Effects of rapid maxillary expansion in cleft patients resulting from the use of two different expanders

Abstract

Objective:The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. Methods:Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). Results:In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p < 0.05) and no significant forward and/or downward movement of the maxilla (p > 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p < 0.05). Cleft and non-cleft sides were symmetrically expanded and there was no difference in dental tipping between both sides (p > 0.05). Conclusions:The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one.

Interdisciplinary treatment approaches for cleft lip and palate patients to obtain esthetic and functional results

“…When the prosthetic treatment is well planned and prepared, ideal oral and dental hygiene can be achieved without causing any damage in teeth and periodontal structures. The results not only enhance the esthetics, but can also be instrumental in the psychological and social acceptance of the cleft palate patients (Murray, 2002;Haque and Alam, 2015;Rygh and Tindlund, 1982;Camporesi et al, 2010;Figueiredo et al, 2016;Moore and Mc Cord, 2004).…”

“…Conducting multidisciplinary approach on such patients is important to obtain better effective therapeutic result as their problems can be responded in better fashion. There is a consensus that understanding of the requirements and specialist skills of the other team members is necessary so that all members within the team can work coordinately which leads to improving outcomes (Camporesi et al, 2010;Figueiredo et al, 2016;Papi et al, 2015;Krieger et al, 2009).…”

Rapid Arch Expansion in Cleft Lip and Palate Children: Comparison Between Fan-Shaped Expander and Hyrax-Type Expander by Using Cone Beam Computed Tomography

“…However, both American and European guidelines for CBCT rationalize its usage in orthodontic research with clinical benefit to individuals with CLP as one of the indications. (21,26,27) Skeletal correction of the transverse maxillary constriction was achieved by both appliances. However, amount of posterior expansion at the level of the basal bone and the alveolar bone were more in the maxillae expanded by the Hyrax.…”

Cleft Lip and Palate Management from Birth to Adulthood: An Overview

“…If maxillary segments and dentition on either side of the cleft are well aligned, it is not necessary to do presurgical orthodontics [45]. Thus, orthodontic treatment is not generally commenced until age 9 or 10 years when, if necessary, the maxillary segments are expanded to correct the transverse relationship using palatal expansion appliances, these include upper removable appliance, quad helix (Figure 12), rapid maxillary expansion, bonded "fan" appliance (Figure 13), and others [46,47].…”