Differential treatment effects of two anchorage systems for rapid maxillary expansion: a retrospective cephalometric study

Hourfar, Jan; Kinzinger, Gero; Ludwig, Björn; Spindler, Julia; Lisson, Jörg A.

doi:10.1007/s00056-016-0037-1

Cited by 9 publications

(7 citation statements)

References 63 publications

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“…For the sagittal and vertical measurements, our data clearly showed that in all classes of malocclusion, there was a slightly forward displacement of the maxilla and backward rotation of mandible in the sagittal plane, this forward displacement was more prominence and significant in Class III than Class II and Class I patients. is result is in accordance with the study conducted by Hourfar et al [44] which reported advancement of the maxilla based on SNA in the Class III patients treated with a combined tooth-and bone-borne appliance. It should be noted that in our study, even the ANB difference in Class III patients improved by +1.6° as the result of an anterior movement of the maxilla and downward and backward rotation of the mandible, the amount of maxillary forward movement was small (+0.88°), which might not be clinically significant.…”

Section: Discussionsupporting

confidence: 93%

Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology

Almaqrami

Ngan

Alhammadi

et al. 2022

APOS

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Objectives: Skeletally mature patients with transverse deficiency are best treated with surgically assisted rapid palatal expansion (RPE) procedure. Recent studies have shown that microimplant-assisted RPE (MARPE) appliances can be effective in achieving skeletal expansion in young adults. This retrospective study aimed to evaluate the skeletal and dental alveolar changes in response to treatment with MARPE appliances in three types of anteroposterior skeletal malocclusions using cone-beam computed tomography (CBCT) scans. Material and Methods: Seventy-eight subjects diagnosed with maxillary transverse deficiency and treated with the MARPE appliance (mean age of 22.9 ± 4.2 years) were divided into skeletal Class I, II, and III malocclusions with 26 subjects in each group. Pre- and post-treatment CBCT scans were used for superimposition to examine the skeletal and dentoalveolar changes following maxillary expansion treatment. Results: Significant lateral separation of the maxilla was found at the levels of the nasal floor, interzygomatic bones, and the inferior palatine margin of the alveolar process (P < 0.05) in the whole sample. Most of the sagittal and vertical variables change significantly in the whole sample and each studied group separately. Intergroup comparisons revealed no significant differences among the three skeletal classes except for the left frontozygomatic angle, left maxillary inclination angle, and torque in the first and second premolars. In Class III patients, the maxilla moved forward significantly in most of the cases (eight of 26 cases) (0.88°, P < 0.05) and the mandible moved downward and backward improving the anteroposterior skeletal relationship. Significant differences were also found in the vertical measurements (N-Me, MMP, and MP/SN, P < 0.05) in all three types of anteroposterior malocclusions. Conclusion: Maxillary expansion with the MARPE appliance in young adult patients induced different skeletal and dentoalveolar changes in the anteroposterior and vertical dimensions in each skeletal malocclusion with no significant difference among the three skeletal classes.

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Section: Discussionsupporting

confidence: 93%

Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology

Almaqrami

Ngan

Alhammadi

et al. 2022

APOS

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“…CBCT results showed a more pronounced increase in the maxillary skeletal width in the premolar region with the Hybrid Hyrax appliance (Table 3), possibly because of skeletal anchorage. 14,22 In the molar region (Table 3), a significant difference was observed between the groups for maxillary width, with a higher increase in HHG than in HG (Table 3). Garib et al 22 found similar results and suggested that hybrid appliances had a higher orthopedic effect in this region.…”

Section: Discussionmentioning

confidence: 96%

“…10 In addition, the device can be used with digital technology for better accuracy in appliance manufacturing. 11,12 Despite its safety and efficacy, 13,14 there is a lack of evidence on the effects of Hybrid Hyrax on RME in growing patients. Initial discussions and analyses showed optimal results related to the effect of the appliance as a skeletal anchorage during maxillary protraction.…”

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confidence: 99%

Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth‐borne and tooth‐bone‐borne expanders: A randomized clinical trial

Pasqua

André

Paiva

et al. 2022

Orthod Craniofacial Res

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Objectives: To compare, using cone-beam computed tomography, the dentoskeletal changes in rapid maxillary expansion with tooth-bone-borne (Hybrid Hyrax) and tooth-borne (Hyrax) appliances.Setting and sample population: Forty-two patients who met the eligibility criteria (aged 11-14 years; transverse maxillary deficiency, posterior crossbite, and presence of upper first premolars and molars) were screened and allocated into two groups: HHG (treatment with Hybrid Hyrax) and HG (treatment with Hyrax). Main outcome measures:The primary outcomes included nasomaxillary dimensional changes. CBCT was performed before and 3 months after the activation phase.Measurements were performed using Dolphin ® . Baseline data were compared using one-way ANOVA. For intergroup comparison, ANCOVA was used to analyze the initial age, appliance activations (mm), and mid-palatal suture maturation data as covariates. Statistical significance was set at 5%. Results:The premolar region in HHG showed increased skeletal changes than in HG, with the difference being 1.5 mm (0.5; 2.6) in the nasal cavity (P = .004), 1.4 mm (0.3; 2.5) in the nasal floor (P = .019), and 1.1 mm (0.2; 2.1) in the maxilla (P = .022). The molar region in HHG showed increased skeletal changes with the difference being 0.9 mm (0.2; 1.5) in the nasal cavity (P = .005), and 0.9 mm (0; 1.8) in the maxilla (P = .042) than in HG. Premolar inclination was higher in HG. Conclusion:Hybrid Hyrax showed more skeletal changes and fewer dental side effects, especially in the first premolar region. The amount of activation influenced the higher nasal skeletal changes in the Hybrid hyrax group. K E Y W O R D Scone-beam computed tomography, maxillary expansion, orthodontic anchorage technique | INTRODUC TI ONPosterior crossbite associated with maxillary transverse deficiency is among the most discussed topics in orthodontics, with the prevalence being 13.3% in patients with mixed dentition. 1 Such discrepancies, if left untreated, may cause deviations in facial growth, compromising esthetics and resulting in a functional deviation of the mandible. 2 Therefore, early correction is important,

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“…However, the clinical limitations of these devices are not clear (Hourfar et al. ). To date, no clear scientific evidence exists for the clinical indications, limitations and restrictions for the application of RME in adult patients.…”

Section: Introductionmentioning

confidence: 99%

Development of a novel histological and histomorphometric evaluation protocol for a standardized description of the mid‐palatal suture – An ex vivo study

et al. 2019

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The hard palate and mid-palatal suture are highly important for orthodontic treatment. In cases of transverse maxillary deficiency, palatal expansion is the treatment of choice. As nowadays a growing number of adult patients receive orthodontic treatment, an understanding of suture development throughout life is important to derive tailored orthodontic treatment techniques for each age group. Histological, histochemical and immunohistochemical stains (haematoxylin & eosin, Azan, Movat pentachrome, Masson-Goldner trichrome, Sirius Red, CD 31, osteopontin and TRAP) and histomorphometric analyses were re-established to detect the structural conditions of the mid-palatal suture in human cadavers of three different age groups (20-39, 40-59 and 60-80 years). The mid-palatal suture of the selected age groups (total of n = 12; n = 4 in every group m = f) exhibited marked differences in sutural morphology and metabolism. A wide, interdigitated and well-vascularized suture was observed in younger specimens compared with straighter and smaller sutures with fewer vessels and lower bone density in the 60-80 year group. The fibre composition within the sutural gap differed between the three age groups. Delicate fibres were found in the 20-39 year group, and a tightly interwoven 3D fibre-network was observed in the 40-59 year group. Atrophy primarily characterized the fibres in the 60-80 year group. This evidence demonstrates differences between the evaluated groups. These results suggest that the staining methods used are suitable for the description and evaluation of the morphology and metabolism of mid-palatal sutures. Further investigation is necessary to provide an in-depth description of sutural maturation over a lifetime.

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Differential treatment effects of two anchorage systems for rapid maxillary expansion: a retrospective cephalometric study

Abstract: Hybrid (combined tooth- and bone-borne) appliances for rapid maxillary expansion might be preferable in the treatment of skeletal Class III patients, since they possibly exert a more pronounced skeletal effect on the sagittal position of the maxilla.

Cited by 9 publications

References 63 publications

Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology

Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology

Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth‐borne and tooth‐bone‐borne expanders: A randomized clinical trial

Development of a novel histological and histomorphometric evaluation protocol for a standardized description of the mid‐palatal suture – An ex vivo study

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