Maxillary Orthodontic Expansion Assisted by Unilateral Alveolar Corticotomy and Low-Level Laser Therapy: A Novel Approach for Correction of a Posterior Unilateral Cross-Bite in Adults

Abstract

Introduction: The treatment of a true unilateral posterior crossbite often requires asymmetric maxillary expansion; however, this is challenging to achieve with conventional expansion methods because of several biomechanical limitations. In this paper, we introduce a new protocol for the treatment of a unilateral posterior crossbite in adults based on maxillary orthodontic expansion assisted by corticotomy and low-level laser therapy (LLLT) performed on the crossbite side. Methods: The study sample included 15 adults (8 females, 7 males) affected by a true unilateral posterior crossbite, with a mean age of 21.6 ± 3.1 years at the at the beginning of treatment. After the application of orthodontic appliances (palatal expander and self-ligating brackets), corticomy was performed at the buccal aspect of the crossbite side while LLLT was monthly administered up to the correction of the crossbite. The efficacy of the technique was evaluated through measurements performed on maxillary digital models. Results: All subjects reported successful correction of the posterior unilateral crossbite, and functional occlusion was achieved as well. The average expansion was greater at the crossbite side compared to the unaffected side and such difference was significant at the levels of first premolars (P < 0.05), second premolars (P < 0.05) and first molars (P < 0.05). Conclusion: Orthodontic maxillary expansion assisted by unilateral corticotomy and LLLT was effective in the treatment of the true unilateral crossbite.

Description of a Digital Work-Flow for CBCT-Guided Construction of Micro-Implant Supported Maxillary Skeletal Expander

“…The use of skeletal anchorage is getting widespread among orthodontists since it facilitates the management of complex orthodontic biomechanics; as a consequence, skeletal anchorage can be useful in treating borderline cases such as transversal maxillary deficiency in adults. In this respect, miniscrews-assisted rapid maxillary expansion was found to effectively open the mid-palatal suture in adults without the necessity to undergo orthognathic surgery [12,24,[28][29][30][31][32][33][34][35][36][37].…”

A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial

“…[29][30][31] The red and near-infrared regions of the spectrum represent the most effective ranges of irradiation, since they thoroughly penetrate into the living tissues to induce cell proliferation and differentiation without overheating the tissues. 8,12,22,23 In vitro and in vivo studies also suggested that irradiation dose could influence the rate of orthodontic movement. In particular, the effective dosage that was proven to accelerate canine retraction during space closure…”

“…20 However, we decided to enroll 100 subjects (50 for each group) counteracting any potential incompleteness of data. The enrollment process was based on the following criteria: (1) age between 13 and 30 years, (2) permanent mandibular dentition, (3) angle class I malocclusion, (4) lower 6-6 mild crowding measured on dental cast, (5) no diastema or spaces in the lower arch, (6) no ectopic teeth, (7) no extractions required or intraoral or extraoral auxiliary devices, and (8) no previous orthodontic treatment.…”

“…5 Thus, improving the efficiency of orthodontic treatment is a primary concern for both patients and clinicians. 6 Surgical procedures such as corticotomy 7,8 and accelerated osteogenic orthodontics 9,10 have been proposed as effective methods to accelerate orthodontic tooth movement, however, these methods cause more discomfort than conventional treatment and require highly skilled oral surgeons and specific surgical equipment. In this respect, nonsurgical methods for accelerating orthodontic treatment such as the daily use of portable vibration device or electric toothbrush can be considered patient-friendly approaches, however, there is no sufficient evidence of their effectiveness.…”

New Technologies in Orthodontics: A Digital Workflow to Enhance Treatment Plan and Photobiomodulation to Expedite Clinical Outcomes

“…PBM can create a favorable environment for tooth movement, as two types of host responses occur in the irradiated tissues. First, photobiomodulation increases the production of mitochondrial ATP by upregulating the cytochrome c oxidase [12,14,[39][40][41][42][43][44][45] and promotes the cellular viability and the expression of osteocalcin in the tension areas of PDL [12][13][14][15][39][40][41][42][43]. This increased metabolic activity accelerates cellular turnover (osteoclast, osteoblast, and fibroblasts) [44][45][46][47][48][49][50][51][52][53] and the production of cytokines involved in the bone remodeling, mainly the IL-1b [46,[54][55][56][57].…”