An Improved Method of Differential Rapid Maxillary Expansion in Cleft Palate

Devenish, E.A.; Foster, T. D.; Chinn, D.

doi:10.1179/bjo.9.3.129

British Journal of Orthodontics

1982

DOI: 10.1179/bjo.9.3.129

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An Improved Method of Differential Rapid Maxillary Expansion in Cleft Palate

E.A. Devenish

T. D. Foster

D. Chinn

Abstract: A system of differential rapid maxillary expansion is described. This method is particularly useful in patients with cleft lip and palate who have severe defects of lateral maxillary growth, since it enables the maxillary segments to be rotated so that intercanine width increases without a concomitant increase in the intermolar width.

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1986

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Cited by 4 publications

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“…8–10,12,13 On the other hand, fan-type expanders promote a transversal increase only in the anterior region of the dental arch. 14–17 Recently, a novel maxillary expander was designed especially for achieving different amounts of expansion in the anterior and posterior regions of the maxillary dental arch in patients with complete BCLP. 18 …”

mentioning

confidence: 99%

Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial

Garib

Lauris

Calil

et al. 2016

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction The purpose of this 2-arm parallel study was to evaluate the dentoskeletal effects of rapid maxillary expansion with differential opening (EDO) compared with the hyrax expander in patients with complete bilateral cleft lip and palate. Methods A sample of patients with complete bilateral cleft lip and palate was prospectively and consecutively recruited. Eligibility criteria included participants in the mixed dentition with lip and palate repair performed during early childhood and maxillary arch constriction with a need for maxillary expansion before the alveolar bone graft procedure. The participants were consecutively divided into 2 study groups. The experimental and control groups comprised patients treated with rapid maxillary expansion using EDO and the hyrax expander, respectively. Cone-beam computed tomography examinations and digital dental models of the maxillary dental arches were obtained before expansion and 6 months postexpansion. Standardized cone-beam computed tomography coronal sections were used for measuring maxillary transverse dimensions and posterior tooth inclinations. Digital dental models were used for assessing maxillary dental arch widths, arch perimeters, arch lengths, palatal depths, and posterior tooth inclinations. Blinding was used only during outcome assessment. The chi-square test was used to compare the sex ratios between groups (P <0.05). Intergroup comparisons were performed using independent t tests with the Bonferroni correction for multiple tests. Results Fifty patients were recruited and analyzed in their respective groups. The experimental group comprised 25 patients (mean age, 8.8 years), and the control group comprised 25 patients (mean age, 8.6 years). No intergroup significant differences were found for age, sex ratio, and dentoskeletal variables before expansion. No significant differences were found between the EDO and the hyrax expander groups regarding skeletal changes. The EDO promoted significantly greater increases of intercanine width (difference, 3.63 mm) and smaller increases in canine buccal tipping than the conventional hyrax expander. No serious harm was observed other than transitory variable pressure sensations on the maxillary alveolar process in both groups. Conclusions The EDO produced skeletal changes similar to the conventional hyrax expander. The differential expander is an adequate alternative to conventional rapid maxillary expanders when there is need for greater expansion in the maxillary dental arch anterior region. Registration This trial was not registered. Protocol The protocol was not published before trial commencement.

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mentioning

confidence: 99%

Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial

Garib

Lauris

Calil

et al. 2016

American Journal of Orthodontics and Dentofacial Orthopedics

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Expansion im oberen Zahnbogen bei Patienten mit Lippen-Kiefer-Gaumen-Spalten

Janson¹,

Loh

1986

Fortschritte der Kieferorthopäadie

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Alignment Strategy for Constricted Maxillary Dental Arch in Patients With Unilateral Cleft Lip and Palate Using Fixed Orthodontic Appliance

Park¹,

Park²,

Baek

2018

Journal of Craniofacial Surgery

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The purpose of this study was to compare the alignment pattern of the constricted maxillary dental arch by fixed orthodontic treatment (FOT) in the well-aligned and constricted arches of unilateral cleft lip and palate (UCLP) patients. 19 UCLP patients were divided into Group 1 (well-aligned arch, n = 9) and Group 2 (constricted arch, n = 10). After the cephalometric and maxillary dental arch variables before (T1) and after FOT (T2) were measured, statistical analysis was performed. There were no significant differences in the surgical timing of cheiloplasty, palatoplasty, and secondary alveolar bone grafting and in the surgical method of cheiloplasty between the 2 groups. However, Group 2 had a higher percentage of palatoplasty method, which could leave the denuded bone for secondary healing than Group 1 (P < 0.05). Although Group 2 showed more constriction and asymmetry in the maxillary dental arch compared to Group 1 at the T1 stage (inter-second premolar width, greater segment angle [GSA], and lesser segment angle [LSA], all P < 0.05), these problems could be effectively resolved by FOT. As a result, at the stage T2, there was no significant difference in all the variables between the 2 groups. During T1-T2, there was a different pattern in change of variables between Groups 1 and 2 (anterior segment angle in the greater segment [P < 0.05] in Group 1 and U1-SN [P < 0.01], inter-molar width [P < 0.05], GSA [P < 0.05[, and LSA [P < 0.01] in Group 2). Therefore, according to the maxillary dental arch shape, different strategy is necessary to obtain proper alignment by FOT.

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An Improved Method of Differential Rapid Maxillary Expansion in Cleft Palate

Cited by 4 publications

References 1 publication

Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial

Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial

Expansion im oberen Zahnbogen bei Patienten mit Lippen-Kiefer-Gaumen-Spalten

Alignment Strategy for Constricted Maxillary Dental Arch in Patients With Unilateral Cleft Lip and Palate Using Fixed Orthodontic Appliance

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