Soft tissue evaluation after MARPE skeletal expansion

Lead Author Affiliation

Department of Orthodontics

Lead Author Program & Year

DDS Year 2

Presentation Category

Research

Introduction/Context/Diagnosis

Rapid palatal expansion (RPE) can be achieved with both tooth-borne and bone-borne appliances. Micro-implant assisted RPEs can be used to gain skeletal expansion with minimal loss of transverse width and prevent orthodontic relapse. They can also be used with patients who are past their pre-pubertal growth spurt, where tooth-borne RPEs are less effective.

Methods/Treatment Plan

35 patients between the ages of 10 and 28 years old received Microimplant Assisted RPEs as part of their orthodontic treatment. CBCTs were taken pre-treatment (T1) and between 1-6 months after the expansion was finished (T2). The average time between T1 and T2 was 6.3 months. Three-dimensional imaging was used to locate landmarks using Invivo 6 Anatomage software by one orthodontic resident and five second-year dental students after calibration. Tracing points of nasal soft tissues, hard tissues, and the nasal airway were made to evaluate differences between pre and post-expansion facial soft tissue changes. A total of eight soft tissue values landmarks were traced and measured by 3 judges. Data was continually averaged and outliers were re-traced to ensure quality of data. The data was analyzed using paired t-tests and a Wilcoxon signed-rank test.

Results/Outcome

The results of this study indicated three soft tissue measurements which changed significantly from T1 to T2. The measurement of right to left alar increased by 0.81 ± 2.84 mm with a p-value of 0.01. The measurement of right to left alar curvature increased by 1.69 ± 3.26 mm with a p-value of 0.004. The measurement of right alar curvature to pronasale to left alar curvature increased by 3.13 ± 6.65 mm with a p-value of 0.009.

Significance/Conclusions

The micro-implant assisted RPEs in this study demonstrated significant effects on various hard and soft tissue landmarks of the maxilla. The interalar width of the nasal soft tissues increased with expansion which may cause a visible widening of the nose during treatment. The relationship between suture opening at A-point and soft tissue alar base widening was found to have a positive correlation.

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Soft tissue evaluation after MARPE skeletal expansion

Rapid palatal expansion (RPE) can be achieved with both tooth-borne and bone-borne appliances. Micro-implant assisted RPEs can be used to gain skeletal expansion with minimal loss of transverse width and prevent orthodontic relapse. They can also be used with patients who are past their pre-pubertal growth spurt, where tooth-borne RPEs are less effective.