Long-term assessment of conventional and mini-screw–assisted rapid palatal expansion on the nasal cavity

Abstract

Objectives To evaluate the long-term effects of mini-screw–assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and controls on the nasal cavity with cone-beam computed tomography (CBCT). Materials and Methods A total of 180 CBCT scans that were part of a previous randomized trial were evaluated retrospectively for 60 patients at pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were randomly assigned into 3 groups: MARPE, RPE, and controls (time period T1 to T3; MARPE: 2 years 8 months; RPE: 2 years 9 months; control: 2 years 7 months). Nasal height, nasal length, nasion–ANS height, ANS–PNS length, pyriform height, and nasal septal deviation angle were measured. The changes in alar width, alar base width, anterior nasal cavity width, posterior nasal cavity width, maxillary intermolar width, and maxillary intercanine width were also evaluated. Results The alar base width, posterior nasal cavity width, anterior nasal cavity width, maxillary intercanine width, and maxillary intermolar width significantly increased (P < .05), and the nasal septal deviation angle significantly decreased (P < .05) in both the MARPE and RPE groups as compared with controls in the short term. In the long term, the nasal septal deviation angle was significantly decreased (P < .05) in the MARPE and RPE groups as compared with controls, and the posterior nasal cavity width was significantly increased (P < .05) in the MARPE group compared with the RPE group and controls. Conclusions MARPE and RPE led to a significant increase in the nasal cavity and alar base width compared with controls in the short term. In the long term, a significant increase was observed only in the posterior nasal cavity width with MARPE. Both MARPE and RPE led to a minimal decrease in nasal septal deviation angle in comparison with controls.

Comparison of palatal volume and surface changes between bone-borne and tooth-tissue-borne maxillary expansion on cone beam computed tomography digital cast models

“…The sample size of 22 models of the subjects was set to detect an effect size coefficient of 0.8 for both palatal parameters (surface area and volume). 10 The study was approved by the ethical committee of Al-Azhar University, (approval number REC16-032), in addition to the University of Campania, Naples, Italy (approval number 24797/ 2018).…”

“…5,9 Others have evaluated bone-borne expanders anchored only with mini-implants. 10 Such studies were designed to determine whether there was any additional orthopedic contribution to maxillary expansion by adding miniscrew anchorage at such young ages. More research is needed to investigate the potential superiority of miniscrew-supported maxillary expanders over Hyrax or Haas expanders in different age groups.…”

A CBCT Evaluation of Nasal Septal Deviation and Related Nasofacial Structures after Maxillary Skeletal Expansion

“…Several studies [7][8][9][10][11] have been conducted to evaluate the effects of maxillary expansion on the NS. Schwarz et al [9] suggested no significant positional change in the NS with surgically-assisted rapid maxillary expansion (SARME).…”

“…Aziz et al [10] suggested a potentially positive effect of RME on NSD during childhood but no significant change during adolescence. Recently, Mehta et al [11] concluded that rapid palatal expansion (RPE) and microimplant-assisted RPE (MARPE) significantly improved NSD in the short and long term.…”

“…However, a conventional RME has several side effects, including dentoalveolar tipping and a lack of long-term stability [14,15]. In order to improve stability and increase the skeletal effect, a MARPE has recently been developed and is being widely used [11,[16][17][18].…”