Efficacy of the rapid maxillary expansion with a modified acrylic splint palatal expander: A randomized clinical trial

Silvia Maria Buratti Corrêa¹ image, Luiza Pereira Alves2 image, Murilo Matias3 image, Mayara Paim Patel4 image, Ana Carla Raphaelli Nahás5 image, Liliana Ávila Maltagliati6 image

Highlights

The modified acrylic splint palatal expander (MASPE) does not increase the amount of skeletal effects.

The MASPE does not increase palatal area compared to the tooth-borne bonded palatal expander.

Even with the extended acrylic covering the palatal vault, the intergroup comparison showed a similar expansion for both appliances.

Abstract

Aim: This prospective randomized clinical trial aimed at analyzing the skeletal effects of this modified acrylic splint palatal expander (MASPE) used for maxillary transversal deficiency treatment in mixed dentition. Methods: Eligibility criteria included maxillary transverse deficiencies in children between 7 and 10 years of age. Eighteen individuals who met the inclusion criteria and reached the end of treatment were evaluated (mean age of 8.66 years old) and randomly assigned to be submitted to rapid maxillary expansion with either the MASPE experimental device or a well-known tooth-borne expander (control group). CBCT scans taken before expansion and at the end of the retention period were evaluated. The palatal area was calculated, and the length of expansion was measured. Treatment changes were analyzed using paired t-tests, whereas independent t-tests were used to compare the two groups. Results: There were statistically significant (p<0.05) increases in maxillary width at the suture level in both groups, with a substantial increase in the palatal area. The group differences were not significant. Conclusions: MASPE showed good efficiency and skeletal effects but no superiority over the control group.

Keywords: Maxillary expansion; Mixed Dentition; Orthodontics; Orthopedics

Author Affiliations

  1. MsC in Orthodontics, Guarulhos University, Brazil
  2. MsC in Orthodontics, Guarulhos University, Brazil
  3. PhD, Researcher and professor at Guarulhos University, Department of Orthodontics Guarulhos University, Brazil (Correspondence:murilo.matias@prof.ung.br)
  4. PhD, Researcher and professor at Guarulhos University, Department of Orthodontics Guarulhos University, Brazil
  5. PhD, Researcher and professor at Guarulhos University, Department of Orthodontics Guarulhos University, Brazil
  6. PhD, Researcher and professor at Guarulhos University, Department of Orthodontics Guarulhos University, Brazil
  1. Lanteri V, Cossellu G, Gianolio A, Beretta M, Lanteri C, Cherchi C, et al. Comparison between RME, SME, and Leaf Expander in growing patients: a retrospective postero-anterior cephalometric study. Eur J Paediatric Dent 2018;19:199-204
  2. De Sousa RV, Ribeiro GL, Firmino RT, Martins CC, Granville-Garcia AF, Paiva SM. Prevalence and associated factors for the development of anterior open bite and posterior crossbite in the primary dentition. Braz Dental J 2014;25:336-342
  3. Kiliç N, Oktay H. Effects of rapid maxillary expansion on nasal breathing and some naso-respiratory and breathing problems in growing children: a literature review. Int J Pediatric Otorhinolaryngology 2008;72:1595-1601
  4. Almuzian M, Ju X, Almukhtar A, Ayoub A, Al-Muzian L, McDonald JP. Does rapid maxillary expansion affect nasopharyngeal airway? A prospective Cone Beam Computerized Tomography (CBCT) based study. The surgeon. J R Coll Surg Edinb 2018;16:1-11
  5. Buck LM, Dalci O, Darendeliler MA, Papageorgiou SN, Papadopoulou AK. Volumetric upper airway changes after rapid maxillary expansion: a systematic review and meta-analysis. European J Orthodont 2016;39:463-473
  6. Camacho M, Chang ET, Song SA, Abdullatif J, Zaghi S, Pirelli P. Rapid maxillary expansion for pediatric obstructive sleep apnea: A systematic review and meta‐analysis. The Laryngoscope 2017;127:1712-1719
  7. Villa MP, Rizzoli A, Miano S, Malagola C. Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up. Sleep Breath 2011;15:179-184
  8. Wendling LK, McNamara JA, Jr., Franchi L, Baccetti T. A prospective study of the short-term treatment effects of the acrylic-splint rapid maxillary expander combined with the lower Schwarz appliance. Angle Orthodont 2005;75:7-14
  9. McNamara JA, Jr. An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod 1987;21:598-608
  10. McNamara JA. Maxillary transverse deficiency. Am J Orthod Dentofacial Orthop 2000;117:567-570
  11. Garib DG, Henriques JFC, Janson G, Freitas MR, Coelho RA. Rapid Maxillary Expansion—Tooth Tissue-Borne Versus Tooth-Borne Expanders: A Computed Tomography Evaluation of Dentoskeletal Effects. Angle Orthodont 2005;75:548-557
  12. Spolyar JL. The design, fabrication, and use of a full-coverage bonded rapid maxillary expansion appliance. Amer J Orthodont 1984;86:136-145
  13. Franchi L, Baccetti T, Cameron CG, Kutcipal EA, McNamara Jr JA. Thin‐plate spline analysis of the short‐and long‐term effects of rapid maxillary expansion. European J Orthodontics 2002;24:143-150
  14. Sarver DM, Johnston MW. Skeletal changes in vertical and anterior displacement of the maxilla with bonded rapid palatal expansion appliances. Am J Orthod Dentofacial Orthop 1989;95:462-466
  15. Reed N, Ghosh J, Nanda RS. Comparison of treatment outcomes with banded and bonded RPE appliances. Am J Orthod Dentofacial Orthop 1999;116:31-40
  16. Kanomi R, Deguchi T, Kakuno E, Takano-Yamamoto T, Roberts WE. CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance. Angle Orthodont 2013;83:851-857
  17. Olmez H, Akin E, Karacay S. Multitomographic evaluation of the dental effects of two different rapid palatal expansion appliances. European J Orthodontics. 2007;29:379-385
  18. De Carvalho GD. S.O.S. mouthbreather: a functional and clinical view of breastfeeding. São Paulo: Lovise Editor; 2010
  19. Pirelli P, Saponara M, Guilleminault C. Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12-year follow-up. Sleep Medicine. 2015;16:933-935
  20. Da Silva Filho OG, Montes LAP, Torelly LF. Rapid maxillary expansion in the deciduous and mixed dentition evaluated through posteroanterior cephalometric analysis. Am J Orthod Dentofacial Orthop 1995;107:268-275
  21. Machado-Júnior AJ, Zancanella E, Crespo AN. Rapid maxillary expansion and obstructive sleep apnea: A review and meta-analysis. Med Oral Patol Oral Cir Bucal 2016;21: e465-469
  22. Scarfe WC, Azevedo B, Toghyani S, Farman AG. Cone Beam Computed Tomographic imaging in orthodontics. Australian Dental J 2017;62:33-50
  23. Maltagliati LA, Farias MD, da Rocha SE, Corre SMB, Aguiar RCO, et al. Epidemiological study of the incidence of malocclusion in schoolchildren in the city of guarulhos. Saude 2019;13:15-21
  24. DiPaolo RJ. Thoughts on palatal expansion. J Clinical Orthodont 1970;4:493-497
  25. Locks A, Weissheimer A, Ritter DE, Ribeiro GLU, Menezes LMd, et al. Posterior crossbite: a more didactic classification. Dental Press J Orthodont 2008;13:146-158
  26. Da Silva Filho OG, Valladares Neto J, Rodrigues de Almeida R. Early correction of posterior crossbite: biomechanical characteristics of the appliances. J Clin Pediatr Dent. 1989;13:195-221
  27. Haas AJ. Palatal expansion: just the beginning of dentofacial orthopedics. Amer J Orthodont. 1970;57:219-255
  28. Hass AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthodont 1961;31:73-90
  29. McNamara JA, Lione R, Franchi L, Angelieri F, Cevidanes LH, et al. The role of rapid maxillary expansion in the promotion of oral and general health. Progress in Orthodontics. 2015;16:33-40
  30. Quo SD, Hyunh N, Guilleminault C. Bimaxillary expansion therapy for pediatric sleep-disordered breathing. Sleep medicine 2017;30:45-51
  31. Tapia IE, Marcus CL. Newer treatment modalities for pediatric obstructive sleep apnea. Paediatr Respir Rev 2013;14:199-203
  32. Smith-Bindman R, Lipson J, Marcus R, Kim KP, Mahesh M, Gould R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 2009;169:2078-2086
  33. Farman AG. ALARA still applies. Oral Surg, Oral Med, Oral Pathol and Oral Rad and Endodontics 2005;100:395-407
  34. AAOMR. Clinical recommendations regarding use of cone beam computed tomography in orthodontics. [corrected]. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg, Oral Med, Oral Pathol and Oral Rad 2013;116:238-357
  35. Weissheimer A, de Menezes LM, Mezomo M, Dias DM, de Lima EM, Rizzatto SM. Immediate effects of rapid maxillary expansion with Haas-type and hyrax-type expanders: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2011;140:366-376
  36. Zuccati G, Casci S, Doldo T, Clauser C. Expansion of maxillary arches with crossbite: a systematic review of RCTs in the last 12 years. European J Orthodontics 2013;35:29-37
  37. Christie KF, Boucher N, Chung CH. Effects of bonded rapid palatal expansion on the transverse dimensions of the maxilla: a cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2010;137:79-85
  38. 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. European J Orthodontics 2007;29:37-44
  39. Gracco A, Malaguti A, Lombardo L, Mazzoli A, Raffaeli R. Palatal volume following rapid maxillary expansion in mixed dentition. Angle Orthodont 2010;80:153-159
  40. Shahen S, Carrino G, Carrino R, Abdelsalam R, Flores-Mir C, Perillo L. Palatal volume and area assessment on digital casts generated from cone-beam computed tomography scans. Angle Orthodont 2018;88:397-402
  41. Oliveira De Felippe NL, Da Silveira AC, Viana G, Kusnoto B, Smith B, Evans CA. Relationship between rapid maxillary expansion and nasal cavity size and airway resistance: short- and long-term effects. Am J Orthod Dentofacial Orthop. 2008;134:370-382 

Article Info

Contemp Pediatr Dent 2023:4(3):115-125

Received: 16 September 2023

Accepted: 08 December 2023

Online First: 15 December 2023

DOI: 10.51463/cpd.2023.179

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					Silvia Maria Buratti Corrêa, Luiza Pereira Alves, Murilo Matias, Mayara Paim Patel, Ana Carla Raphaelli Nahás, Liliana Ávila Maltagliati. Efficacy of the rapid maxillary expansion with a modified acrylic splint palatal expander: A randomized clinical trial. Contemp Pediatr Dent 2023:4(3):115-125.

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