Skeletal and Alveolar Changes in Conventional Rapid Palatal Expansion (RPE) and Miniscrew-assisted RPE(MARPE): a Prospective Randomized Clinical Trial Using Low-dose CBCT

Background: This prospective randomized clinical trial aimed to evaluate the short-term effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) on skeletal, dentoalveolar, and periodontal structures in adolescent and young adult patients. Methods: Thirty-six patients (12 men and 24 women) requiring maxillary expansion were randomly allocated to RPE (n=17) or MARPE (n=19) groups. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). Skeletal, dentoalveolar, and periodontal measurements were performed at each time point. Results: A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after expansion (T1-T0) and consolidation periods (T2-T0) in MARPE group (P<0.05). MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW) (P<0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT) (P<0.05).Conclusions: Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. This evidence can help clinicians decide the appliance design for maxillary expansion, while preventing periodontal side effects, such as buccal bone dehiscence Trial registration: WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration Date 27/12/2021)

The value of computer aided detection system for mammography in the fatty breast: the results of the single-centered, prospective, randomized clinical trial

Aim. To assess the reasonability to use CAD added to mammography with subsequent targeted ultrasound (US) of CAD markings in patients with low-density (ACR A-В) breasts.Materials and methods. In the prospective study we included 2326 women with low breast density. They were randomized for CAD (MammCheck II of our own design) checking with subsequent targeted US (MMG + CAD group) or without CAD (MMG only group). After the initial screening we performed the 3-year follow-up phase.Results. Totally, during the primary screening in the MMG only group we found 77 breast cancers (BCs) (28,57% of them sized less than 1 cm), in the MMG + CAD group – 69 BCs (36,23% of them sized less than 1 cm), р > 0.05. The suspicious lesion was identified only during the targeted US of the CAD marking in 4 of 25 women in the MMG + CAD group, and all these BCs were below 1 cm in size. During the subsequent follow-up in the MMG only group we found 5 additional BCs, with no such cases in the MMG + CAD group (p < 0.05). Three of these five BCs were retrospectively marked by CAD. The only visible BC that was not marked by CAD was 3 mm in size.Discussion. The overall false positive marking rate was 0.31 и 0.28 per film-screen and digital image, respectively (р > 0.05).Conclusion. The CAD usage added to mammography with subsequent targeted US of markings in patients with low-density (ACR A-В) breast is reasonable due to the significant decrease of the BC rate diagnosed during the 3-year follow-up. This combination detected 77 of the 77 (100.00%) BCs compared to 69 of 74 (93.24%) BCs when only mammography used.