Soft tissue profile changes after rapid maxillary expansion with a bonded expander

Abstract

The aim of this study was to evaluate the short- and long-term treatment effects of rapid maxillary expansion (RME) on the soft tissue facial profile of subjects treated with a modified acrylic-hyrax device. The sample comprised 10 males and 10 females in the mixed dentition. Their average age was 9.3 years ± 10 months pre-treatment (T1), with a narrow maxilla and posterior crossbite, treated with a modified fixed maxillary expander with an occlusal splint. Lateral cephalometric radiographs obtained at T1, immediately post-expansion (T2), and after retention (T3) were used to determine possible changes in the soft tissue facial profile. The means and standard deviations for linear and angular cephalometric measurements were analysed statistically using analysis of variance and Tukey's test (α = 0.05). The measurements at T2 differed significantly from those at T1 and T3. However, RME did not produce any statistically significant alteration (P > 0.05) in the soft tissue profile for any of the cephalometric landmarks evaluated when compared at T1 and T3. The use of a fixed expander associated with an occlusal splint did not cause significant alterations in the soft tissue facial profile at T3. This modified device is effective for preventing the adverse vertical effects of RME such as an increase anterior face height in patients with a crossbite.

Effects of different rapid maxillary expansion appliances on facial soft tissues using three-dimensional imaging

“…These findings are in agreement with a previous study, which reported an increase of 0.5u in the nasolabial angle with bonded RME. 23 The changes in the nasolabial angle were observed in all groups in the present study, but there was no significant difference among groups. The slight increase in this angle in the banded and bonded groups may result from retrusion of the upper incisors after RME.…”

“…Asanza et al 22 found that the patients treated with bonded posterior occlusal coverage RME appliances showed less inferior movement of the posterior aspect of the palate versus those treated with banded RME appliances. Dos Santos et al 23 investigated the effects of using bonded appliances on facial soft tissue profile and found no significant alterations in the soft tissues at the end of the retention period. In this study, there was no significant effect on the soft tissue or lower and total facial height with any of the RME appliances.…”

Camouflage treatment of skeletal Class III malocclusion with multiloop edgewise arch wire and modified Class III elastics by maxillary mini-implant anchorage

“…11,12,16,17 In the treatment of Class III patients using protraction headgear or during maxillary expansion, for instance, prevention of adverse vertical tooth movements and mandibular counterclockwise rotation are desirable, particularly in patients with an open bite tendency. 16,17 Camouflage treatment does not exclude orthodontists from better controlling tooth movements. On the contrary, treatment with more rational mechanical systems should be developed to improve treatment results.…”

“…These changes resulting from intermaxillary Class III elastics would be an undesirable outcome in patients with open bite, long face, or high mandibular plane angle and should be avoided for facial balance and esthetics. 16,18,19 The lower lip is often protruded in relation to the upper in skeletal Class III patients. 20 The reduction of lower lip protrusion in the experimental group improved facial esthetics, while the upper and lower lips became more protrusive in the control group.…”

Palatal Expansion and its Effects in Orthodontics

“…They concluded these changes were primarily due to the presence of the expander appliance. However, they concluded that following a retention period of six months, minimal soft tissue changes are seen following expansion [17]. A similar study was conducted which consisted of 18 patients with bilateral posterior crossbite.…”