Evaluation of palate area before and after rapid maxillary expansion, using cone-beam computed tomography

Abstract

Objective: The aim of this study was to estimate the changes in the palate area after rapid maxillary expansion (RME) with the Hyrax expander in growing subjects, using cone beam computed tomography (CBCT). Methods: Fourteen patients (9 girls and 5 boys; mean age = 11.7 ± 2.4 years) who required RME as part of their orthodontic treatment were included in this study. CBCT records had been taken before RME treatment (T0), at the end of active expansion (T1) and after a 6-month retention period (T2). The CBCT scans were manipulated with Dolphin Imaging® version 11.7 Premium software, in which landmarks were positioned and measured in relation to sagittal, coronal and axial planes, to verify the palate surface area. In addition, linear measurements of the palatal depth and width were assessed. These measurements were compared by using analysis of variance (ANOVA) for repeated measures. A p-value smaller than 0.05 was considered statistically significant. Results: The palatal surface area and width significantly increased from T0 to T1, respectively by 9.27% and 9.71%, and both decreased in a non-significant manner from T1 to T2. The palatal depth had non-significant differences at T0, T1 and T2. Conclusions: RME promotes a significant gain in the surface area of the palate and an increase in intermolar width. The Hyrax appliance was effective for the treatment of maxillary atresia in growing patients. There was no vertical alteration of the palate. After a 6-month retention period, the maxilla transverse dimension and the surface area of the palate remained stable.

Palatal Vault Morphometric Analysis of the Effects of Two Early Orthodontic Treatments in Anterior Open Bite Growing Subjects: A Controlled Clinical Study

“…These ndings agree partially with the ones present in literature on patients with maxillary constriction [39][40][41][42][43] and con rm that RME signi cantly increases transversal dimensions of the palatal vault. However, to our knowledge, no study associated the RME to a decrease in the palatal depth.…”

“…However, to our knowledge, no study associated the RME to a decrease in the palatal depth. On the contrary, Bruder C. et al, 43 demonstrated that maxillary constricted patients treated by RME have no vertical alteration of the palate. This result is in contrast with the one of our study.…”

Novel Digital Measurement Technique to Analyze the Palatine Suture Expansion after Palatine Rapid Maxillary Expansion Technique

“…Numerous authors have already demonstrated the efficacy of RME in the transverse gain of the maxilla through different pre and postoperative measurement processes using sagittal, coronal and axial planes given by CBCT scan so that numerous measures can be obtained through linear records, angulations between planes and surface areas [19][20][21][33][34][35]. However, despite the use of CBCT technology that allows for the three-dimensional analysis of cranial structures, to our knowledge there are no studies that measure the maxillary volume obtained after RME procedures.…”

“…Previous studies have analyzed the dento-skeletal [10] and morphological outcomes [11] of RME procedures using a computed tomography (CT) scan [12] or cone-beam computed tomography (CBCT) scan [4], and highlighted both width and depth increasing of the maxilla and also an increase in the inclination of the dentoalveolar process after RME procedures [1,[13][14][15][16][17]. In addition, the maxillary expansion after RME procedures has also been quantified by linear [18] and angular measurements [19] and even by analyzing the area of the palate surface [20][21][22][23]. However, Marini et al reported that the palatal volume increases in patients treated with RME procedures and recommended the application of three-dimensional (3D) measurement techniques to evaluate the skeletal changes [2].…”

A pilot study of mandibular expansion in combination with a fixed-appliance for increasing the effective space of the mandibular arch

“…With respect to transverse dimension, constricted arch problems have been solved through expansion, with increments in arch dimensions having been clearly demonstrated. [ 1 , 2 ] Mandibular expansion has not been recommended because the maxilla has a mid-palatal suture, [ 3 ] unlike the mandible. [ 4 ] A variety of methods such as the Schwarz and Bi-Helix appliances have been used, with limited dimension change and questionable expansion of the effective space primarily due to the inclination of teeth.…”