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      Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion

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          Abstract

          Objective

          Miniscrew-assisted rapid palatal expansion (MARPE) is a means for expanding the basal bone without surgical intervention in young adults. Here, we assessed the differences in dental, alveolar, and skeletal measurements taken before (T0), immediately after (T1), and 1 year after (T2) MARPE.

          Methods

          Twenty-four patients (mean age, 21.6 years) who had undergone MARPE and cone-beam computed tomography at T0, T1, and T2 were included. Changes in the following parameters were compared using paired t-tests: intercusp, interapex, alveolar, nasal floor, and nasal cavity widths; inclination of the first molar (M1) and its alveolus; and thickness and height of the alveolar bone. A linear mixed-effects model was used to determine variables that affected periodontal changes in the M1.

          Results

          MARPE produced significant increases in most measurements during T0–T2, despite relapse of some measurements during T1–T2. The alveolar thickness decreased on the buccal side, but increased on the palatal side. The alveolar crest level at the first premolar moved apically. Changes in the thickness and height of the alveolar bone were affected by the corresponding initial values.

          Conclusions

          MARPE can be used as an effective tool for correcting maxillomandibular transverse discrepancy, showing stable outcomes 1 year after expansion.

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          Most cited references35

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          Skeletal and dental changes accompanying rapid midpalatal suture opening.

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            Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation.

            The force delivered during rapid maxillary expansion (RME) produces areas of compression on the periodontal ligament of the supporting teeth. The resulting alveolar bone resorption can lead to unwanted tooth movement in the same direction. The purpose of this study was to evaluate periodontal changes by means of computed tomography after RME with tooth-tissue-borne and tooth-borne expanders. The sample comprised 8 girls, 11 to 14 years old, with Class I or II malocclusions with unilateral or bilateral posterior crossbites Four girls were treated with tooth-tissue-borne Haas-type expanders, and 4 were treated with tooth-borne Hyrax expanders. The appliances were activated up to the full 7-mm capacity of the expansion screw. Spiral CT scans were taken before expansion and after the 3-month retention period when the expander was removed. One-millimeter thick axial sections were exposed parallel to the palatal plane, comprising the dentoalveolar area and the base of the maxilla up to the inferior third of the nasal cavity. Multiplanar reconstruction was used to measure buccal and lingual bone plate thickness and buccal alveolar bone crest level by means of the computerized method. RME reduced the buccal bone plate thickness of supporting teeth 0.6 to 0.9 mm and increased the lingual bone plate thickness 0.8 to 1.3 mm. The increase in lingual bone plate thickness of the maxillary posterior teeth was greater in the tooth-borne expansion group than in the tooth-tissue-borne group. RME induced bone dehiscences on the anchorage teeth's buccal aspect (7.1 +/- 4.6 mm at the first premolars and 3.8 +/- 4.4 mm at the mesiobuccal area of the first molars), especially in subjects with thinner buccal bone plates. The tooth-borne expander produced greater reduction of first premolar buccal alveolar bone crest level than did the tooth-tissue-borne expander.
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              Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence.

              To evaluate the immediate effects of rapid maxillary expansion (RME) on the transverse skeletal and dentoalveolar changes with bone-borne (C-expander) and tooth-borne type expanders using cone-beam computed tomography (CBCT) in late adolescents.
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                Author and article information

                Journal
                Korean J Orthod
                Korean J Orthod
                KJOD
                Korean Journal of Orthodontics
                Korean Association of Orthodontists
                2234-7518
                2005-372X
                September 2017
                27 July 2017
                : 47
                : 5
                : 313-322
                Affiliations
                Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.
                Author notes
                Corresponding author: Yoon Jeong Choi. Assistant Professor, Department of Orthodontics, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel +82-2-2228-3101, yoonjchoi@ 123456yuhs.ac
                Article
                10.4041/kjod.2017.47.5.313
                5548712
                28861393
                dbef3ed6-eab7-4a62-b2bd-c3f14e9c85ba
                © 2017 The Korean Association of Orthodontists.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 January 2017
                : 02 April 2017
                : 24 April 2017
                Categories
                Original Article

                Dentistry
                cone-beam computed tomography,miniscrew-assisted rapid palatal expansion,stability,expansion

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