Lead Author Affiliation

Resident of Orthodontics

Lead Author Program & Year

Graduate Orthodontics

Second Author Program & Year

DDS Year 2

Third Author Program & Year

DDS Year 2

Presentation Category

Research

Introduction/Context/Diagnosis

Maxillary transverse deficiency is a highly prevalent malocclusion present in primary and permanent dentition. In growing patients, this condition can be easily treated with a conventional rapid palatal expansion. Studies have demonstrated the possibility to expand the maxilla in non-growing patients using microimplants anchorage to correct skeletal transverse discrepancies. The purpose of this study is to evaluate the short-term and long-term changes of the hard and soft tissues of the face after microimplant-assisted expansion.

Methods/Treatment Plan

17 patients (mean age at treatment start: 15.8 yr) who had received successful expansion with a microimplant-assisted rapid palatal expander (MARPE) were included. All patients were at cervical stage 5 or 6 and had passed the growth peak at least 1 year before starting treatment. CBCT was taken at pre- treatment (T1), after expansion was completed (T2), and treatment completion (T3). A 3-D analysis configuration was created to trace hard and soft tissue landmarks of the midface and nasal cavity regions. A repeated measures ANOVA test was used for statistical comparison across three time points. Pairwise paired t-tests with Bonferroni correction was used for pairwise comparison.

Results/Outcome

Expansion can affect hard tissue and overlying soft tissue. Increases in skeletal width from the ANS down to the maxillary alveolar bone were statistically significant in short term (T1-T2) and long term (T1-T3). The nasal cavity width at inferior turbinate area increased significantly after expansion (T2) and remained increased at treatment completion (T3). Soft tissue changes showed that the increased width of the nose after expansion therapy reduced to the initial width at treatment completion. Nasal soft tissue changes were not statistically significant.

Significance/Conclusions

Maxillary expansion with microimplant assisted expanders resulted in skeletal changes throughout the maxilla and led to a significant long-term increase in nasal cavity width. Soft tissue changes were less pronounced. A widening of the base of the nose may be expected after skeletal expansion using a MARPE, this change may not persist at the end of orthodontic treatment.

Comments/Acknowledgements

We would like to thank Dr. Park and Dr. Oh for their guidance on this project. We would also like to thank Luke Wu, Daniel Nguyen, Nicole Vega-Valbuena, and Hanisha Pasupulate who contributed their time to the tracings.

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Assessment of Short and Long-Term Changes of the Hard and Soft Tissue of the Face with Miniscrew-Assisted Rapid Maxillary Palatal Expanders

Maxillary transverse deficiency is a highly prevalent malocclusion present in primary and permanent dentition. In growing patients, this condition can be easily treated with a conventional rapid palatal expansion. Studies have demonstrated the possibility to expand the maxilla in non-growing patients using microimplants anchorage to correct skeletal transverse discrepancies. The purpose of this study is to evaluate the short-term and long-term changes of the hard and soft tissues of the face after microimplant-assisted expansion.