Journal List > Korean J Orthod > v.41(3) > 1043667

TOOLS
Baysal, Veli, Ucar, Eruz, Ozer, and Uysal: Changes in mandibular transversal arch dimensions after rapid maxillary expansion procedure assessed through cone-beam computed tomography
Original Article

Korean J Orthod 2011;41(3):200-210.

Published online: 21 January 2011

DOI: https://doi.org/10.4041/kjod.2011.41.3.200

Changes in mandibular transversal arch dimensions after rapid maxillary expansion procedure assessed through cone-beam computed tomography

Asli Baysala, Ilknur Velib, Faruk Izzet Ucarc, Murat Eruzc, Torun Ozerd, Tancan Uysale, f

DDS, PhD

DDS

DDS

DDS

DDS, PhD

DDS, PhD

aResearch Assistant, Department of Orthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.

bResearch Assistant, Department of Orthodontics, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey.

cResearch Assistant, Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.

dAssociate Professor, Department of Orthodontics, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey.

eProfessor and Chair, Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey.

fProfessor, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.

Corresponding author: Tancan Uysal. İzmir Katip Çelebi Üniversitesi Dişhekimliği Fakültesi, Ortodonti A.D. Çiğli, İzmir, Turkey. ＋902323293999; e-mail, tancan.uysal@ikc.edu.tr.

* King Saud University, Visiting Professor Project Unit (Grant No: KSU-VPP-112).

Received 12 February 20111 April 20115 April 2011

Copyright © 2011 The Korean Association of Orthodontists

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

This study aimed at evaluating the changes in mandibular arch widths and buccolingual inclinations of mandibular posterior teeth after rapid maxillary expansion (RME).

Methods

Baseline and post-expansion cone-beam computed tomographic (CBCT) images of patients who initially had bilateral posterior cross-bite and underwent RME with a banded-type expander were assessed in this study. The patients included 9 boys (mean age: 13.97 ± 1.17 years) and 11 girls (mean age: 13.53 ± 2.12 years). Images obtained 6 months after retention were available for 10 of these patients. Eighteen angular and 43 linear measurements were performed for the maxilla and mandible. The measurements were performed on frontally clipped images at the following time points; before expansion (T1), after expansion (T2), and after retention (T3). Statistical significance was assessed with paired sample t-test at p ＜ 0.05.

Results

T1-T2 comparisons showed statistically significant post-RME increases for all measurements; similarly, T2-T1 and T3-T1 comparisons showed statistically significant changes. The maxillary linear and angular measurements showed decreases after expansion, and mandibular linear and angular measurements increased after retention.

Conclusion

All mandibular arch widths increased and mandibular posterior teeth were uprighted after RME procedure.

Keywords: CT, Arch form, Expansion

REFERENCES

1.Angell EC. Treatment of irregularity of the permanent or adult teeth. Dent Cosmos. 1860. 1:540–4.
2.Miller CL. Concomitant changes in mandibular arch dimensions during bonded and banded rapid maxillary expansion (dissertation). Missouri: Saint Louis University. 2010.
3.Haas AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the mid-palatal suture. Angle Orthod. 1961. 31:73–90.
4.Haas AJ. The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod. 1965. 35:200–17.
5.Haas AJ. Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod. 1970. 57:219–55.
crossref
6.Wertz RA. Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod. 1970. 58:41–66.
crossref
7.Bishara SE., Staley RN. Maxillary expansion: clinical implications. Am J Orthod Dentofacial Orthop. 1987. 91:3–14.
8.Byrum AG Jr. Evaluation of anterior-posterior and vertical skeletal change vs. dental change in rapid palatal expansion cases as studied by lateral cephalograms. Am J Orthod. 1971. 60:419.
crossref
9.Hicks EP. Slow maxillary expansion. A clinical study of the skeletal versus dental response to low magnitude force. Am J Orthod. 1978. 73:121–41.
10.Brodie AG. The fourth dimension in orthodontia. Angle Orthod. 1954. 24:15–30.
11.Gryson JA. Changes in mandibular interdental distance concurrent with rapid maxillary expansion. Angle Orthod. 1977. 47:186–92.
12.Lima AC., Lima AL., Filho RM., Oyen OJ. Spontaneous mandibular arch response after rapid palatal expansion: a long-term study on Class I malocclusion. Am J Orthod Dentofacial Orthop. 2004. 126:576–82.
crossref
13.Scarfe WC., Farman AG., Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006. 72:75–80.
14.Kartalian A., Gohl E., Adamian M., Enciso R. Cone-beam computerized tomography evaluation of the maxillary dentoskeletal complex after rapid palatal expansion. Am J Orthod Dentofacial Orthop. 2010. 138:486–92.
crossref
15.Baker LW. The influence of the formative dental organs on the growth of the bones of the face. Am J Orthod. 1941. 27:489–506.
crossref
16.Isaacson RJ., Wood JL., Ingram AH. Forces produced by rapid maxillary expansion. Angle Orthod. 1964. 34:256–70.
17.Sandstrom RA., Klapper L., Papaconstantinou S. Expansion of the lower arch concurrent with rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 1988. 94:296–302.
crossref
18.Geran RG., McNamara JA Jr., Baccetti T., Franchi L., Shapiro LM. A prospective long-term study on the effects of rapid maxillary expansion in the early mixed dentition. Am J Orthod Dentofacial Orthop. 2006. 129:631–40.
crossref
19.Moyers RE., van der Linden FPGM., Riolo ML., McNamara JA Jr. Standards of Human Occlusal Development. Monograph 5. Craniofacial Growth Series. Ann Arbor: Center for Human Growth and Development, University of Michigan;1976. p. 49–157.
20.Moorrees CF., Reed RB. Changes in dental arch dimensions expressed on the basis of tooth eruption as a measure of biologic age. J Dent Res. 1965. 44:129–41.
crossref
21.Haas AJ. Long-term posttreatment evaluation of rapid palatal expansion. Angle Orthod. 1980. 50:189–217.
22.Moussa R., O'Reilly MT., Close JM. Long-term stability of rapid palatal expander treatment and edgewise mechanotherapy. Am J Orthod Dentofacial Orthop. 1995. 108:478–88.
crossref
23.Glenn G., Sinclair PM., Alexander RG. Nonextraction orthodontic therapy: posttreatment dental and skeletal stability. Am J Orthod Dentofacial Orthop. 1987. 92:321–8.
crossref
24.Lagravère MO., Heo G., Major PW., Flores-Mir C. Meta-analysis of immediate changes with rapid maxillary expansion treatment. J Am Dent Assoc. 2006. 137:44–53.
crossref

Fig 1.
Mandibular linear and angular measurements. A, External mandibular measurements performed at 3 different levels: alveolar crest, most prominent point of the crown, and buccal cusp tip; B, internal mandibular measurements were performed at 2 different levels: alveolar crest and most prominent point of the crown; C, mandibular long axis measurement performed between the long axis of the mesial root and to the reference plane, which passes through the most prominent point of the lower borders (right and left) of the mandible.
kjod-41-200_f1.tif
Fig 2.
Maxillary linear and angular measurements. A, Nasal and palatal floor measurements; B, external maxillary measurements performed at 4 different levels: apical, alveolar crest, most prominent point of the crown, and buccal cusp tip; C, internal maxillary measurements were performed at 3 different levels: apical, alveolar crest, and most prominent point of the crown; D, maxillary long axis measurement performed between the long axis of the palatal root and to the palatal plane.
kjod-41-200_f2.tif
Table 1.
Comparison of mandibular linear measurements before and after rapid maxillary expansion (unit, mm)
Mandibular linear measurements N T1 T2 Significance
Mean SD Mean SD
External
36 - 46 occlusal 20 50.69 3.62 51.91 3.72 *
36 - 46 buccal 20 56.78 2.64 57.74 2.77 *
36 - 46 alveolar crest 20 56.88 2.70 58.05 2.58 *
35 - 45 occlusal 20 40.97 2.87 43.32 2.74 *
35 - 45 buccal 20 47.34 1.69 48.76 1.68 *
35 - 45 alveolar crest 20 47.93 1.78 50.79 2.54 *
34 - 44 occlusal 20 34.54 2.59 36.52 2.46 *
34 - 44 buccal 20 39.72 2.30 41.65 2.42 *
34 - 44 alveolar crest 20 39.30 2.03 41.35 2.07 *
33 - 43 occlusal 20 25.75 2.29 27.63 2.22 *
33 - 43 buccal 20 31.52 1.69 33.50 1.89 *
33 - 43 alveolar crest 20 30.94 1.81 33.11 2.03 *
Internal
36 - 46 lingual 20 35.07 2.51 35.88 2.40 *
36 - 46 alveolar crest 20 38.56 2.14 39.76 2.02 *
35 - 45 lingual 20 31.82 2.47 33.75 2.35 *
35 - 45 alveolar crest 20 34.34 1.75 36.01 1.78 *
34 - 44 lingual 20 26.36 1.81 28.61 1.95 *
34 - 44 alveolar crest 20 27.44 2.12 30.21 2.34 *
33 - 43 lingual 20 18.97 1.59 20.58 1.90 *
33 - 43 alveolar crest 20 18.78 1.75 20.74 1.65 *

SD, Standard deviation. *p < 0.001.

Table 2.
Comparison of the changes in mandibular linear measurements between the active expansion and retention periods (unit, mm)
Mandibular linear measurements N T2-T1 T3-T1 Significance
Mean SD Mean SD
External
36 - 46 occlusal 10 0.90 0.39 1.32 0.38 †
36 - 46 buccal 10 0.73 0.39 1.46 0.49 ‡
36 - 46 alveolar crest 10 0.88 0.41 1.41 0.64 †
35 - 45 occlusal 10 2.24 1.22 2.81 1.37 †
35 - 45 buccal 10 1.27 1.22 1.48 1.29 *
35 - 45 alveolar crest 10 1.69 0.77 2.00 0.92 *
34 - 44 occlusal 10 1.59 2.20 2.35 2.08 ‡
34 - 44 buccal 10 1.77 0.67 2.23 0.67 †
34 - 44 alveolar crest 10 1.84 0.95 2.53 0.90 ‡
33 - 43 occlusal 10 1.50 0.90 2.24 0.91 ‡
33 - 43 buccal 10 1.68 0.68 2.02 0.83 ‡
33 - 43 alveolar crest 10 2.02 0.76 2.38 0.99 *
Internal
36 - 46 lingual 10 0.89 0.44 1.08 0.48 *
36 - 46 alveolar crest 10 1.25 0.68 1.37 0.77 *
35 - 45 lingual 10 2.02 0.76 2.55 0.82 ‡
35 - 45 alveolar crest 10 1.59 0.88 1.92 1.01 ‡
34 - 44 lingual 10 1.84 1.21 2.58 1.13 ‡
34 - 44 alveolar crest 10 2.49 0.39 3.02 0.34 ‡
33 - 43 lingual 10 1.56 0.55 2.26 0.64 ‡
33 - 43 alveolar crest 10 2.04 0.98 2.46 1.16 †

SD, Standard deviation. *p < 0.05; †p < 0.01; ‡p < 0.001.

Table 3.
Comparison of mandibular angular measurements before and after rapid maxillary expansion (unit, mm)
Mandibular angular measurements N T1 T2 Significance
Mean SD Mean SD
46 long axis 20 75.20 1.11 75.88 1.03 *
36 long axis 20 75.39 0.64 76.33 0.98 *
45 long axis 20 75.67 1.99 76.94 2.28 *
35 long axis 20 79.40 1.87 80.26 1.95 *
44 long axis 20 87.12 0.92 88.43 0.98 *
34 long axis 20 88.07 1.16 89.85 1.38 *

SD, Standard deviation. *p < 0.001.

Table 4.
Comparison of the changes in mandibular angular measurements between the active expansion and retention periods (unit, mm)
Mandibular angular measurements N T2-T1 T3-T1 Significance
Mean SD Mean SD
46 10 0.67 0.24 1.10 0.29 *
36 10 1.00 0.67 1.93 0.94 *
45 10 1.24 0.77 2.58 1.90 *
35 10 0.78 0.44 1.65 0.52 *
44 10 1.18 0.41 2.04 0.38 *
34 10 1.90 0.63 2.77 0.57 *

SD, Standard deviation. *p < 0.001.

Table 5.
Comparison of maxillary angular measurements before and after rapid maxillary expansion (unit, mm)
Maxillary angular measurements N T1 T2 Significance
Mean SD Mean SD
16 long axis 20 98.05 1.79 101.66 2.10 *
26 long axis 20 98.34 1.40 101.97 2.12 *
15 long axis 20 95.32 2.05 96.52 2.08 *
25 long axis 20 85.81 1.48 87.49 1.64 *
14 long axis 20 90.77 1.00 96.36 1.10 *
24 long axis 20 91.71 1.19 96.16 2.75 *

SD, Standard deviation. *p < 0.001.

Table 6.
Comparison of the changes of maxillary angular measurements in the active expansion and retention periods (unit, mm)
Maxillary angular measurements N T2-T1 T3-T1 Significance
Mean SD Mean SD
16 long axis 10 3.52 0.74 2.21 0.55 *
26 long axis 10 3.26 0.86 2.53 0.72 *
15 long axis 10 1.17 0.43 0.88 0.45 *
25 long axis 10 1.58 0.60 1.13 0.64 *
14 long axis 10 5.43 0.72 3.59 0.58 *
24 long axis 10 5.07 0.61 3.10 0.80 *

SD, Standard deviation. *p < 0.001.

Table 7.
Comparison of maxillary linear measurements before and after rapid maxillary expansion (unit, mm)
Maxillary linear measurements N T1 T2 Significance
Mean SD Mean SD
Nasal floor 20 64.02 3.37 68.12 3.46 *
Palatal floor 20 60.88 2.99 65.08 3.04 *
External
16 - 26 apex 20 30.00 2.37 34.06 2.38 *
16 - 26 alveolar crest 20 52.85 2.88 57.05 3.07 *
16 - 26 buccal 20 52.30 2.61 56.51 2.67 *
16 - 26 occlusal 20 50.08 2.63 54.29 2.64 *
15 - 25 apex 20 35.71 2.07 38.51 2.00 *
15 - 25 alveolar crest 20 44.21 1.84 47.35 1.79 *
15 - 25 buccal 20 44.47 0.98 47.42 1.17 *
15 - 25 occlusal 20 39.36 3.37 42.24 3.21 *
14 - 24 apex 20 30.19 2.27 34.07 2.22 *
14 - 24 alveolar crest 20 39.37 0.75 42.85 0.77 *
14 - 24 buccal 20 39.66 1.27 43.26 1.34 *
14 - 24 occlusal 20 34.68 0.65 38.34 0.79 *
Internal
16 - 26 palatal apex 20 30.10 1.71 34.37 1.78 *
16 - 26 palatal alveolar crest 20 29.49 2.35 33.42 2.37 *
15 - 25 palatal apex 20 29.97 1.20 32.55 1.16 *
15 - 25 palatal alveolar crest 20 27.66 1.20 27.77 1.44 *
14 - 24 palatal apex 20 22.01 1.72 26.21 1.57 *
14 - 24 palatal alveolar crest 20 22.77 1.24 26.69 1.34 *

SD, Standard deviation. *p < 0.001.

Table 8.
Comparison of the changes of maxillary linear measurements between the active expansion and retention
Maxillary linear measurements N T2-T1 T3-T1 Significance
Mean SD Mean SD
Nasal floor 10 3.94 1.11 2.93 1.21 *
Palatal floor 10 4.06 1.10 2.96 1.18 *
External
16 - 26 apex 10 3.97 1.07 2.87 0.96 *
16 - 26 alveolar crest 10 4.02 1.17 2.81 1.14 *
16 - 26 buccal 10 3.99 1.16 2.74 1.11 *
16 - 26 occlusal 10 4.01 1.15 2.78 1.13 *
15 - 25 apex 10 2.89 0.52 1.99 0.58 *
15 - 25 alveolar crest 10 3.07 0.53 2.20 0.48 *
15 - 25 buccal 10 2.69 1.55 1.83 1.54 *
15 - 25 occlusal 10 2.93 0.70 2.03 0.64 *
14 - 24 apex 10 4.00 0.37 3.05 0.67 *
14 - 24 alveolar crest 10 3.76 0.38 2.58 0.46 *
14 - 24 buccal 10 3.77 0.38 2.55 0.45 *
14 - 24 occlusal 10 3.99 0.36 3.99 0.36 *
Internal
16 - 26 palatal apex 10 3.78 0.79 2.77 0.69 *
16 - 26 palatal alveolar crest 10 4.19 0.56 3.25 0.51 *
15 - 25 palatal apex 10 -0.05 1.58 -0.92 0.32 *
15 - 25 palatal alveolar crest 10 2.68 0.69 1.77 0.72 *
14 - 24 palatal apex 10 4.12 0.41 2.92 0.47 *
14 - 24 palatal alveolar crest 10 4.20 0.22 2.83 0.34 *

SD, Standard deviation. *p < 0.001.

TOOLS
Similar articles