Dental and Skeletal Changes after Transpalatal Distraction

Abstract

Maxillary constriction is a common skeletal craniofacial abnormality, and transverse maxillary deficiency affects 30% of patients receiving orthodontic and surgical treatment. The aim of the study was to analyse craniofacial skeletal changes in adults with maxillary constriction after transpalatal distraction. The study group consisted of 36 patients (16 women) aged 17 to 42 years (M = 27.1; SD = 7.8) with a known complete skeletal crossbite and who underwent transpalatal distraction procedure. The measurements were obtained on diagnostic models, and cephalometric PA radiograms were obtained at time points, i.e., before treatment (T1) and after the completion of active distraction (T2). The analysis of diagnostic models involving the arch width measurement at different levels demonstrated a significant increase in L1, L2, L3, L4, L5, and L6 dimensions after transpalatal distraction. The largest width increase (9.5 mm) was observed for the L3 dimension (the intercanine distance). The analysis of frontal cephalograms displayed a significant increase in W1, W2, and W3 dimensions after transpalatal distraction. The largest width increase (4.9 mm) was observed for the W1 dimension at the level of the alveolar process of the maxilla. Transpalatal distraction is an effective treatment for transverse maxillary deficiency after the end of bone growth. The expansion observed on diagnostic models is close to a parallel segment shift mechanism, with a mild tendency towards a larger opening anteriorly. The maxillary segment rotation pattern analysed based on the frontal cephalograms is close to a hand fan unfolding with the rotation point at the frontonasal suture.

Comparison of Tooth- and Bone-Borne Appliances on the Stress Distributions and Displacement Patterns in the Facial Skeleton in Surgically Assisted Rapid Maxillary Expansion—A Finite Element Analysis (FEA) Study

“…ANSYS is a finite element analysis (FEA) software tool for structural analysis in a simulated environment. In ANSYS 15.0, the mechanical properties of the materials in the models were assigned, as shown in Table 1 , and an analysis using the finite element method was made [ 24 , 27 , 28 , 29 ]. As a result of the dense discretisation, a dense mesh of higher-order finite elements was created, consisting of over 1.8 million elements, with an element edge length of 1–2 mm ( Figure 1 ).…”

“…In MARPE (microimplant-assisted rapid palatal expansion) therapy, the teeth and the palatal process of the maxilla are used for fixing the device. MARPE is a combination of the two types of device fixation mentioned above [ 24 , 25 ]. Each type of expander has its supporters and opponents.…”

Parathyroid hormone promotes maxillary expansion and reduces relapse in the repeated activation maxillary expansion rat model by regulating Wnt/β-catenin pathway

“…Maxillary constriction is one of the most common craniofacial deformities, which can lead to crowding, posterior crossbite, anterior open bite and other types of malocclusion [ 1 ]. Its etiology is complex, generally believed to be associated with bad habits such as finger sucking or oral breathing [ 2 ].…”