Cephalometric evaluation of rapid and slow maxillary expansion in patients with BCLP: Secondary data analysis from a randomized clinical trial

Abstract

Objective: To compare the dentoskeletal effects of rapid (RME) and slow (SME) maxillary expansion in patients with bilateral complete cleft lip and palate (BCLP). Materials and Methods: This was a secondary analysis of a previous randomized controlled trial (RCT). Forty-six patients (34 male, 12 female) with BCLP and posterior crossbite (mean age of 9.2 years) were randomly assigned to two study groups. Group RME comprised subjects treated with Haas/Hyrax expander. Group SME included patients treated with quad-helix appliance. Cone-beam computed tomography (CBCT) was performed before expansion (T1) and after appliance removal at the end of a 6-month retention period (T2) for a previous RCT that compared the transverse skeletal effects of RME and SME. CBCT-derived cephalometric images were generated and cephalometric analysis was performed using Dolphin Imaging Software (Chatsworth, Calif). Intergroup comparisons were performed using t tests (P < .05). Results: Baseline forms were similar between groups. No significant differences between RME and SME groups were found. Conclusions: Rapid and slow maxillary expansion produced similar sagittal and vertical changes in patients with BCLP. Both Haas/Hyrax and quad-helix appliances can be used in patients with vertical facial pattern. Clinical relevance: RME and SME can be equally indicated in the treatment of maxillary arch constriction in patients with BCLP.

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

“…In the case reported here, the Haas-type expander was selected due to its maximum anchorage that provided stable expansion. 15,16 In addition, apart from the type of expander, the biochemical reaction to expansion includes the cardinal signs and symptoms of inflammation, such as swelling and pain, 17 as verified in the present study. However, the presence of the acrylic part may lead to ischemia with the formation of necrotic lesions followed by pain, the ulceration of palatal mucosa and excessive bleeding.…”

Effect of Maxillary Expansion on the Maxillary Arch Width in Patients with Bilateral Cleft Palate: A Review

“…When patients began their orthodontic treatment before the age of six, they demonstrated a better response in anterior maxillary expansion [24], which resulted in a significant improvement in the dental arch relationship. The clinical findings imply that maxillary expansion using the Quad Helix appliance is an acceptable alternative to conventional rapid maxillary expansion appliances among cleft patients [25][26][27][28][29]. This conclusion is based on the fact that the appliance is able to expand the maxilla more effectively.…”

“…This was reported after the active expansion phase had been completed. RME and SME might have similar effects on vertical and sagittal alterations in children with bilateral cleft lip and palate (BCLP), according to the findings of a secondary analysis carried out by the same research group [29].…”

Assessment of early dental arch growth modification with removable maxillary expansion by cone-beam computed tomography and lateral cephalometric radiographs: a retrospective study

“…A decrease in angle ANB and an increase in Ptm-A were found after treatment in this study. Previous studies had shown that maxillary expansion might cause the extrusion of the palatal cusps of the posterior teeth, resulting in the clockwise rotation of the mandible and the increase of the mandibular plane angle, SNB angle, and the ANB angle [ 37 , 38 ]. However, the results of this study showed that the ANB angle statistically decreased by an average of 0.5° after treatment.…”