THE EFFECTS OF MAXILLARY EXPANSION ON THE SOFT TISSUE FACIAL PROFILE

Işıl Aras, Sultan Ölmez, Mehmet Cemal Akay, Tayfun Günbay, Aynur Aras
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Abstract


Purpose: The aims of this retrospective study were to evaluate the possible changes in soft tissue facial profile induced by orthopedic rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME), and to correlate them with the underlying hard tissue alterations.

Material and Methods: 16 patients who received bone borne SARME and 25 patients who were subjected to RME using metal cast splint hyrax appliance were studied retrospectively. This research was conducted on lateral cephalometric radiographs taken on 2 occasions: before expansion (T1) and at the beginning of any further orthodontic treatment (T2). Investigated lateral cephalometric parameters consisted of Holdaway soft tissue measurements with some supplementary soft tissue, skeletal and dental assessments.

Results:  The acquisition of T2 cephalograms which conforms to the initiation of further orthodontic treatment corresponded to 83.25±3.51 days for SARME and 85.68±4.37 days for RME after the expansion was completed. The only significant change in soft tissue profile of the SARME group was a decrease in upper lip thickness (p<0.05), whereas in the RME group, decrease in soft tissue facial profile angle and increase in H angle were found to be statistically significant. For the RME group, the changes in soft tissue facial profile angle and H angle correlated only with the changes in SNB angle (p<0.05). 

Conclusion: While bone-borne SARME did not seem to poses the potential to alter soft tissue profile, tooth-borne RME caused a more convex soft tissue profile related to a reduction in SNB.


Keywords


Maxillary expansion; palatal expansion; lateral cephalometry; soft tissue profile; orthodontics

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DOI: http://dx.doi.org/10.17096/jiufd.85884

References


Bishara SE, Staley RN. Maxillary expansion: Clinical implications. Am J Orthod Dentofacial Orthop 1987;91(1):3-14.

Podesser B, Williams S, Crismani AG, Bantleon HP. Evaluation of the effects of rapid maxillary expansion in growing children using computer tomography scanning: A pilot study. Eur J Orthod 2007;29(1):37-44.

Suri L, Taneja P. Surgically assisted rapid palatal expansion: A literature review. Am J Orthod Dentofacial Orthop 2008;133(2):290-302.

Koudstaal MJ, Poort LJ, van der Wal KG, Wolvius EB, Prahl-Andersen B, Schulten AJ. Surgically assisted rapid maxillary expansion (sarme): A review of the literature. Int J Oral Maxillofac Surg 2005;34(7):709-714.

Lagravere MO, Major PW, Flores-Mir C. Dental and skeletal changes following surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg 2006;35(6):481-487.

Loddi PP, Pereira MD, Wolosker AB, Hino CT, Kreniski TM, Ferreira LM. Transverse effects after surgically assisted rapid maxillary expansion in the midpalatal suture using computed tomography. J Craniofac Surg 2008;19(2):433-438.

Gerlach KL, Zahl C. Transversal palatal expansion using a palatal distractor. J Orofac Orthop 2003;64(6):443-449.

Gunbay T, Akay MC, Gunbay S, Aras A, Koyuncu BO, Sezer B. Transpalatal distraction using bone-borne distractor: Clinical observations and dental and skeletal changes. J Oral Maxillofac Surg 2008;66(12):2503-2514.

Matteini C, Mommaerts MY. Posterior transpalatal distraction with pterygoid disjunction: A short-term model study. Am J Orthod Dentofacial Orthop 2001;120(5):498-502.

Mommaerts MY. Transpalatal distraction as a method of maxillary expansion. Br J Oral Maxillofac Surg 1999;37(4):268-272.

Nada RM, Fudalej PS, Maal TJ, Berge SJ, Mostafa YA, Kuijpers-Jagtman AM. Three-dimensional prospective evaluation of tooth-borne and bone-borne surgically assisted rapid maxillary expansion. J Craniomaxillofac Surg 2012;40(8):757-762.

Pinto PX, Mommaerts MY, Wreakes G, Jacobs WV. Immediate postexpansion changes following the use of the transpalatal distractor. J Oral Maxillofac Surg 2001;59(9):994-1000; discussion 1001.

Ramieri GA, Spada MC, Austa M, Bianchi SD, Berrone S. Transverse maxillary distraction with a bone-anchored appliance: Dento-periodontal effects and clinical and radiological results. Int J Oral Maxillofac Surg 2005;34(4):357-363.

Seeberger R, Kater W, Schulte-Geers M, Davids R, Freier K, Thiele O. Changes after surgically-assisted maxillary expansion (sarme) to the dentoalveolar, palatal and nasal structures by using tooth-borne distraction devices. Br J Oral Maxillofac Surg 2011;49(5):381-385.

Altorkat Y, Khambay BS, McDonald JP, Cross DL, Brocklebank LM, Ju X. Immediate effects of rapid maxillary expansion on the naso-maxillary facial soft tissue using 3d stereophotogrammetry. Surgeon 2016;14(2):63-68.

Berger JL, Pangrazio-Kulbersh V, Thomas BW, Kaczynski R. Photographic analysis of facial changes associated with maxillary expansion. Am J Orthod Dentofacial Orthop 1999;116(5):563-571.

de Carvalho APMC GF AF, Siqueira DF, Bommarito S, Scanavini MA, Kanashiro LK. . Assessment of changes in smile after rapid maxillary expansion. Dental Press J Orthod 2012;17(5):94-101.

Filho HN, Goncales ES, Berrentin-Felix G, de Souza Cesar U, Achja GL. Evaluation of the facial soft tissues following surgically assisted maxillary expansion associated with the simple v-y suture. Int J Adult Orthodon Orthognath Surg 2002;17(2):89-97.

Johnson BM, McNamara JA, Bandeen RL, Baccetti T. Changes in soft tissue nasal widths associated with rapid maxillary expansion in prepubertal and postpubertal subjects. Angle Orthod 2010;80(6):995-1001.

Kim KB AD AE, Behrents RG. Evaluation of immediate soft tissue changes after rapid maxillary expansion. Dental Press J Orthod 2012;17(5):157-164.

Magnusson A, Bjerklin K, Kim H, Nilsson P, Marcusson A. Three-dimensional computed tomographic analysis of changes to the external features of the nose after surgically assisted rapid maxillary expansion and orthodontic treatment: A prospective longitudinal study. Am J Orthod Dentofacial Orthop 2013;144(3):404-413.

Nada RM, van Loon B, Maal TJ, Berge SJ, Mostafa YA, Kuijpers-Jagtman AM, Schols JG. Three-dimensional evaluation of soft tissue changes in the orofacial region after tooth-borne and bone-borne surgically assisted rapid maxillary expansion. Clin Oral Investig 2013;17(9):2017-2024.

Silva Filho OG, Lara TS, Ayub PV, Ohashi AS, Bertoz FA. Photographic assessment of nasal morphology following rapid maxillary expansion in children. J Appl Oral Sci 2011;19(5):535-543.

Akkaya S, Lorenzon S, Ucem TT. A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures. Eur J Orthod 1999;21(2):175-180.

Alpern MC, Yurosko JJ. Rapid palatal expansion in adults with and without surgery. Angle Orthod 1987;57(3):245-263.

Basciftci FA, Karaman AI. Effects of a modified acrylic bonded rapid maxillary expansion appliance and vertical chin cap on dentofacial structures. Angle Orthod 2002;72(1):61-71.

Chung CH, Font B. Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofacial Orthop 2004;126(5):569-575.

Haas AJ. Palatal expansion: Just the beginning of dentofacial orthopedics. Am J Orthod 1970;57(3):219-255.

Majourau A, Nanda R. Biomechanical basis of vertical dimension control during rapid palatal expansion therapy. Am J Orthod Dentofacial Orthop 1994;106(3):322-328.

Wertz R, Dreskin M. Midpalatal suture opening: A normative study. Am J Orthod 1977;71(4):367-381.

dos Santos BM, Stuani AS, Stuani AS, Faria G, Quintao CC, Stuani MB. Soft tissue profile changes after rapid maxillary expansion with a bonded expander. Eur J Orthod 2012;34(3):367-373.

Karaman AI BF Gelgör IE, Demir A. Examination of soft tissue changes after rapid maxillary expansion. World J Orthod 2002;3(3):217-222.

Kilic N, Kiki A, Oktay H, Erdem A. Effects of rapid maxillary expansion on holdaway soft tissue measurements. Eur J Orthod 2008;30(3):239-243.

Holdaway RA. A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Am J Orthod 1983;84(1):1-28.

Dahlberg G. Statistical methods for medical and biological students. Sydney, G. Allen & Unwin ltd, 1940, p.78-79.

Zimring JF, Isaacson RJ. Forces produced by rapid maxillary expansion. 3. Forces present during retention. Angle Orthod 1965;35(3):178-186.

Biederman W. Rapid correction of Class III malocclusion by midpalatal expansion. Am J Orthod 1973;63(1):47-55.

Ramieri GA, Nasi A, Dell'acqua A, Verze L. Facial soft tissue changes after transverse palatal distraction in adult patients. Int J Oral Maxillofac Surg 2008;37(9):810-818.

Kasai K. Soft tissue adaptability to hard tissues in facial profiles. Am J Orthod Dentofacial Orthop 1998;113(6):674-684.

Oliver BM. The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod 1982;82(2):141-149.




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