Long-term efficacy of reverse-pull headgear therapy

Objective Miniscrew-assisted rapid palatal expansion (MARPE) is a means for expanding the basal bone without surgical intervention in young adults. Here, we assessed the differences in dental, alveolar, and skeletal measurements taken before (T0), immediately after (T1), and 1 year after (T2) MARPE. Methods Twenty-four patients (mean age, 21.6 years) who had undergone MARPE and cone-beam computed tomography at T0, T1, and T2 were included. Changes in the following parameters were compared using paired t-tests: intercusp, interapex, alveolar, nasal floor, and nasal cavity widths; inclination of the first molar (M1) and its alveolus; and thickness and height of the alveolar bone. A linear mixed-effects model was used to determine variables that affected periodontal changes in the M1. Results MARPE produced significant increases in most measurements during T0-T2, despite relapse of some measurements during T1-T2. The alveolar thickness decreased on the buccal side, but increased on the palatal side. The alveolar crest level at the first premolar moved apically. Changes in the thickness and height of the alveolar bone were affected by the corresponding initial values. Conclusions MARPE can be used as an effective tool for correcting maxillomandibular transverse discrepancy, showing stable outcomes 1 year after expansion.

https://ir.ymlib.yonsei.ac.kr/bitstream/22282913/161296/1/T201704434.pdf

Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion

Class III malocclusion represents a growth-related dentofacial deformity with mandibular prognathism in relation to the maxilla and/or cranial base. Its prevalence varies greatly among and within different races, ethnic groups, and geographic regions studied. Class III malocclusion has a multifactorial etiology, which is the expression of a moderate distortion of normal development as a result of interaction between innate factors or genetic hereditary with environmental factors. Various skeletal topographies of underlying Class III malocclusion are due to discrepancy in the maxillary and mandibular growth along with vertical and/or transverse problems apart from sagittal malformations. The spectrum of complications for Class III malocclusion ranges in gravity from dentoalveolar problems with functional anterior shift of the mandible to true skeletal problems with serious maxillomandibular discrepancies, which makes its diagnosis highly challenging in growing children. Concern regarding early treatment and the need for interceptive care in the case of Class III malocclusion has always been a dilemma, knowing that not all problems will be solved in these cases until maxillomandibular growth is further completed, and the long-term outcome of various treatment approaches may depend on the growth tendency of an individual. Interceptive treatment of Class III malocclusions should be undertaken if it prevents damage to the oral tissues and/or significantly reduces the amount or severity of future orthodontic and surgical interventions. This paper presents an overview of developing Class III malocclusion, with the emphasis on challenges and their solutions based on the best current available evidence.

/pdf/developing-class-iii-malocclusions-challenges-and-solutions-1zh0w4p4sm.pdf

Developing Class III malocclusions: challenges and solutions.

Midfacial changes in the coronal plane induced by microimplant-supported skeletal expander, studied with cone-beam computed tomography images

The advancement of intraoral scanners has allowed for more efficient workflow in the dental clinical setting. However, limited data exist regarding the accuracy of the digital impressions produced with various scanner settings and scanning approaches. The purpose of this in vitro study was to compare the accuracy of digital impressions at the crown preparation margin using different scanning resolutions of a specific intraoral scanner system. An all-ceramic crown preparation of a mandibular first molar was constructed in a typodont, and a scan (n = 3) was created with an industrial-grade laboratory scanner (3Shape D2000) as the control. Digital impressions were obtained with an intraoral scanner (3Shape TRIOS 3) under three settings—high resolution (HR), standard resolution (SR), and combined resolution (SHR). Comparative 3D analysis of scans was performed with Geomagic Control X software to measure the discrepancy between intraoral scans and the control scan along the preparation finish line. The scan time and number of images captured per scan were recorded. Statistical analysis was performed by one-way ANOVA, two-way repeated measures ANOVA, Pearson’s correlation, and Dunnett’s T3 test (α = 0.05). Significant differences were observed for scan time and for number of images captured among scan resolution settings (α < 0.05). The scan time for the SR group was, on average, 34.2 s less than the SHR group and 46.5 s less than the HR group. For discrepancy on the finish line, no significant differences were observed among scanning resolutions (HR: 31.5 ± 5.5 μm, SHR: 33.2 ± 3.7 μm, SR: 33.6 ± 3.1 μm). Significant differences in discrepancy were observed among tooth surfaces, with the distal surface showing the highest discrepancies. In conclusion, the resolution of the intra-oral scanner is primarily defined by the system hardware and optimized for default scans. A software high-resolution mode that obtains more data over a longer time may not necessarily benefit the scan accuracy, while the tooth preparation and surface parameters do affect the accuracy.

Accuracy of CAD/CAM Digital Impressions with Different Intraoral Scanner Parameters.

OBJECTIVE The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). METHODS This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. RESULTS The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of 1.1°-2.9°. CONCLUSIONS Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.

/pdf/skeletal-and-dentoalveolar-changes-after-miniscrew-assisted-12cnll4d2y.pdf

Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study

Prediction of long-term success of orthopedic treatment in skeletal Class III malocclusions.

In this study, we evaluated the effects of mandibular anterior interdental space on the accuracy of intraoral scanners. Four models of mandibular arch with varying distances of anterior interdental space were analyzed; incisors were evenly spaced out between the two canines by 0 mm, 1 mm, 3 mm, and 5 mm. The full arch of each model was scanned 10 times with iTero® and Trios®. The images were superimposed with those from the reference scanner (Sensable S3) and compared using Geomagic Verify. Statistical analysis was conducted using a t-test, paired t-test, and one-way analysis of variance (ANOVA). Differences in the accuracy of images were statistically significant according to both iTero® and Trios®; a greater deviation was noted with increasing anterior interdental space (p < 0.05). Upon dividing the lower arch into five sections, larger deviation was observed with iTero® in the molar area, except in the model with 1 mm space. With Trios®, the largest deviation was observed in the right molar area in all models. The maximum deviations of intermolar width were 0.66 mm and 0.76 mm in iTero® and Trios®, respectively. This comparison suggests that Trios® demonstrates a higher accuracy than iTero® in all models and in all sections of the arch. However, the mean deviations indicate that both iTero® and Trios® are clinically acceptable.

Analysis on the Accuracy of Intraoral Scanners: The Effects of Mandibular Anterior Interdental Space

Objective: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT) Methods: This retrospective study included 14 patients (mean age, 201 years; range, 16–26 years) with maxillary transverse deficiency treated with MARPE Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion Statistical analyses were performed using paired t -test or Wilcoxon signed-rank test according to normality of the data Results: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 005) after MARPE Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm The amount of expansion decreased in the superior direction, with values of 55, 32, 20, and 08 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 005) The buccal bone thickness and height of the alveolar crest had decreased by 06–11 mm and 17–22 mm, respectively, with the premolars and molars exhibiting buccal tipping of 11o–29o Conclusions: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults

Ji Hyun Tahk

Papers

Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study

Prediction of long-term success of orthopedic treatment in skeletal Class III malocclusions.

Analysis on the Accuracy of Intraoral Scanners: The Effects of Mandibular Anterior Interdental Space

Skeletal and dentoalveolar changes after miniscrewassisted rapid palatal expansion in young adults