Objective: Cone-beam computed tomography (CBCT) is a reliable method of assessing the oral cavity and upper airways. We conducted this study to examine the changes introduced by rapid maxillary expansion in the nasal cavity, nasopharynx, and oropharynx as seen with images obtained by CBCT. Materials and Methods: We evaluated 15 patients with maxillary width deficiency treated with RME. Patients were subjected to CBCT at the beginning of RME and after the retention period of 4 months. Results: The nasal cavity presented a significant transverse increase in the lower third, in the anterior (1.08 mm 6 0.15), medium (1.28 mm 6 0.15), and posterior regions (0.77 mm 6 0.12). No significant change occurred in the nasopharynx in volume (P 5 .11), median sagittal area (P 5 .33), or lower axial area (P 5 .29) resulting from the RME. A significant change was noted in the oropharynx in volume (P 5 .05), median sagittal area (P 5 .01), and lower axial area (P 5 .04) before and immediately after the RME. Conclusions: RME is able to increase the transverse width of the nasal cavity, but it does not have the same effect in the nasopharynx. Changes noted in the oropharynx may be due to the lack of a standardized position of the head and tongue at the time of image acquisition. (Angle Orthod. 2012;82:458-463.)
Background
The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. The aim of this study was to evaluate the treatment of class III patients with maxillary retrusion, using orthodontic mini-implants (MI) associated with intermaxillary elastics in comparison with the rapid maxillary expansion and facemask protocol (RME/FM).
Methods
In this prospective non-randomized clinical trial, the sample of 24 participants between 7 and 12 years of age (median age of 10.0 years and interquartile range = 3.0 years), at the stage prior to the pre-pubertal growth spurt, was divided in two groups. In group facemask (FM) (
n
= 12), the individuals received orthopedic treatment with RME/FM. In group MI (
n
= 12), two mini-implants were inserted in the region close to the maxillary first molar roots, and the other two in the region of the mandibular canines. Initial and final lateral teleradiographs were taken for cephalometric evaluation of all the cases. Statistical analysis included the Mann-Whitney, Wilcoxon, and Fisher’s exact tests. The level of significance was 5% (α = 0.05).
Results
Improvement was verified in the facial profile and occlusion of the participants, showing advancement of the maxilla in the two groups, with significant differences (
P
≤ 0.05) between T0 and T1 in the following measurements: SNA, ANB, Wits, Co-A, Co-Gn, NAP, A-Npog, overjet, and molar relationship. There was no statistically significant intergroup difference (
P
> 0.05) in the cephalometric measurements evaluated, but the time of treatment was significant, and was faster for group MI.
Conclusions
The protocol with mini-implants may be an option for the correction of Class III due to maxillary deficiency.
Objectives: This review aimed at evaluating changes in alveolar bone thickness after completion of orthodontic treatment. Methods: Only prospective clinical studies that reported bone thickness in adult patients undergoing non-surgical orthodontic treatment were considered eligible. MEDLINE, EMBASE and LILACS databases were searched for articles published up to July 2018. Results: A total of 12 studies met the selected criteria. Most of the studies showed that orthodontic treatment produces a reduction in bone thickness of incisors, mainly at the palatal side. Conclusion: On patients undergoing different orthodontic treatment techniques, there was a significant bone thickness reduction, mainly on the palatal side. Clinical relevance: These findings are relevant and have to be considered in diagnosis and planning of tooth movement, in order to prevent the occurrence of dehiscence and fenestration in alveolar bone.
The four custom base-cleaning methods presented the same efficiencies on indirect bond of the brackets; thus, practitioners can choose the method that works best for them.
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