INVESTIGATION OF THE EFFECTS OF RAPID MAXILLARY EXPANSION WITH A LOCKED MODIFIED ACRYLIC BONDED APPLIANCE ON DENTOSKELETAL STRUCTURES IN MIXED DENTITION: A PROSPECTIVE CLINICAL STUDY
Year 2025,
Volume: 34 Issue: 2, 256 - 266, 15.08.2025
Celal Irgın
,
Zafer Sari
Abstract
The objective of this study was to examine the effects of a locked rapid maxillary expansion appliance on the dentoskeletal structures of patients who experienced transverse maxillary constriction with a true unilateral posterior crossbite. The appliance used in this study was a modification of the tooth- and tissue-supported, fully covered acrylic rapid maxillary expansion appliance. To provide asymmetric expansion of the maxillary halves, an acrylic locking unit was constructed on the occlusal surface of the noncrossbite side of the appliance, anchored by the lower posterior teeth on the same side. This study included a total of 30 patients (14 girls and 16 boys; mean age 8.74 ± 0.56 years) with mixed dentition. Lateral and frontal cephalograms and plaster model records were taken before expansion, immediately after expansion, and 3 months after retention. Repeated measures analysis of variance was used to compare the measurements at various time points. Covariance analysis was also used to evaluate the differences between the crossbite and noncrossbite sides. The level of statistical significance was set at 0.05.The results indicated that the appliance producedstatistically significant maxillary expansion on the crossbite side compared with the noncrossbite side (p<0.05). The maxilla exhibited greater skeletal movement in the transverse plane than in the sagittal and vertical planes. In the treatment of true unilateral posterior crossbites in mixed dentition, this appliance is effective and might be preferred.
Ethical Statement
Ethics committee approval was received for this study from the Ethics Committee of XXXX University Faculty of Dentistry (Date: 26/03/2007, Number: 90).
Supporting Institution
This study was supported by XXX University Scientific Research Projects Department with project number 08102026. This research did not receive support from any funding agency/industry.
References
-
Leonardi RM, Aboulazm K, Giudice AL, et al. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique. Clin Oral Investig. 2021;25(4):1775-1785. doi:10.1007/s00784-020-03480-5.
-
Ramón R, Adanero A, Miegimolle M. A new approach to diagnosis to posterior cross bite: intraoral photography and Wala ridge. Int J Environ Res Public Health. 2022;19(15):9443. doi:10.3390/ijerph19159443.
-
Caroccia F, Moscagiuri F, Falconio L, Festa F, D’Attilio M. Early orthodontic treatments of unilateral posterior crossbite: a systematic review. J Clin Med. 2020;10(1):33. doi:10.3390/jcm10010033.
-
Lim YN, Baharin F, Lin GSS, et al. Evaluation of the Changes of the Intercanine and Intermolar Widths Following Palatal Expansion in the Mixed Dentition Patients with Bilateral Posterior Crossbite: A Systematic Review. Dent J (Basel). 2023;11(2):52. doi:10.3390/dj11020052.
-
Khda M, Kiliaridis S, Antonarakis GS. Spontaneous correction and new development of posterior crossbite from the deciduous to the mixed dentition. Eur J Orthod. 2023;45(3):266-270. doi:10.1093/ejo/cjac061.
-
Proffit WR, Fields HW.Treatment of skeletal transverse and Class III problems. Contemporary Orthodontics. Proffit WR, Fields HW, Larson BE, Sarver DM. 6th Edition, Philadelphia, Elsevier; 2019:430-440.
-
McNamara JA, Lione R, Franchi L, et al. The role of rapid maxillary expansion in the promotion of oral and general health. Prog Orthod. 2015;16(33). doi:10.1186/s40510-015-0105-x.
-
Evangelista K, Ferrari-Piloni C, Barros LAN, et al. Three‐dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study. Orthod Craniofac Res. 2020;23(3):300-312. doi:10.1111/ocr.12370.
-
Marshall SD, Southard KA, Southard TE. Early transverse treatment. Semin Orthod. 2005;11(3):130-139. doi:10.1053/j.sodo.2005.04.006.
-
Kutin G, Hawes RR. Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod. 1969;56(5):491-504.
-
Thilander B, Wahlund S, Lennartsson B. The effect of early interceptive treatment in children with posterior cross-bite. Eur J Orthod. 1984;6(1):25-34.
-
Peiro AC. Interceptive orthodontics: The need for early diagnosis and treatment of posterior crossbites. Med Oral Patol Oral Cir Bucal. 2006;11(2):E210-4.
-
Alsawaf DH, Almaasarani SG, Hajeer MY, Rajeh N. The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis. Prog Orthod. 2022;23(1):5. doi:10.1186/s40510-022-00398-4.
-
Fiorelli G, Merlo P. Asymmetric dental-alveolar transversal corrections with skeletal anchorage.Seminars in Orthodontics. 2022;28(3):212-226. doi:10.1053/j.sodo.2022.10.014.
-
Karabiber G, Yılmaz HN, Nevzatoğlu Ş, Uğurlu F, Akdoğan T. Three-dimensional evaluation of surgically assisted asymmetric rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2019;155(5):620-626. doi:10.1016/j.ajodo.2018.05.024.
-
Toroglu MS, Uzel E, Kayalioglu M, Uzel İ. Asymmetric maxillary expansion (AMEX) appliance for treatment of true unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 2002;122(2):164-173. doi:10.1067/mod.2002.125563.
-
Erdur EA, Yıldırım M, Karatas RMC, Akin M. Effects of symmetric and asymmetric rapid maxillary expansion treatments on pharyngeal airway and sinus volume. Angle Orthod. 2020;90(3):425-431. doi:10.2319/050819-320.1.
-
Hoque T, Srinivasan D, Chakravarthi S, Kannan R. Evaluation and comparison of stresses and displacements generated by four different types of asymmetric maxillary expansion appliances in true unilateral crossbite using finite element method. Int Orthod. 2022;20(3):100668. doi:10.1016/j.ortho.2022.100668.
-
Baka ZM, Akin M, Ucar FI, Ileri Z. Cone-beam computed tomography evaluation of dentoskeletal changes after asymmetric rapid maxillary expansion. Am J Orthod Dentofacial Orthop.2015;147(1):61-71. doi:10.1016/j.ajodo.2014.09.014.
-
Dzingle J, Mehta S, Chen P-J, Yadav S. Correction of unilateral posterior crossbite with U-MARPE.Turk J Orthod. 2020;33(3):192. doi:10.5152/TurkJOrthod.2020.20034.
-
Ramoglu SI, Sari Z. Maxillary expansion in the mixed dentition: rapid or semi-rapid? Eur J Orthod. 2010;32(1):11-18. doi:10.1093/ejo/cjp057.
-
Lu L, Zhang L, Li C, Yi F, Lei L, Lu Y. Treatment effects after maxillary expansion using invisalign first system vs. acrylic splint expander in mixed dentition: a prospective cohort study. BMC Oral Health. 2023;23(1):598. doi:10.1186/s12903-023-03312-4.
-
Sawchuk D, Currie K, Vich ML, Palomo JM, Flores-Mir C. Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review.Korean J Orthod. 2016;46(5):331-342. doi:10.4041/kjod.2016.46.5.331.
-
Ferro F, Spinella P, Lama N. Transverse maxillary arch form and mandibular asymmetry in patients with posterior unilateral crossbite. Am J Orthod Dentofacial Orthop. 2011;140(6):828-838. doi:10.1016/j.ajodo.2011.08.003.
-
Sandikçiolu M, Hazar S. Skeletal and dental changes after maxillary expansion in the mixed dentition. Am J Orthod Dentofacial Orthop.1997;111(3):321-327. doi:10.1016/S0889-5406(97)70191-4.
-
Çörekçi B, Göyenç YB. Dentofacial changes from fan-type rapid maxillary expansion vs traditional rapid maxillary expansion in early mixed dentition: a prospective clinical trial. Angle Orthod. 2013;83(5):842-850. doi:10.2319/103112-837.1.
-
da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofacial Orthop.1991;100(2):171-179. doi:10.1016/s0889-5406(05)81524-0.
KARMA DENTİSYON DÖNEMİNDE KİLİTLİ MODİFİYE AKRİLİK BONDED APAREY İLE YAPILAN HIZLI ÜST ÇENE GENİŞLETMESİNİN DENTOİSKELETSEL YAPILAR ÜZERİNE ETKİLERİNİN İNCELENMESİ: PROSPEKTİF KLİNİK ÇALIŞMA
Year 2025,
Volume: 34 Issue: 2, 256 - 266, 15.08.2025
Celal Irgın
,
Zafer Sari
Abstract
Bu çalışmanın amacı, üst çene darlığıyla birliktegerçek tek taraflı posterior çapraz kapanışı bulunan hastalarda kilitli hızlı üst çene genişletme apareyinin dento iskeletsel yapılar üzerine etkilerini incelemekti. Çalışmada diş ve doku destekli, tam akrilikhızlı üst çene genişletme apareyinin bir modifikasyonu kullanıldı. Üst çene segmentlerinin asimetrik genişlemesini sağlamak amacıyla apareyin normal kapanış tarafının okluzal kısmına aynı taraftaki alt posterior dişlerden ankraj alan akrilik bir kilit mekanizması eklendi. Çalışma, karma dişlenme döneminde toplam 30 hasta (14 kız ve 16 erkek; ortalama yaş 8.74 ± 0.56 yıl) üzerinde yürütüldü. Lateral ve frontal sefalometrik röntgenler ile alçı model kayıtları üst çene genişletilmesinden önce, genişletmeden hemen sonra ve 3 aylık pekiştirme dönemindensonra alındı. Farklı zamanlarda alınan kayıtlarda yapılan ölçümlerin istatistiksel olarak karşılaştırılması,tekrarlayan ölçümlerde varyans analizi ile gerçekleştirildi. Çapraz kapanış ve normal kapanış tarafları arasındaki ölçümlerin karşılaştırılmasındaise kovaryans analizi kullanıldı. İstatistiksel olarak anlamlılık düzeyi 0.05 olarak belirlendi. Sonuçlar, apareyin çapraz kapanış tarafında normal kapanış tarafına göre istatistiksel olarak anlamlı maksiler ekspansiyon meydana geldiğini gösterdi (p<0.05). Üst çenenin transversal düzlemde, sagital ve dikey düzlemlere göre daha fazla iskeletsel olarak hareket ettiği tespit edildi. Karma dişlenme döneminde gerçek tek taraflı posterior çapraz kapanışların tedavisinde bu aparey etkilidir ve tercih edilebilir.
Ethical Statement
Bu çalışma için XXXX Üniversitesi Diş Hekimliği Fakültesi Etik Kurulundan (Tarih: 26/03/2007, Sayı: 90) onay alınmıştır.
Supporting Institution
Bu çalışma XXXX Üniversitesi Bilimsel Araştırma Projeleri Bölümü tarafından 08102026 numaralı proje ile desteklenmiştir. Bu araştırma herhangi bir finansman kuruluşundan/sektörden destek almamıştır.
References
-
Leonardi RM, Aboulazm K, Giudice AL, et al. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique. Clin Oral Investig. 2021;25(4):1775-1785. doi:10.1007/s00784-020-03480-5.
-
Ramón R, Adanero A, Miegimolle M. A new approach to diagnosis to posterior cross bite: intraoral photography and Wala ridge. Int J Environ Res Public Health. 2022;19(15):9443. doi:10.3390/ijerph19159443.
-
Caroccia F, Moscagiuri F, Falconio L, Festa F, D’Attilio M. Early orthodontic treatments of unilateral posterior crossbite: a systematic review. J Clin Med. 2020;10(1):33. doi:10.3390/jcm10010033.
-
Lim YN, Baharin F, Lin GSS, et al. Evaluation of the Changes of the Intercanine and Intermolar Widths Following Palatal Expansion in the Mixed Dentition Patients with Bilateral Posterior Crossbite: A Systematic Review. Dent J (Basel). 2023;11(2):52. doi:10.3390/dj11020052.
-
Khda M, Kiliaridis S, Antonarakis GS. Spontaneous correction and new development of posterior crossbite from the deciduous to the mixed dentition. Eur J Orthod. 2023;45(3):266-270. doi:10.1093/ejo/cjac061.
-
Proffit WR, Fields HW.Treatment of skeletal transverse and Class III problems. Contemporary Orthodontics. Proffit WR, Fields HW, Larson BE, Sarver DM. 6th Edition, Philadelphia, Elsevier; 2019:430-440.
-
McNamara JA, Lione R, Franchi L, et al. The role of rapid maxillary expansion in the promotion of oral and general health. Prog Orthod. 2015;16(33). doi:10.1186/s40510-015-0105-x.
-
Evangelista K, Ferrari-Piloni C, Barros LAN, et al. Three‐dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study. Orthod Craniofac Res. 2020;23(3):300-312. doi:10.1111/ocr.12370.
-
Marshall SD, Southard KA, Southard TE. Early transverse treatment. Semin Orthod. 2005;11(3):130-139. doi:10.1053/j.sodo.2005.04.006.
-
Kutin G, Hawes RR. Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod. 1969;56(5):491-504.
-
Thilander B, Wahlund S, Lennartsson B. The effect of early interceptive treatment in children with posterior cross-bite. Eur J Orthod. 1984;6(1):25-34.
-
Peiro AC. Interceptive orthodontics: The need for early diagnosis and treatment of posterior crossbites. Med Oral Patol Oral Cir Bucal. 2006;11(2):E210-4.
-
Alsawaf DH, Almaasarani SG, Hajeer MY, Rajeh N. The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis. Prog Orthod. 2022;23(1):5. doi:10.1186/s40510-022-00398-4.
-
Fiorelli G, Merlo P. Asymmetric dental-alveolar transversal corrections with skeletal anchorage.Seminars in Orthodontics. 2022;28(3):212-226. doi:10.1053/j.sodo.2022.10.014.
-
Karabiber G, Yılmaz HN, Nevzatoğlu Ş, Uğurlu F, Akdoğan T. Three-dimensional evaluation of surgically assisted asymmetric rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2019;155(5):620-626. doi:10.1016/j.ajodo.2018.05.024.
-
Toroglu MS, Uzel E, Kayalioglu M, Uzel İ. Asymmetric maxillary expansion (AMEX) appliance for treatment of true unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 2002;122(2):164-173. doi:10.1067/mod.2002.125563.
-
Erdur EA, Yıldırım M, Karatas RMC, Akin M. Effects of symmetric and asymmetric rapid maxillary expansion treatments on pharyngeal airway and sinus volume. Angle Orthod. 2020;90(3):425-431. doi:10.2319/050819-320.1.
-
Hoque T, Srinivasan D, Chakravarthi S, Kannan R. Evaluation and comparison of stresses and displacements generated by four different types of asymmetric maxillary expansion appliances in true unilateral crossbite using finite element method. Int Orthod. 2022;20(3):100668. doi:10.1016/j.ortho.2022.100668.
-
Baka ZM, Akin M, Ucar FI, Ileri Z. Cone-beam computed tomography evaluation of dentoskeletal changes after asymmetric rapid maxillary expansion. Am J Orthod Dentofacial Orthop.2015;147(1):61-71. doi:10.1016/j.ajodo.2014.09.014.
-
Dzingle J, Mehta S, Chen P-J, Yadav S. Correction of unilateral posterior crossbite with U-MARPE.Turk J Orthod. 2020;33(3):192. doi:10.5152/TurkJOrthod.2020.20034.
-
Ramoglu SI, Sari Z. Maxillary expansion in the mixed dentition: rapid or semi-rapid? Eur J Orthod. 2010;32(1):11-18. doi:10.1093/ejo/cjp057.
-
Lu L, Zhang L, Li C, Yi F, Lei L, Lu Y. Treatment effects after maxillary expansion using invisalign first system vs. acrylic splint expander in mixed dentition: a prospective cohort study. BMC Oral Health. 2023;23(1):598. doi:10.1186/s12903-023-03312-4.
-
Sawchuk D, Currie K, Vich ML, Palomo JM, Flores-Mir C. Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review.Korean J Orthod. 2016;46(5):331-342. doi:10.4041/kjod.2016.46.5.331.
-
Ferro F, Spinella P, Lama N. Transverse maxillary arch form and mandibular asymmetry in patients with posterior unilateral crossbite. Am J Orthod Dentofacial Orthop. 2011;140(6):828-838. doi:10.1016/j.ajodo.2011.08.003.
-
Sandikçiolu M, Hazar S. Skeletal and dental changes after maxillary expansion in the mixed dentition. Am J Orthod Dentofacial Orthop.1997;111(3):321-327. doi:10.1016/S0889-5406(97)70191-4.
-
Çörekçi B, Göyenç YB. Dentofacial changes from fan-type rapid maxillary expansion vs traditional rapid maxillary expansion in early mixed dentition: a prospective clinical trial. Angle Orthod. 2013;83(5):842-850. doi:10.2319/103112-837.1.
-
da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofacial Orthop.1991;100(2):171-179. doi:10.1016/s0889-5406(05)81524-0.