The current available data provide insufficient and weak evidence to form a solid and firm conclusion. There is poor, very low-quality evidence regarding the positional and dimensional effects of posterior crossbite correction on the TMJs.

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BACKGROUND:Piezocision-assisted orthodontics (PAO) is considered one of the modern techniques aiming at reducing the treatment time and overcoming some limitations of orthodontic treatment. The use of piezocision as an adjunct in the treatment of posterior crossbite is limited, so additional research in this area is required.AIM:To three-dimensionally compare the skeletal and dental effects produced by piezocision-assisted rapid maxillary expansion (PARME) and conventional rapid maxillary expansion (RME) using cone beam computed tomography (CBCT).MATERIALS AND METHODS:This prospective controlled study comprised 14 consecutive non-syndromic patients with posterior crossbite. In 7 patients (mean age = 16.1 ± 0.3 years), PARME was used to correct the crossbite; whereas in the remaining 7 (mean age = 15.9 ± 0.5 years), RME was done. Cone beam computed tomography (CBCT) scans were performed before expansion (T1) and 3 months later after expansion (T2) to compare the skeletal and dental effects produced by the two expansion techniques. Transverse skeletal, dentolinear, and dentoangular variables at the level of maxillary first and second premolars and maxillary first molars were measured and compared within and between groups using the appropriate statistical test.RESULTS:For the transverse skeletal variables, PARME showed a non-significant increase; whereas, RME showed a significant increase. Regarding the dentolinear measurements, a significant increase in coronal widths and an insignificant increase in apical widths was seen in PARME, whereas, the RME showed a non-significant increase for both coronal and apical widths. Non-significant decreases (protrusion of teeth) in the dentoangular measurements were seen in both groups. Between-group comparisons showed a non-significant difference except for the dentolinear coronal widths.CONCLUSION:PARME is effective in treating posterior crossbite. Because of the more dental expansion produced by PARME as compared to the conventional RME, PARME should be limited only to mild or moderate not severe forms of palatal constriction. The available evidence regarding the effectiveness of corticotomy- and/or piezocision-assisted maxillary expansion for correction of posterior crossbite is limited and inadequate.

Aim: The aim of this randomized controlled trial (RCT) was to determine whether gargling with green tea was effective in reducing pain after orthodontic elastomeric separators placement. Materials and methods: A total of 50 patients with an age range between 13 and 17 years were recruited and randomly allocated in a ratio of 1:1 to the green tea mouthwash group (GTG) and the control group (CG). Patients in GTG were instructed to gargle with green tea mouthwash after two hours from separators placement and every eight hours afterwards for a week, while participants of CG were asked not to rinse their mouths. The patients in the two groups were instructed not to use any kind of local or systemic analgesics throughout the duration of the study. A 10-cm horizontal visual analog scale (VAS) was used to assess the pain at two hours, six hours, bedtime, 24 hours, and then daily after separators placement for seven days. Results: One patient in each group was lost to follow up and one patient in the CG was excluded because of using analgesics; therefore, 23 patients in the CG and 24 patients in the GTG were analyzed. Although the pain scores were lower at all time points in GTG group, the difference between the two groups was statistically non-significant. Conclusion: Gargling with green tea mouthwash three times daily does not seem to significantly reduce the pain after orthodontic elastomeric separators placement as compared to controls.

AIM: The aim of the study was to investigate whether chewing gum (CG) can reduce pain as compared to non-CG (NG) after orthodontic elastomeric separators placement. MATERIALS AND METHODS: Sixty patients were randomly allocated in a ratio of 1:1 to CG group (mean age = 21.82 ± 0.87 years) and NG group (mean age = 22.31 ± 1.09 years). Patients in the CG group were instructed to chew sugar-free gum for 10 min immediately after separators placement and then at 8-h intervals for 1 week, while the patients in the NG group were instructed not to chew any type of gum for the duration of the study. Patients in the two groups were asked not to use any type of analgesics. The patients were asked to register their pain level using a 10-cm horizontal line visual analog scale at 2 h, 6 h, bedtime, 24 h, and then daily for 1 week after separators placement. RESULTS: The data from 53 patients (27 in the NG group and 26 in the CG group) were analyzed. The pain scores were significantly lower in CG as compared to NG at 2 h, 6 h, bedtime, 24 h, and 2 days after separators placement. From day 3 to the end of the week duration of the study, the pain scores stayed lower in the CG group, but the difference was not statistically significant. CONCLUSION: CG significantly reduced pain resulting from orthodontic elastomeric separators placement as compared to non-CG controls.