Rapid maxillary expansion

Top PDF Rapid maxillary expansion:

Rapid maxillary expansion outcomes according to midpalatal suture maturation levels

Rapid maxillary expansion outcomes according to midpalatal suture maturation levels

Besides the treatment method, at the beginning of the treatment, it is very important for an orthodontist to be able to predict whether the enlargement will be more den- tal than skeletal, or contrary. Highly matured midpalatal suture can be seen even though in young patients, and some kind of complications like pain, alveolar bending, and recession in gingiva or failures such as absence of su- tural opening debonding of the expander may be observed during rapid maxillary expansion (RME) treatment [11 – 13]. Orthopedic correction of maloclussions, as well as RME treatment, is more easily and effectively per- formed in puberty. With an exception of individual differ- ences, it is known that increase of interdigitation in the midpalatal suture causes a decrease in response to skeletal expansion especially after puberty [8, 14, 15].
Show more

7 Read more

Computational fluid dynamics analysis of the upper airway after rapid maxillary expansion: a case report

Computational fluid dynamics analysis of the upper airway after rapid maxillary expansion: a case report

Rapid maxillary expansion (RME) is a dentofacial ortho- pedic procedure that is routinely used by dental clini- cians and orthodontists to treat maxillary transverse discrepancies such as “ posterior crossbites ” ; the same technique has been reported by some researchers to help expand the upper airway and improve breathing func- tion in patients with nasal breathing disorders [1-3]. The main objective would be that correcting the existing pos- terior crossbite and widening of the maxillary dental

8 Read more

Role of mandibular displacement and airway size in improving breathing after rapid maxillary expansion

Role of mandibular displacement and airway size in improving breathing after rapid maxillary expansion

Methods: The final sample of this retrospective study comprised 14 Caucasian patients (mean age 7.6 years) who undergone rapid maxillary expansion with Haas-type expander banded on second deciduous upper molars. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). Mandibular landmarks localization and airway semiautomatic segmentation on cone beam computed tomography scans allowed airway volume computing and measurements.

7 Read more

Displacements prediction from 3D finite element model of maxillary protraction with and without rapid maxillary expansion in a patient with unilateral cleft palate and alveolus

Displacements prediction from 3D finite element model of maxillary protraction with and without rapid maxillary expansion in a patient with unilateral cleft palate and alveolus

finite element model is needed for precise and realistic simulation. Although tet- rahedral elements have commonly been used in biomechanical applications [58, 64, 65] because automated meshing techniques are available, hexahedral elements offer attractive numerical properties relative to tetrahedrons [66, 67]. Benzley et al. compared the accuracy of the hexahedral meshes with the tetrahedral meshes in their study, found that linear hexahedrons could generally deform in a lower strain energy state, thus making them more accurate than linear tetrahedrons in numer- ous situations [68]. Xiulin Yan et al. reported that tetrahedral elements are not as accuracy and reliable as hexahedral elements for finite element models with com- plicated geometry [34]. In this study, an element model consisting of 1,277,568 hex- ahedral elements (C3D8) and 1,801,945 nodes individually was established, which greatly increase the accuracy of the model. The results of this study may differ from data obtained from in vivo investigations. Additional biochemical and clinical stud- ies, as well as animal experiments, are needed to understand the effects of max- illary protraction with and without the use of rapid maxillary expansion in more detail. Progressive research with clinical identification of dynamic modeling is also required to investigate the effects of protraction, both with and without the use of maxillary expansion on the facial musculature and other soft tissues.
Show more

15 Read more

Evaluation of surgically assisted rapid maxillary expansion with piezosurgery versus oscillating saw and chisel osteotomy   a randomized prospective trial

Evaluation of surgically assisted rapid maxillary expansion with piezosurgery versus oscillating saw and chisel osteotomy a randomized prospective trial

Once skeletal maturity has been reached, orthodontic treatment alone cannot provide a stable widening of the constricted maxilla in cases of deficiencies of more than 5 mm. In general, an orthodontist can camouflage trans- verse discrepancies less than 5 mm with orthopedic forces alone [4]. Tooth extractions for alignment of dental arches are often unnecessary [5]. As mentioned before, surgically assisted rapid maxillary expansion (SARME) is a form of distraction that was applied be- fore its biological healing principles were known [5]. Physicians have to decide between two methods of ex- pansion: SME (slow maxillary expansion) and RME (rapid maxillary expansion). Applying SME, the maxilla is broadened by 0.5 to 1 mm per week; meanwhile, using RME demands an expansion of 0.6 to 0.8 mm three times a day. Both methods have advantages and disadvantages [6]. The surgically assisted rapid maxil- lary expansion is a method which, using combined orthodontic-oral surgical treatment, leads to a distinctive extension of the midline palatal suture. Thereby, it is pos- sible to avoid extractions, widen the nasal floor and sup- port the change from oral to nasal breathing [7].
Show more

9 Read more

Evaluation of the changes in the upper central incisors after rapid  maxillary expansion

Evaluation of the changes in the upper central incisors after rapid maxillary expansion

to identify and properlylocate the craniofacial structures (Ballanti, 2010). Currently, computed tomographies (CT scans) have become a moreaccurate tool to obtain a correct diagnosis, being considered a reliable method providing high precision information and data accuracy, producing real sizeanatomical images 1:17,10,17. This research study aimed at evaluating the changes in the position ofpermanent upper central incisors after rapid maxillary expansion by computed tomography in mouth-breather patients with maxillary atresia.
Show more

6 Read more

Immediate effects of rapid maxillary expansion on the naso-maxillary facial soft tissue using 3D stereophotogrammetry

Immediate effects of rapid maxillary expansion on the naso-maxillary facial soft tissue using 3D stereophotogrammetry

Rapid maxillary expansion (RME) has been advocated to increase the transverse width of a narrow maxilla. The expansion facilitates posterior crossbite correction, relief of crowding, increase in airway dimensions and has been used in conjunction with facemask therapy to facilitate maxillary advancement. 1-3 The dental and skeletal effects of RME are well documented in the literature. The main skeletal effects produce separation of the mid-palatal suture, more anteriorly then posteriorly, with vertical expansion extending to varying levels. The expansion is often pyramidal in shape with the greatest expansion around the region of the nasal aperture. 4-8 Studies based on two- dimensional lateral cephalograms have shown that the maxilla displaces downwards and forwards to a varying degree following RME treatment. 9 One of the most noticeable dental effects during RME activation is a diastema between the upper central incisors but tipping of the maxillary posterior teeth and alveolar processes laterally have also been reported. 9-12
Show more

23 Read more

The role of rapid maxillary expansion in the promotion of oral and general health

The role of rapid maxillary expansion in the promotion of oral and general health

Rapid maxillary expansion (RME) is an effective orthopedic procedure that can be used to address problems concerned with the growth of the midface. This procedure also may produce positive side effects on the general health of the patient. The aim of the present consensus paper was to identify and evaluate studies on the changes in airway dimensions and muscular function produced by RME in growing patients. A total of 331 references were retrieved from a database search (PubMed). The widening of the nasal cavity base after midpalatal suture opening in growing patients allows the reduction in nasal airway resistance with an improvement of the respiratory pattern. The effects of RME on the upper airway, however, have been described as limited and local, and these effects become diminished farther down the airway, possibly as a result of soft-tissue adaptation. Moreover, limited information is available about the long-term stability of the airway changes produced by RME. Several studies have shown that maxillary constriction may play a role in the etiology of more severe breathing disorders such as obstructive sleep apnea (OSA) in growing subjects. Early orthodontic treatment with RME is able to reduce the symptoms of OSA and improve polysomnographic variables. Finally, early orthopedic treatment with RME also is beneficial to avoid the development of facial skeletal asymmetry resulting from functional crossbites that otherwise may lead to functional and structural disorders of the stomatognathic system later in life.
Show more

7 Read more

An adolescent treated with rapid maxillary expansion presenting with strabismus: a case report

An adolescent treated with rapid maxillary expansion presenting with strabismus: a case report

Introduction: Few in vivo studies have investigated the effect of maxillary expansion on strabismus; however, some in vitro studies hypothesized that changes in the palatal width obtained with rapid maxillary expansion appliances could involve other bone structures that contain blood vessels and nerves conveying to the orbital cavity. The present case report seems to support that hypothesis, even if no analysis of pathogenetic mechanisms could be drawn.

5 Read more

Facial soft tissue changes after nonsurgical rapid maxillary expansion: a systematic review and meta-analysis

Facial soft tissue changes after nonsurgical rapid maxillary expansion: a systematic review and meta-analysis

Background: The present systematic review and meta-analysis aimed to test the hypothesis that no facial soft tissue changes occur after nonsurgical rapid maxillary expansion (RME), in order to provide a reference for orthodontists. Methods: PubMed, EMBASE, Cochrane Library, OVID, MEDLINE, CINAHL, Scopus, and ScienceDirect databases were electronically and manually searched up to December 2017, and randomized controlled, clinical controlled trials, cohort studies and retrospective studies where soft tissue changes were measured before and after nonsurgical RME were identified. Study appraisal and synthesis were performed by two reviewers who completed the study selection and quality assessment procedures independently and in duplicate. Data from the involved studies were pooled using Revman 5.3.
Show more

10 Read more

Stress Distribution and Displacement Analysis during a Surgically Assisted Rapid Maxillary Expansion using a Bone-Borne Device a Finite Element Study

Stress Distribution and Displacement Analysis during a Surgically Assisted Rapid Maxillary Expansion using a Bone-Borne Device a Finite Element Study

Introduction: The surgically assisted rapid maxillary expansion (SARME) is a method used for transverse maxillary correction in non-growing individuals or patients who have not achieved successful results with previous conventional treatments. There are several devices associated with SARME. The most common are the Hyrax and Hass expansion appliances. Bone-borne devices have also been reported; however, their high cost often makes their use unfeasible. Methods: Geometrical structures of the maxilla, skull, and bone-borne device were constructed. All materials were assumed to be homogeneous, isotropic, and to have linear elasticity. The maxilla was separated from the skull through a Le Fort I osteotomy and the intermaxillary suture was separated through a mid-sagittal osteotomy. The appliance was activated by 1 mm and the data were graphically analyzed. Results: The highest concentration of applied force was found on the contact region between the plate and the bone, as well as on the uppermost part of the hard palate. We also observed a larger opening in the anterior region in comparison with the posterior region, leading to a “V”-shaped opening.
Show more

5 Read more

Prediction of Class II improvement after rapid maxillary expansion in early mixed dentition

Prediction of Class II improvement after rapid maxillary expansion in early mixed dentition

Methods: Lateral cephalograms of 30 patients (mean age 8.3 ± 1.6 years old) showing Class II molar relationship and undergone to rapid maxillary expansion on the upper deciduous molars were traced before treatment, and molar relation changes were evaluated on dental casts before and after treatment. Overall treatment time lasted 10. 2 ± 2 months. Good responders (18 subjects, 10 females and 8 males) showed improvement of at least 2.50 mm, and bad responders (12 subjects, 7 females and 5 males) showed no improvement, improvement less than 2.50 mm, or worsening of molar relationship after treatment. Student ’ s t test was used to assess significance of differences between groups, and discriminant analysis allowed identification of predictive pretreatment variables.
Show more

8 Read more

Osteo-regeneration personalized for children by rapid maxillary expansion: an imaging study based on synchrotron radiation microtomography

Osteo-regeneration personalized for children by rapid maxillary expansion: an imaging study based on synchrotron radiation microtomography

Personalized maxillary expansion procedure was proposed to correct maxillary transversal deficiency [1, 2] by split- ting the midpalatal suture stimulating cell growth towards osteo-regeneration [3]. Different protocol of stem cell acti- vation were suggested and rapid maxillary expansion (RME) is the most spread among clinicians. RME was re- cently indicated as treatment not only to solve transversal maxillary deficiency but for a variety of clinical conditions [4] since sagittal problems and underdevelopment of the midface might be the consequences of untreated transver- sal deficiency [5–11]. Moreover, occlusal disharmony and functional problems involving breathing pattern changes might derive from maxillary arch deficiency [12–14]. RME was then underlined to have positive effects not only in in- creasing maxillary arch perimeter but also on general health of growing patients, then increasing the potential of its indications [4, 15, 16].
Show more

10 Read more

Transverse Expansion and Stability after Segmental Le Fort I Osteotomy versus Surgically Assisted Rapid Maxillary Expansion: a Systematic Review

Transverse Expansion and Stability after Segmental Le Fort I Osteotomy versus Surgically Assisted Rapid Maxillary Expansion: a Systematic Review

Objectives: The objective of the present systematic review was to test the hypothesis of no difference in transverse skeletal and dental arch expansion and relapse after segmental Le Fort I osteotomy versus surgically assisted rapid maxillary expansion. Material and Methods: A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted by including human studies published in English from January 1, 2000 to June 1, 2016. Results: The search provided 130 titles and four studies fulfilled the inclusion criteria. All the included studies were characterized by high risk of bias and meta-analysis was not possible due to considerable variation. Both treatment modalities significantly increase the transverse maxillary skeletal and dental arch width. The transverse dental arch expansion and relapse seems to be substantial higher with tooth-borne surgically assisted rapid maxillary expansion compared to segmental Le Fort I osteotomy. The ratio of dental to skeletal relapse was significantly higher in the posterior maxilla with tooth-borne surgically assisted rapid maxillary expansion. Moreover, a parallel opening without segment tilting was observed after segmental Le Fort I osteotomy.
Show more

13 Read more

Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion—a finite element method study

Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion—a finite element method study

Displacement of various craniofacial structures with rapid maxillary expansion by using finite element analysis Maximum lateral displacement was at the incisal edge of the upper central incisor. The pyramidal displacement of maxilla was evident. The apex of the pyramid faced the nasal bone, and the base was located on the oral side. The posterosuperior part of the nasal cavity had moved minimally in the lateral direction, and the width of the nasal cavity at the floor of the nose increased markedly, whereas no significant lateral displacement was observed at the temporal, parietal, frontal, sphenoid, and occipital bones. The studies done by Haas et al., Jafari et al. [13], Cleall et al. [16], Davis and Kronman [17], and Iseri et al. [14] showed similar findings.
Show more

8 Read more

Assessment of dental changes after rapid maxillary expansion

Assessment of dental changes after rapid maxillary expansion

on the buccal bone plate can be extremely important (Starnbach et al., 1966; Greenbaum and Zachrisson, 1982; Gonçales, 2011). Traditionally, two-dimensional radiographic images have been used to identify specific anatomic landmarks from which dental and skeletal dimensions can be measured. More recently, three-dimensional (3D) radiographic images have been used for the same purposes, with several advantages (CappelletteJúnior et al., 2012; Alqerban et al., 2011; Alqerban et al., 2013; Alqerban et al., 2014). Computed tomography (CT) offers rapid and precise acquisition of thin slices that can be used for 3D multiplanar reconstruction. This capacity increases the utility of CT as a diagnostic method (Ghoneima et al., 2010). Computed tomography therefore makes it possible to measure transverse, vertical and sagittal dimensions in any part of the maxilla, in addition to changes to the axial angles of anterior and posterior teeth (Capelozza Filho and Silva Filho Od, 1997; Barreto et al., 2005; Bazargani et al., 2013). The objective of this study is to assess the transverse projection angle of central incisors and maxillary first molars before and after rapid maxillary expansion.
Show more

6 Read more

Original Article Effects of osthole on bone regeneration in the mid-palatal suture of rats during rapid maxillary expansion

Original Article Effects of osthole on bone regeneration in the mid-palatal suture of rats during rapid maxillary expansion

Rapid maxillary expansion (RME) is an effective approach to correct transverse maxillary defi- ciency [1, 2]. It was originally used for growing adolescents whose suture remains patent, but now the practice can also be for adults with the aid of lateral maxillary and mid-palatal osteoto- mies [3]. Some studies [4-6] analyzed the long- term effects of RME and proved that a passive retainer was needed for a minimum of three months to prevent the relapse after rapid expansion therapy. This is because, it takes at least three months to complete the process of mineralization in the expanded suture [7]. Inadequate bone formation after expansion may result in an undesired relapse due to the pressure of facial bones and muscles [8]. The effects of RME can be maintained only through establishing a stable structure in the mid-pala- tal suture. Therefore, to prevent post-treatment relapse, it is extremely important to accelerate bone remodeling in the expanded suture.
Show more

9 Read more

Rapid Maxillary Expansion and Conductive Hearing Loss

Rapid Maxillary Expansion and Conductive Hearing Loss

21 Laptook T. Conductive hearing loss and rapid maxillary expansion: Report of a case. Am J Orthod 1981; 80: 325-31. 22. Bishara SE, Staley RN. Maxillary expansion: clini-cal implications. Am J Orthod Dentofac Orthop 1987; 91: 3-14. 23. Graber TM, Swain BF. Dentofacial orthopedics. In: Current orthodontic concepts and techniques, Vol 1. Philadelphia: Saunders, 1975.

6 Read more

Computed tomography and acoustic rhinometry techniques for evaluation of the nasal volume changes following rapid maxillary expansion

Computed tomography and acoustic rhinometry techniques for evaluation of the nasal volume changes following rapid maxillary expansion

on the development of the nasal cavity (Cappellette, 2008; Cappellette, 2017). The maxillary bones form part of the nasal cavity’s anatomic structure; therefore, the RME would affect the anatomy and the physiology of the nasal cavity (Oliveira de Felippe, 2008 and Basciftci, 2002), and it promotes the separation of the maxillary bones with a total increase in the nasal cavity’s volume and could result in improvement in the patient’s ability to breathe through the nose. More controversial is the question of whether rapid maxillary expansion can achieve a shift from oral to nasal breathing modes. The examination of the upper airway plays an important role in the evaluation of the growth and general health of subjects with breathing disorders. Because of the great complexity of airway anatomy and function, several measurement methods have been proposed. These methods can complement each other in the assessment of changesin breathing function after RME (Eichenberger, 2014; Ghoneima, 2015). The anterior portion of the nasal cavity, the nasal valve, is an extremely important site of maximum resistance along the entire respiratory tract. Small changes in nasal valve size result in large changes in airflow resistance, which in turn affects nasal function (Miman, 2006; Lee, 2009). There is no gold standard for measuring the nasal airway (Magnusson, 2011). For decades, rhinologists have been trying to find an
Show more

8 Read more

Effects of surgically assisted rapid maxillary expansion on mandibular position: a three-dimensional study

Effects of surgically assisted rapid maxillary expansion on mandibular position: a three-dimensional study

Surgery was carried out under general anesthesia in hospital environment by two surgeons (V.A.P-F. and E.S.G.). SARME was performed with Subtotal LeFort I osteotomy, midpalatal suture separation, and pterygo- maxillary disjunction. Patients were treated with Hyrax type appliance and activation rate of one quarter turn (0.2 mm) three times a day until the crossbite correc- tion. The appliance activation was initiated 7 days post- operatively. After achieving the intended expansion of the maxilla width, the appliance was blocked and left in place for about 4 months. Afterward, it was removed and replaced by a transpalatal arch.
Show more

6 Read more

Show all 10000 documents...