Differences in dentoskeletal and soft tissue changes due to rapid maxillary expansion using a tooth-borne expander between adolescents and adults: A retrospective observational study

Abstract

Objective The purpose of this study was to compare the differences in dentoskeletal and soft tissue changes following conventional tooth-borne rapid maxillary expansion (RME) between adolescents and adults. Methods Dentoskeletal and soft tissue variables of 17 adolescents and 17 adults were analyzed on posteroanterior and lateral cephalograms and frontal photographs at pretreatment (T1) and after conventional RME using tooth-borne expanders (T2). Changes in variables within each group between T1 and T2 were analyzed using Wilcoxon signed-rank test. Mann–Whitney U test was used to determine the differences in the pretreatment age, expansion and post-expansion durations, and dentoskeletal and soft tissue changes after RME between the groups. Spearman’s correlation between pretreatment age and transverse dentoskeletal changes in the adolescent group was calculated. Results Despite similar amounts of expansion at the crown level in both groups, the adult group underwent less skeletal expansion with less intermolar root expansion after RME than the adolescent group. The skeletal vertical dimension increased significantly in both groups without significant intergroup difference. The anteroposterior position of the maxilla was maintained in both groups, while a greater backward displacement of the mandible was evident in the adult group than that in the adolescent group after RME. The soft tissue alar width increased in both groups without a significant intergroup difference. In the adolescent group, pretreatment age was not significantly correlated with transverse dentoskeletal changes. Conclusions Conventional RME may induce similar soft tissue changes but different dentoskeletal changes between adolescents and adults.

Rapid Maxillary Expansion Treatment in Patients with Cleft Lip and Palate: A Survey on Clinical Experience in the European Cleft Centers

“…Since nose growth takes a long time, the changes are discreet [17]. However, recent literature reveals that nasal and alar base widths increased significantly after expansion [63,64]. A nasal widening of around 2 mm was seen in a study [65] evaluated through photometric analysis.…”

Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report

“…Gökçe [ 23 ] compared pre-treatment and post-treatment posteroanterior cephalometric values of adolescents treated with RME and in the Hyrax wearing group observed a mild increase in the maxillary and nasopharyngeal width, leading to an improved breathing function, but also an increase in upper intermolar width. Depending on the stage of maturation of the suture, the expansion obtained in late adolescents is half skeletal and half dental [ 44 ] and the force of the apparatus has negative consequences on the anchoring teeth [ 45 , 46 ].…”

“…Gökçe [23] compared pre-treatment and post-treatment posteroanterior cephalometric values of adolescents treated with RME and in the Hyrax wearing group observed a mild increase in the maxillary and nasopharyngeal width, leading to an improved breathing function, but also an increase in upper intermolar width. Depending on the stage of maturation of the suture, the expansion obtained in late adolescents is half skeletal and half dental [44] and the force of the apparatus has negative consequences on the anchoring teeth [45,46]. Therefore, expansion with classic tooth-borne devices is frequently related to undesirable implications such as extrusion of the posterior teeth, increase in the buccal angulation of the anchoring elements, dentoalveolar tipping, root resorption of the anchoring elements and contiguous teeth, bone dehiscence, periodontal sequelae such as gingival recessions and loss of alveolar support due to horizontal and vertical reduction in the alveolar ridge [37].…”

Miniscrews position for a tissue bone borne palatal C-expander affects the displacement pattern of nasomaxillary complex: a finite element study

“… 10 – 12 However, in skeletally mature adults and late adolescents, the stronger interdigitation of the midpalatal suture presents limitations in resolving transverse deficiencies solely through dental expansion. 13 – 15 This can lead to adverse effects on anchor teeth, including tipping, extrusion, root resorption, relapse, and periodontal issues. 16 Recently, surgical approaches such as surgically assisted rapid palatal expansion (SARPE) or surgical segmental surgery have been introduced for adult patients with maxillary transverse deficiency, and they have shown effectiveness.…”