Dental root development associated with treatments by rapid maxillary expansion/reverse headgear and slow maxillary expansion

Abstract

Summary Objectives To assess dental root development in two groups of paediatric patients who received treatments with reverse headgear and rapid maxillary expansion and slow maxillary dental arch expansion. Materials and methods The 20 subjects (13 girls, 7 boys; mean age: 8.9 ± 1.3 years) in the first group were treated with a Petit-type reverse headgear attached to a full-coverage bonded rapid maxillary expander via elastics (RME&RHg group). The 20 subjects included in the second group (9 girls, 11 boys; mean age: 9.1 ± 2.2 years) were selected among patients who were treated with Hawley appliances for slow maxillary expansion (SME group). Digitized panoramic radiographs were used. A total of 960 permanent teeth (maxillary–mandibular incisors, canines, premolars, and first molars) were measured quantitatively for pre-treatment and post-treatment. Results No significant increase was found except for the right and left maxillary and mandibular second premolars and left mandibular and first premolar in the RME&RHg group (P < 0.05). Teeth length values increased significantly in all maxillary and mandibular teeth except maxillary first molars and mandibular incisors in the SME group (P < 0.05). Inter-group comparisons showed that statistically significant differences were observed in maxillary and mandibular incisors, left maxillary first premolar, and molar teeth (P > 0.05). Limitation A limitation of this study is the use of two-dimensional radiographic images for root length measurement. However, ethical obligations limit the dental cone beam computed tomography imaging application for protection of paediatric patients from harm. Conclusions RME&RHg therapy inhibits root development of maxillary and mandibular teeth in the early period. However, further studies should be performed to determine whether this effect on root development is reversible or irreversible.

Evaluation of apical root resorption in Class III patients who received one- or two-phase orthodontic treatment

“…[21,22] Considering that RME&RHg therapy is usually performed in pediatric patients, who still have immature roots, little is known about the long-term possible negative effects of the treatment such as root resorption on teeth. [8,23,24] To the best of our knowledge, no previous study has been published on the relationship between formation of root resorption during fixed orthodontic treatment and past RME&RHg therapy.…”

“…[27] e correction formula of root length value was used to eliminate the magnification differences between the panoramic radiographs at t1 and t2, similar to the previous studies in the literature. [8,15,16] e changes in the inclinations of the upper and lower incisors related to fixed orthodontic treatment outcomes may cause shorter or longer root length seen on panoramic radiographs than the actual length. [8] erefore, the changes in the inclination of the maxillary and mandibular incisors from T1 to T2 were calculated.…”

“…[8,15,16] e changes in the inclinations of the upper and lower incisors related to fixed orthodontic treatment outcomes may cause shorter or longer root length seen on panoramic radiographs than the actual length. [8] erefore, the changes in the inclination of the maxillary and mandibular incisors from T1 to T2 were calculated. Since no statistically significant differences were observed in the change of inclination between the groups, it was considered that the change in the inclination of the incisors had no influence on the root length measured on the panoramic radiographs.…”

“…[3,6] Although there is a general idea that heavy forces lead to interruption of root development in teeth with incomplete root formation, the potential side effects of orthopedic treatment using RME&RHg are not well documented in the literature. [7] A previous study [8] reported that heavy orthopedic forces interrupt root development in the mixed dentition period, and the combination of RME&RHg treatment is a possible risk factor for future root resorption. Root resorption due to orthodontic treatment is a pathological condition that is characterized by loss of the superficial layer of the cells of tooth roots.…”

Salivary MRP-8/14 and the presence of periodontitis-associated bacteria in children with bonded maxillary expansion treatment

“…Rigid acrylic, bonded rapid maxillary expanders are commonly used to correct a maxillary transversal deficiency in mixed dentitions [ 20 – 22 ] and to open the maxillary sutures before treating maxillary skeletal deficiencies in growing children [ 23 , 24 ]. Skeletal and dental effects and facial soft tissue changes after maxillary expansion are extensively reported in the literature [ 25 – 27 ]. However, the adverse impact of these appliances was also reported: a recent study shows that patients wearing full-coverage bonded rapid maxillary expanders developed after two months more white spot lesions than the control group [ 28 ].…”