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VOLUME 13 , ISSUE 6 ( November-December, 2022 ) > List of Articles

ORIGINAL RESEARCH

Skeletal Changes after Miniscrew-assisted Rapid Palatal Expansion in Young Adults: A Cone-beam Computed Tomography Technique Study

Pragati Nakra, Akhil Shetty, Sanjeevani Ratti

Keywords : Buccal bone, Cone-beam computed tomography, Miniscrew-assisted rapid palatal expansion, Skeletal expansion

Citation Information : Nakra P, Shetty A, Ratti S. Skeletal Changes after Miniscrew-assisted Rapid Palatal Expansion in Young Adults: A Cone-beam Computed Tomography Technique Study. World J Dent 2022; 13 (6):617-622.

DOI: 10.5005/jp-journals-10015-2124

License: CC BY-NC 4.0

Published Online: 26-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: To evaluate the skeletal changes in buccal bone thickness (BBT) and height in subjects treated with miniscrew-assisted rapid palatal expansion (MARPE) using Cone-beam Computed Tomography (CBCT). Materials and methods: CBCT records of 19 patients (age 18–30 years) were selected from the archives. The scans were taken before and immediately after the completion of expansion treatment using the MARPE appliance. These CBCT scans were calibrated and analyzed. The skeletal, dental, and airway parameters were evaluated for every patient at selected landmarks and a comparison was made before and after expansion. Skeletal measurements consisted of BBT, buccal bone height loss (BBHL), and midpalatal suture density ratio (MPSD). A paired t-test was employed to compare the means of the skeletal parameters pretreatment and posttreatment with the significance set at p < 0.05. Results: Statistically significant differences were noted in the skeletal parameters posttreatment. BBT decreased by 1.14 mm while buccal bone height reduced by 1.84 mm with a decrease in MPSD indicating successful expansion. Conclusion: MARPE treatment results in significant skeletal changes. The skeletal expansion opens up new avenues of treatment in contemporary orthodontics for mature patients. Clinical significance: MARPE is an effective technique for skeletal expansion to correct the transverse discrepancy in adults without the use of surgery.


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  1. Dierkes JM. The beauty of the face: an orthodontic perspective. J Am Dent Assoc 1987;Spec No:89E–95E. DOI: 10.14219/jada.archive.1987.0313
  2. Leonardi R, Lo Giudice A, Rugeri M, et al. Three-dimensional evaluation on digital casts of maxillary palatal size and morphology in patients with functional posterior crossbite. Eur J Orthod 2018;40(5):556–562. DOI: 10.1093/ejo/cjx103
  3. Bell RA, Kiebach TJ. Posterior crossbites in children: Developmental-based diagnosis and implications to normative growth patterns. In: Seminars in Orthodontics. Elsevier; 2014:77–113.
  4. Grippaudo C, Paolantonio EG, Antonini G, et al. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital 2016;36(5):386–394. DOI: 10.14639/0392-100X-770
  5. Andrucioli MCD, Matsumoto MAN. Transverse maxillary deficiency: treatment alternatives in face of early skeletal maturation. Dental Press J Orthod 2020;25(1):70–79. DOI: 10.1590/2177-6709.25.1.070-079.bbo
  6. Haas AJ. The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod 1965;35:200–217. DOI: 10.1043/0003-3219(1965)035<0200:TTOMDB>2.0.CO;2
  7. Haas AJ. Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod 1970;57(3):219–255. DOI: 10.1016/0002-9416(70)90241-1
  8. Handelman CS, Wang L, BeGole EA, et al. Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander. Angle Orthod 2000;70(2):129–144. DOI: 10.1043/0003-3219(2000)070<0129:NRMEIA>2.0.CO;2
  9. Garrett BJ, Caruso JM, Rungcharassaeng K, et al. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2008;134(1):8–9. DOI: 10.1016/j.ajodo.2008.06.004
  10. Tausche E, Hansen L, Hietschold V, et al. Three-dimensional evaluation of surgically assisted implant bone-borne rapid maxillary expansion: a pilot study. Am J Orthod Dentofacial Orthop 2007;131(4 Suppl):S92–S99. DOI: 10.1016/j.ajodo.2006.07.021
  11. Harzer W, Schneider M, Gedrange T. Rapid maxillary expansion with palatal anchorage of the hyrax expansion screw—pilot study with case presentation. J Orofac Orthop 2004;65(5):419–424. DOI: 10.1007/s00056-004-0346-7
  12. Chamberland S, Proffit WR. Closer look at the stability of surgically assisted rapid palatal expansion. J Oral Maxillofac Surg 2008;66(9):1895–1900. DOI: 10.1016/j.joms.2008.04.020
  13. Marchetti C, Pironi M, Bianchi A, et al. Surgically assisted rapid palatal expansion vs. segmental Le Fort I osteotomy: transverse stability over a 2-year period. J Craniomaxillofac Surg 2009;37(2):74–78. DOI: 10.1016/j.jcms.2008.08.006
  14. Lee KJ, Park YC, Park JY, et al. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop 2010;137(6):830–839. DOI: 10.1016/j.ajodo.2007.10.065
  15. Ludwig B, Baumgaertel S, Zorkun B, et al. Application of a new viscoelastic finite element method model and analysis of miniscrew-supported hybrid hyrax treatment. Am J Orthod Dentofacial Orthop 2013;143(3):426–435. DOI: 10.1016/j.ajodo.2012.07.019
  16. MacGinnis M, Chu H, Youssef G, et al. The effects of micro-implant assisted rapid palatal expansion (MARPE) on the nasomaxillary complex–a finite element method (FEM) analysis. Prog Orthod 2014;15:52. DOI: 10.1186/s40510-014-0052-y
  17. de Oliveira CB, Ayub P, Ledra IM, et al. Microimplant assisted rapid palatal expansion vs surgically assisted rapid palatal expansion for maxillary transverse discrepancy treatment. Am J Orthod Dentofacial Orthop 2021;159(6):733–742. DOI: 10.1016/j.ajodo.2020.03.024
  18. Park JJ, Park YC, Lee KJ, et al. Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study. Korean J Orthod 2017;47(2):77–86. DOI: 10.4041/kjod.2017.47.2.77
  19. Rungcharassaeng K, Caruso JM, Kan JY, et al. Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2007;132(4):428.e1–428.E8. DOI: 10.1016/j.ajodo.2007.02.052
  20. Yi F, Liu S, Lei L, et al. Changes of the upper airway and bone in microimplant-assisted rapid palatal expansion: a cone-beam computed tomography (CBCT) study. J Xray Sci Technol 2020;28(2):271–283. DOI: 10.3233/XST-190597
  21. Wehrbein H, Yildizhan F. The mid-palatal suture in young adults. A radiological-histological investigation. Eur J Orthod 2001;23(2):105–114. DOI: 10.1093/ejo/23.2.105
  22. Adibi S, Shahidi S, Nikanjam S, et al. Influence of head position on the CBCT accuracy in assessment of the proximity of the root apices to the inferior alveolar canal. J Dent (Shiraz) 2017;18(3):181–186. PMCID: PMC5634357; PMID: 29034272.
  23. Zengin A, Prentice A, Ward KA. Ethnic differences in bone health. Front Endocrinol (Lausanne) 2015;6:24. DOI: 10.3389/fendo.2015.00024
  24. Kapetanović A, Theodorou CI, Bergé SJ, et al. Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis. Eur J Orthod 2021;43(3):313–323. DOI: 10.1093/ejo/cjab005
  25. Baik HS, Kang YG, Choi YJ. Miniscrew-assisted rapid palatal expansion: a review of recent reports. J World Fed Orthod 2020;9(3S):S54–S58. DOI: 10.1016/j.ejwf.2020.08.004
  26. Cantarella D, Dominguez-Mompell R, Moschik C, et al. Zygomaticomaxillary modifications in the horizontal plane induced by micro-implant-supported skeletal expander, analyzed with CBCT images. Prog Orthod 2018;19(1):41. DOI: 10.1186/s40510-018-0240-2
  27. Cantarella D, Dominguez-Mompell R, Moschik C, et al. Midfacial changes in the coronal plane induced by microimplant-supported skeletal expander, studied with cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 2018;154(3):337–345. DOI: 10.1016/j.ajodo.2017.11.033
  28. Lo Giudice A, Quinzi V, Ronsivalle V, et al. Description of a digital work-flow for CBCT-guided construction of micro-implant supported maxillary skeletal expander. Materials (Basel) 2020;13(8):1815. DOI: 10.3390/ma13081815
  29. Grünheid T, Larson CE, Larson BE. Midpalatal suture density ratio: a novel predictor of skeletal response to rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2017;151(2):267–276. DOI: 10.1016/j.ajodo.2016.06.043
  30. Ludlow JB, Davies-Ludlow LE, Brooks SL, et al. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol 2006;35(4):219–226. DOI: 10.1259/dmfr/14340323
  31. Holberg C, Steinhäuser S, Geis P, et al. Cone-beam computed tomography in orthodontics: benefits and limitations. J Orofac Orthop 2005;66(6):434–444. DOI: 10.1007/s00056-005-0519-z
  32. Baumrind S, Carlson S, Beers A, et al. Using three-dimensional imaging to assess treatment outcomes in orthodontics: a progress report from the University of the Pacific. Orthod Craniofac Res 2003;6 Suppl 1:132–142. DOI: 10.1034/j.1600-0544.2003.246.x
  33. Corbridge JK, Campbell PM, Taylor R, et al. Transverse dentoalveolar changes after slow maxillary expansion. Am J Orthod Dentofacial Orthop 2011;140(3):317–325. DOI: 10.1016/j.ajodo.2010.06.025
  34. Vardimon AD, Brosh T, Spiegler A, et al. Rapid palatal expansion. Part 2: dentoskeletal changes in cats with patent versus synostosed midpalatal suture. Am J Orthod Dentofacial Orthop 1998;113(5):488–497. DOI: 10.1016/s0889-5406(98)70259-8
  35. Digregorio MV, Fastuca R, Zecca PA, et al. Buccal bone plate thickness after rapid maxillary expansion in mixed and permanent dentitions. Am J Orthod Dentofacial Orthop 2019;155(2):198–206. DOI: 10.1016/j.ajodo.2018.03.020
  36. Garib DG, Henriques JF, Janson G, et al. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofacial Orthop 2006;129(6):749–58. DOI: 10.1016/j.ajodo.2006.02.021
  37. Starnbach H, Bayne D, Cleall J, et al. Facioskeletal and dental changes resulting from rapid maxillary expansion. Angle Orthod 1966;36(2):152–164. DOI: 10.1043/0003-3219(1966)036<0152:FADCRF>2.0.CO;2
  38. Timms DJ, Moss JP. An histological investigation into the effects of rapid maxillary expansion on the teeth and their supporting tissues. Trans Eur Orthod Soc. 1971;263–271. PMID: 4949742.
  39. Copello FM, Marañón-Vásquez GA, Brunetto DP, et al. Is the buccal alveolar bone less affected by mini-implant assisted rapid palatal expansion than by conventional rapid palatal expansion?—a systematic review and meta-analysis. Orthod Craniofac Res 2020;23(3):237–249. DOI: 10.1111/ocr.12374
  40. Baysal A, Uysal T, Veli I, et al. Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography. Korean J Orthod 2013;43(2):83–95. DOI: 10.4041/kjod.2013.43.2.83
  41. Shin H, Hwang CJ, Lee KJ, et al. Predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in young adults: a preliminary study. Korean J Orthod 2019;49(6):360–371. DOI: 10.4041/kjod.2019.49.6.360
  42. Pimentel AC, Manzi MR, Prado Barbosa AJ, et al. Mini-implant screws for bone-borne anchorage: a biomechanical in vitro study comparing three diameters. Int J Oral Maxillofac Implants 2016;31(5):1072–1076. DOI: 10.11607/jomi.4390
  43. Calil RC, Marin Ramirez CM, Otazu A, et al. Maxillary dental and skeletal effects after treatment with self-ligating appliance and miniscrew-assisted rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2021;159(2):e93–e101. DOI: 10.1016/j.ajodo.2020.09.011
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