Comparison of the treatment effects of different rapid maxillary expansion devices on the maxilla and the mandible. Part 1: Evaluation of dentoalveolar changes

Canan, Selin; Şenışık, Neslihan Ebru

doi:10.1016/j.ajodo.2016.11.022

Cited by 51 publications

(60 citation statements)

References 26 publications

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“…This might be attributed to the fact that the hybrid RME appliance was anchored on the first molars, but not the first premolars. When analyzing dental tipping after RME, it is important to bear in mind the pyramid- or triangle-shaped opening of the suture due to the two centers of rotation, which leads to bending of the alveolar bone and subsequent tipping of the teeth [18, 31]. Therefore, there are some indications that tipping of the anchorage teeth might be influenced by anchorage type, although further evidence is needed to consolidate these.…”

Section: Discussionmentioning

confidence: 99%

Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis

2019

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Background The aim of the current systematic review was to compare the clinical effects of bone-borne or hybrid tooth-bone-borne rapid maxillary expansion (RME) with conventional tooth-borne RME in the treatment of maxillary deficiency. Methods Nine databases were searched up to September 2018 for randomized clinical trials comparing bone-borne or hybrid tooth-bone-borne RME to conventional tooth-borne RME in patients of any age or sex. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. Results A total of 12 papers on 6 unique trials with 264 patients (42.4% male; average age 12.3 years) were finally included. Limited evidence indicated that bone-borne RME was associated with greater suture opening at the first molar post-retention (1 trial; MD 2.0 mm; 95% CI 1.4 to 2.6 mm; moderate evidence quality) compared to tooth-borne RME, while no significant differences could be found regarding tooth inclination, nasal cavity width, and root resorption (very low to low evidence quality). Hybrid tooth-bone-borne RME was associated with less buccal tipping of the first premolar (2 trials; MD − 4.0°; 95% CI − 0.9 to − 7.1°; moderate evidence quality) and lower nasal airway resistance post-retention (1 trial; MD − 0.2 Pa s/cm 3 ; 95% CI − 0.4 to 0 Pa s/cm 3 ; moderate evidence quality) compared to tooth-borne RME, while no significant difference could be found regarding skeletal maxillary width, molar inclination, and analgesic use (low to moderate evidence quality). The main limitations affecting the validity of the present findings were (a) imprecision due to the inclusion of few trials with limited sample sizes that precluded robust detection of existing differences and (b) methodological issues of the included trials that could lead to bias. Conclusions Limited evidence from randomized trials indicates that bone-borne or hybrid tooth-bone-borne RME might present advantages in terms of increased sutural opening, reduced tooth tipping, and lower nasal airway resistance compared to conventional tooth-borne RME. However, the limited number of existing studies and issues in their conduct or reporting preclude the drawing of definite conclusions. Review registration PROSPERO ( CRD42017079107 ). Electronic supplementary material The online version of this article (10.1186/s40510-019-0261-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis

2019

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“…Although hybrid and bone-borne expanders were initially described more than a decade ago (22,40), remarkably limited research has been carried out to compare both designs, and often the results were not in accord. The search through literature yielded three studies that compared the two designs; two were retrospective studies that used cone-beam computed tomography (CBCT) for comparison (28,29), and one was an RCT that employed digital dental casts (36). Ultimately, only the RCT by Canan and Senişik (36) was included in the current systematic review.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…The search through literature yielded three studies that compared the two designs; two were retrospective studies that used cone-beam computed tomography (CBCT) for comparison (28,29), and one was an RCT that employed digital dental casts (36). Ultimately, only the RCT by Canan and Senişik (36) was included in the current systematic review. Since only one study was found to conform to the eligibility criteria, only a narrative synthesis was performed.…”

Section: Summary Of Evidencementioning

confidence: 99%

Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review

et al. 2021

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The aim of this review was to evaluate the current evidence regarding post-treatment effects of tooth-bone-borne vs. bone-borne expanders. A search was conducted in MEDLINE via PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, and Open Gray; in addition to a hand search in reference lists of selected articles and creating a search alert in electronic databases. Selection criteria included randomized and prospective clinical trials comparing post-expansion skeletal and/or dento-alveolar effects of tooth-bone-borne expanders to those of bone-borne expanders. Following study retrieval and selection, relevant data was extracted, and risk of bias was assessed using the revised RoB 2 tool for randomized clinical trials. After examining 10 full text articles, one randomized clinical trial was finally included. The study compared the dento-alveolar effects of tooth-bone-borne and bone-borne expanders, following expansion and after 6 months, using digital dental casts. Using the RoB 2 tool, the study was judged overall to show some concerns. A definitive conclusion could not be drawn from this systematic review due to the scarcity of clinical trials tackling the research question. A need for future well-conducted research was highlighted in this review.

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“…After many years studying the effects of tooth- versus bone-borne devices, results are still controversial. In growing patients, separation of the mid-palatal suture has proven effective with both devices, and neither group has shown statistically significant dentoalveolar bone changes [ 7 – 9 ]. These results have brought to light the need for other criteria to justify the use of bone-borne maxillary expanders in early adolescents, such as: the size of the device for better comfort, fewer anatomical structures supporting the device (teeth, palate, number of miniscrews, etc.)…”

Section: Introductionmentioning

confidence: 99%

CBCT and CAD-CAM technology to design a minimally invasive maxillary expander

2020

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Background A large number of articles in recent years studying the effects of non-surgically assisted tooth- versus bone-borne maxillary expanders in growing patients have found no significant differences in mid-palatal suture disjunction or even dentoalveolar changes. This suggests the need for new criteria and better use of current technology to make more effective devices and enhance the benefits of conventional treatments. This article describes a titanium grade V computer-aided design/computer-aided manufacturing (CAD/CAM) maxillary expander supported by two miniscrews, along with a 3D printed surgical guide. Methods The first step was to obtain a digitized model of the patient’s upper maxilla. To simplify the process and ensure the placement of the device in a high-quality bone area, the patients’ digital dental cast was superimposed with a cone beam computed tomography (CBCT) scan. Improved resistance to expansion forces was secured through the use of 2 mm-wide miniscrews, long enough for bicortical anchorage. Placement site and direction were assessed individually in order to achieve primary stability. We chose a site between the second premolars and first molars, while the inclination followed the natural contour of the palate vault. A 3D-printed, polyamide surgical guide was designed to ensure the correct placement of the device with a manual straight driver. Results Favorable clinical results were presented with 3D images. We confirmed a mid-palatal suture parallel separation of 3.63 mm, along with a higher palatal volume, as well as increased intercanine and intermolar distance. Segmentation of the facial soft tissue showed an expansion of nasal airways and changes in nasal morphology. Conclusions Digital models, CBCT and CAD/CAM technology, are essential to accomplish the goals proposed in this article. Further studies are necessary to establish safer miniscrew placement sites and insertion angles so as to achieve greater in-treatment stability. Both the clinician and the patient can benefit from the use of current technology, creating new devices and updating traditional orthodontic procedures.

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Comparison of the treatment effects of different rapid maxillary expansion devices on the maxilla and the mandible. Part 1: Evaluation of dentoalveolar changes

Cited by 51 publications

References 26 publications

Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis

Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis

Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review

CBCT and CAD-CAM technology to design a minimally invasive maxillary expander

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