: initial bone thickness. Conclusions RME and fixed-appliance therapy can be associated with significant reduction in buccal alveolar bone thickness and an increase in anatomic defects adjacent to the expander anchor teeth. Anchor teeth with greater initial buccal bone thickness have less reduction in buccal bone thickness and are less likely to develop posttreatment anatomic defects of buccal bone.

2019 ◽  
Vol 7 (1) ◽  
pp. 127-133
Author(s):  
Ahmed I. Abdul-Aziz ◽  
Wael M. Refai

BACKGROUND: Piezocision-assisted orthodontics (PAO) is considered one of the modern techniques aiming at reducing the treatment time and overcoming some limitations of orthodontic treatment. The use of piezocision as an adjunct in the treatment of posterior crossbite is limited, so additional research in this area is required. AIM: To three-dimensionally compare the skeletal and dental effects produced by piezocision-assisted rapid maxillary expansion (PARME) and conventional rapid maxillary expansion (RME) using cone beam computed tomography (CBCT). MATERIALS AND METHODS: This prospective controlled study comprised 14 consecutive non-syndromic patients with posterior crossbite. In 7 patients (mean age = 16.1 ± 0.3 years), PARME was used to correct the crossbite; whereas in the remaining 7 (mean age = 15.9 ± 0.5 years), RME was done. Cone beam computed tomography (CBCT) scans were performed before expansion (T1) and 3 months later after expansion (T2) to compare the skeletal and dental effects produced by the two expansion techniques. Transverse skeletal, dentolinear, and dentoangular variables at the level of maxillary first and second premolars and maxillary first molars were measured and compared within and between groups using the appropriate statistical test. RESULTS: For the transverse skeletal variables, PARME showed a non-significant increase; whereas, RME showed a significant increase. Regarding the dentolinear measurements, a significant increase in coronal widths and an insignificant increase in apical widths was seen in PARME, whereas, the RME showed a non-significant increase for both coronal and apical widths. Non-significant decreases (protrusion of teeth) in the dentoangular measurements were seen in both groups. Between-group comparisons showed a non-significant difference except for the dentolinear coronal widths. CONCLUSION: PARME is effective in treating posterior crossbite. Because of the more dental expansion produced by PARME as compared to the conventional RME, PARME should be limited only to mild or moderate not severe forms of palatal constriction. The available evidence regarding the effectiveness of corticotomy- and/or piezocision-assisted maxillary expansion for correction of posterior crossbite is limited and inadequate.


2018 ◽  
Vol 88 (3) ◽  
pp. 299-305 ◽  
Author(s):  
Yingdan Pan ◽  
Yunting Zeng ◽  
Zeyu Zhang ◽  
Yiqin Liu ◽  
Yi Jing ◽  
...  

ABSTRACT Objectives: To evaluate alveolar bone support around cleft-adjacent maxillary central incisors (U1) in patients with unilateral cleft lip, alveolus and palate (UCLAP) in the late mixed dentition and to investigate the correlation between the alveolar bone thickness (ABT) and tooth inclination. Materials and Methods: Cone beam computed tomography scans of 45 subjects with UCLAP (29 boys, 16 girls; mean age = 10.74 ± 1.08 years) were assessed. The distance between the cementoenamel junction (CEJ) and alveolar bone crest (AC), and the ABTs at 3 mm, 6 mm, and the apex were measured on the labial, lingual and distal surfaces of U1. The cleft and normal sides were compared using a paired t-test and Pearson's χ2 test. Pearson's correlation was used to explore the association between the ABT and tooth inclination of cleft-adjacent U1 in the labiolingual and mesiodistal dimensions. Results: The CEJ-AC distances were significantly greater in cleft-adjacent U1 (P < .01), with more bone height reduction observed labially and distally (P < .001). The labial, lingual, and apico-distal ABTs were decreased on the cleft side (P < .01). A positive correlation was found between the apico-labial ABT and the labiolingual inclination (r = 0.568, P < .01). Conclusions: Patients with UCLAP have reduced alveolar bone support around the cleft-adjacent U1, and the apico-labial ABT tends to decrease with increasing lingual tooth inclination; however, the correlation was weak.


2019 ◽  
Vol 89 (5) ◽  
pp. 705-712 ◽  
Author(s):  
Eyad B. Alomari ◽  
Kinda Sultan

ABSTRACT Objectives: To evaluate the effectiveness of platelet-rich plasma (PRP) with its growth factors in minimizing the side effects of rapid maxillary expansion (RME) on the periodontal tissue of anchoring teeth using cone-beam computed tomography (CBCT). Materials and Methods: A randomized, split-mouth clinical trial was conducted on 18 patients aged 12–16 years (14 ± 1.65) with a skeletal maxillary constriction who underwent RME using a Hyrax appliance. The sample was randomly divided into two groups: intervention and control sides. PRP was prepared and injected on the buccal aspect of supporting teeth in the intervention group. High-resolution CBCT imaging (H-CBCT) was carried out preoperatively (T0) and after 3 months of retention (T1) to study the buccal bone plate thickness (BBPT) and buccal bone crest level (BBCL) of anchoring teeth. Changes induced by expansion were evaluated using paired sample t-test (P < .05). Results: Results showed that there was no significant difference in BBPT and BBCL between the two groups after RME (P > .05). The prevalence of dehiscence and fenestrations was increased at (T1) in both groups and the percentage was higher in the PRP group. Conclusions: RME induced vertical and horizontal bone loss. PRP did not minimize alveolar defects after RME.


2021 ◽  
Vol 11 ◽  
pp. 32-40
Author(s):  
Mohamad Sarraj ◽  
Sercan Akyalcin ◽  
Hong He ◽  
Jun Xiang ◽  
Ghaddy AlSaty ◽  
...  

Objectives: The objectives of the study were to compare the skeletal, dentoalveolar, and periodontal changes between two types of microimplant-assisted rapid maxillary expansion appliances: The bone-anchored maxillary expanders (BAME) and the tooth-bone-anchored maxillary skeletal expander (MSE). Materials and Methods: Thirty-four patients with a transverse maxillary deficiency were divided into two groups; the first group (16 patients, average age 14.9 years) was treated with the MSE appliance, and the second group (18 patients, average age 13.8 years) was treated with the BAME appliance. Cone-beam computed tomography scans were taken at pre-treatment (T1) and immediately post-expansion (T2) to measure the changes in midpalatal suture opening, total expansion (TE), alveolar bone bending, dental tipping (DT), and buccal bone thickness. Data were analyzed using paired t-test and two-sample t-test. Results: Midpalatal suture separation was found in 100% of the patients in both groups. The TE at the first molar was 5.9 mm in the MSE group and 4.7 mm in the BAME group. The skeletal contributions were 56% and 83% of TE for the MSE and BAME groups, respectively. Significantly less dental buccal tipping and buccal bone loss were found with the BAME group. The midpalatal suture in both groups exhibited a parallel opening pattern in the axial plane. Conclusion: The use of BAME appliance resulted in greater skeletal effects, less dental tipping, and less buccal bone reduction compared to MSE appliance (immediately after maxillary expansion).


2012 ◽  
Vol 82 (3) ◽  
pp. 458-463 ◽  
Author(s):  
Annelise Nazareth Cunha Ribeiro ◽  
João Batista de Paiva ◽  
José Rino-Neto ◽  
Edson Illipronti-Filho ◽  
Tarcila Trivino ◽  
...  

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