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Published in: Clinical Oral Investigations 7/2016

01-09-2016 | Original Article

Analysis of the dentoalveolar effects of slow and rapid maxillary expansion in complete bilateral cleft lip and palate patients: a randomized clinical trial

Authors: Arthur César de Medeiros Alves, Daniela Gamba Garib, Guilherme Janson, Araci Malagodi de Almeida, Louise Resti Calil

Published in: Clinical Oral Investigations | Issue 7/2016

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Abstract

Objectives

The purpose of this study was to compare the dentoalveolar effects of slow (SME) and rapid (RME) maxillary expansions in patients with complete bilateral cleft lip and palate (BCLP).

Material and methods

A sample of 50 patients with BCLP and maxillary arch constriction was randomly and equally allocated into two groups. Group SME comprised patients (mean age of 8.8 years) treated with quad-helix appliance. Group RME comprised individuals (mean age of 8.9 years) treated with Hyrax expander. Digital dental models obtained immediately pre-expansion (T1) and 6 months after the active expansion period (T2) were used for measuring maxillary dental arch widths, arch perimeter, arch length, palatal depth, buccolingual inclination of posterior teeth and differential amount of expansion accomplished at the canine and molar regions. Inter-phase and intergroup comparisons were performed using paired t tests and t tests, respectively (p < 0.05).

Results

SME and RME caused significant increase of arch widths and arch perimeter. Arch length and palatal depth decreased nonsignificantly with SME but significantly with RME. Buccal tooth inclination was significant only for maxillary deciduous canines in both groups. The quad-helix appliance showed a significant differential expansion between anterior and posterior regions. No differences were observed between SME and RME for all variables.

Conclusions

Differences were not found between the dentoalveolar effects of SME and RME in patients with BCLP. SME demanded a greater therapy time compared to RME.

Clinical relevance

Both expansion procedures can be similarly indicated to correct maxillary arch constriction in patients with BCLP in the mixed dentition.
Literature
1.
go back to reference Yanez-Vico RM, Iglesias-Linares A, Gomez-Mendo I, Torres-Lagares D, Gonzalez-Moles MA, Gutierrez-Perez JL, Solano-Reina E (2012) A descriptive epidemiologic study of cleft lip and palate in Spain. Oral Surg Oral Med Oral Pathol Oral Radiol 114:S1–S4CrossRefPubMed Yanez-Vico RM, Iglesias-Linares A, Gomez-Mendo I, Torres-Lagares D, Gonzalez-Moles MA, Gutierrez-Perez JL, Solano-Reina E (2012) A descriptive epidemiologic study of cleft lip and palate in Spain. Oral Surg Oral Med Oral Pathol Oral Radiol 114:S1–S4CrossRefPubMed
2.
go back to reference Marazita ML, Mooney MP (2004) Current concepts in the embryology and genetics of cleft lip and cleft palate. Clin Plast Surg 31:125–140CrossRefPubMed Marazita ML, Mooney MP (2004) Current concepts in the embryology and genetics of cleft lip and cleft palate. Clin Plast Surg 31:125–140CrossRefPubMed
3.
go back to reference Smahel Z, Veleminska J, Trefny P, Mullerova Z (2009) Three-dimensional morphology of the palate in patients with bilateral complete cleft lip and palate at the stage of permanent dentition. Cleft Palate Craniofac J 46:399–408CrossRefPubMed Smahel Z, Veleminska J, Trefny P, Mullerova Z (2009) Three-dimensional morphology of the palate in patients with bilateral complete cleft lip and palate at the stage of permanent dentition. Cleft Palate Craniofac J 46:399–408CrossRefPubMed
4.
go back to reference Hermann NV, Darvann TA, Jensen BL, Dahl E, Bolund S, Kreiborg S (2004) Early craniofacial morphology and growth in children with bilateral complete cleft lip and palate. Cleft Palate Craniofac J 41:424–438CrossRefPubMed Hermann NV, Darvann TA, Jensen BL, Dahl E, Bolund S, Kreiborg S (2004) Early craniofacial morphology and growth in children with bilateral complete cleft lip and palate. Cleft Palate Craniofac J 41:424–438CrossRefPubMed
5.
go back to reference van den Dungen GM, Ongkosuwito EM, Aartman IH, Prahl-Andersen B (2008) Craniofacial morphology of Dutch patients with bilateral cleft lip and palate and noncleft controls at the age of 15 years. Cleft Palate Craniofac J 45:661–666CrossRefPubMed van den Dungen GM, Ongkosuwito EM, Aartman IH, Prahl-Andersen B (2008) Craniofacial morphology of Dutch patients with bilateral cleft lip and palate and noncleft controls at the age of 15 years. Cleft Palate Craniofac J 45:661–666CrossRefPubMed
6.
go back to reference Heidbuchel KL, Kuijpers-Jagtman AM, Kramer GJ, Prahl-Andersen B (1998) Maxillary arch dimensions in bilateral cleft lip and palate from birth until four years of age in boys. Cleft Palate Craniofac J 35:233–239CrossRefPubMed Heidbuchel KL, Kuijpers-Jagtman AM, Kramer GJ, Prahl-Andersen B (1998) Maxillary arch dimensions in bilateral cleft lip and palate from birth until four years of age in boys. Cleft Palate Craniofac J 35:233–239CrossRefPubMed
7.
go back to reference Heidbuchel KL, Kuijpers-Jagtman AM, Van’t Hof MA, Kramer GJ, Prahl-Andersen B (1998) Effects of early treatment on maxillary arch development in BCLP. A study on dental casts between 0 and 4 years of age. J Craniomaxillofac Surg 26:140–147CrossRefPubMed Heidbuchel KL, Kuijpers-Jagtman AM, Van’t Hof MA, Kramer GJ, Prahl-Andersen B (1998) Effects of early treatment on maxillary arch development in BCLP. A study on dental casts between 0 and 4 years of age. J Craniomaxillofac Surg 26:140–147CrossRefPubMed
8.
go back to reference Heidbuchel KL, Kuijpers-Jagtman AM (1997) Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients form 3 to 17 years of age. Cleft Palate Craniofac J 34:21–26CrossRefPubMed Heidbuchel KL, Kuijpers-Jagtman AM (1997) Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients form 3 to 17 years of age. Cleft Palate Craniofac J 34:21–26CrossRefPubMed
9.
go back to reference Vasant M, Menon S, Kannan S (2009) Maxillary expansion in cleft lip and palate using Quad helix and rapid palatal expansion screw. Med J Armed Forces India 65:150–153CrossRefPubMed Vasant M, Menon S, Kannan S (2009) Maxillary expansion in cleft lip and palate using Quad helix and rapid palatal expansion screw. Med J Armed Forces India 65:150–153CrossRefPubMed
10.
go back to reference Hicks EP (1978) Slow maxillary expansion: a clinical study of the skeletal versus dental response to low-magnitude force. Am J Orthod 73:121–141CrossRefPubMed Hicks EP (1978) Slow maxillary expansion: a clinical study of the skeletal versus dental response to low-magnitude force. Am J Orthod 73:121–141CrossRefPubMed
11.
go back to reference Frank SW, Engel GA (1982) The effects of maxillary quad-helix appliance expansion on cephalometric measurements in growing orthodontic patients. Am J Orthod 81:378–389CrossRefPubMed Frank SW, Engel GA (1982) The effects of maxillary quad-helix appliance expansion on cephalometric measurements in growing orthodontic patients. Am J Orthod 81:378–389CrossRefPubMed
12.
go back to reference Chaconas SJ, de Alba Y, Levy JA (1977) Orthopedic and orthodontic applications of the quad-helix appliance. Am J Orthod 72:422–428CrossRefPubMed Chaconas SJ, de Alba Y, Levy JA (1977) Orthopedic and orthodontic applications of the quad-helix appliance. Am J Orthod 72:422–428CrossRefPubMed
13.
go back to reference Corbridge JK, Campbell PM, Taylor R, Ceen RF, Buschang PH (2011) Transverse dentoalveolar changes after slow maxillary expansion. Am J Orthod Dentofac Orthop 140:317–325CrossRef Corbridge JK, Campbell PM, Taylor R, Ceen RF, Buschang PH (2011) Transverse dentoalveolar changes after slow maxillary expansion. Am J Orthod Dentofac Orthop 140:317–325CrossRef
14.
go back to reference Isaacson RJ, Ingram AH (1964) Forces produced by rapid maxillary expansion: II. Forces present during treatment. Angle Orthod 34:261–270 Isaacson RJ, Ingram AH (1964) Forces produced by rapid maxillary expansion: II. Forces present during treatment. Angle Orthod 34:261–270
15.
go back to reference Wertz RA (1970) Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod 58:41–66CrossRefPubMed Wertz RA (1970) Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod 58:41–66CrossRefPubMed
16.
17.
go back to reference da Silva Filho OG, do Prado Montes LA, Torelly LF (1995) Rapid maxillary expansion in the deciduous and mixed dentition evaluated through posteroanterior cephalometric analysis. Am J Orthod Dentofac OrthopAm J Orthod Dentofacial Orthop 107:268–275CrossRef da Silva Filho OG, do Prado Montes LA, Torelly LF (1995) Rapid maxillary expansion in the deciduous and mixed dentition evaluated through posteroanterior cephalometric analysis. Am J Orthod Dentofac OrthopAm J Orthod Dentofacial Orthop 107:268–275CrossRef
18.
go back to reference Aizenbud D, Ciceu C, Rachmiel A, Hazan-Molina H (2012) Reverse quad helix appliance: differential anterior maxillary expansion of the cleft area before bone grafting. J Craniofac Surg 23:e440–e443CrossRefPubMed Aizenbud D, Ciceu C, Rachmiel A, Hazan-Molina H (2012) Reverse quad helix appliance: differential anterior maxillary expansion of the cleft area before bone grafting. J Craniofac Surg 23:e440–e443CrossRefPubMed
19.
go back to reference Façanha AJO, Lara TS, Garib DG, da Silva Filho OG (2014) Transverse effect of Haas and Hyrax appliances on the upper dental arch in patients with unilateral complete cleft lip and palate: a comparative study. Dental Press J Orthod 19:39–45CrossRefPubMedPubMedCentral Façanha AJO, Lara TS, Garib DG, da Silva Filho OG (2014) Transverse effect of Haas and Hyrax appliances on the upper dental arch in patients with unilateral complete cleft lip and palate: a comparative study. Dental Press J Orthod 19:39–45CrossRefPubMedPubMedCentral
20.
go back to reference Qian Y, Ding X, Yan Y (2002) A postero-anterior cephalometric assessment of UCLP patients before and after rapid maxillary expansion. Shanghai Kou Qiang Yi Xue 11:101–104PubMed Qian Y, Ding X, Yan Y (2002) A postero-anterior cephalometric assessment of UCLP patients before and after rapid maxillary expansion. Shanghai Kou Qiang Yi Xue 11:101–104PubMed
21.
go back to reference Pan X, Qian Y, Yu J, Wang D, Tang Y, Shen G (2007) Biomechanical effects of rapid palatal expansion on the craniofacial skeleton with cleft palate: a three-dimensional finite element analysis. Cleft Palate Craniofac J 44:149–154CrossRefPubMed Pan X, Qian Y, Yu J, Wang D, Tang Y, Shen G (2007) Biomechanical effects of rapid palatal expansion on the craniofacial skeleton with cleft palate: a three-dimensional finite element analysis. Cleft Palate Craniofac J 44:149–154CrossRefPubMed
22.
go back to reference Isaacson RJ, Murphy TD (1964) Some effects of rapid maxillary expansion in cleft lip and palate patients. Angle Orthod 34:143–154 Isaacson RJ, Murphy TD (1964) Some effects of rapid maxillary expansion in cleft lip and palate patients. Angle Orthod 34:143–154
23.
go back to reference Chaconas SJ, Caputo AA (1982) Observation of orthopedic force distribution produced by maxillary orthodontic appliances. Am J Orthod 82:492–501CrossRefPubMed Chaconas SJ, Caputo AA (1982) Observation of orthopedic force distribution produced by maxillary orthodontic appliances. Am J Orthod 82:492–501CrossRefPubMed
24.
go back to reference Liu Y, Tang Y, Xiao L, Liu SS-Y, Yu H (2014) Suture cartilage formation pattern varies with different expansive forces. Am J Orthod Dentofac Orthop 146:442–450CrossRef Liu Y, Tang Y, Xiao L, Liu SS-Y, Yu H (2014) Suture cartilage formation pattern varies with different expansive forces. Am J Orthod Dentofac Orthop 146:442–450CrossRef
25.
go back to reference McNally M, Spary D, Rock W (2005) A randomized controlled trial comparing the quadhelix and the expansion arch for the correction of crossbite. J Orthod 32:29–35CrossRefPubMed McNally M, Spary D, Rock W (2005) A randomized controlled trial comparing the quadhelix and the expansion arch for the correction of crossbite. J Orthod 32:29–35CrossRefPubMed
26.
go back to reference Geran RG, McNamara Jr JA, Baccetti T, Franchi L, Shapiro LM (2006) A prospective long-term study on the effects of rapid maxillary expansion in the early mixed dentition. Am J Orthod Dentofac Orthop 129:631–640CrossRef Geran RG, McNamara Jr JA, Baccetti T, Franchi L, Shapiro LM (2006) A prospective long-term study on the effects of rapid maxillary expansion in the early mixed dentition. Am J Orthod Dentofac Orthop 129:631–640CrossRef
27.
go back to reference Garib DG, Henriques JFC, Janson G, Freitas MR, Coelho RA (2005) Rapid maxillary expansion-tooth tissue-borne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects. Angle Orthod 75:548–557PubMed Garib DG, Henriques JFC, Janson G, Freitas MR, Coelho RA (2005) Rapid maxillary expansion-tooth tissue-borne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects. Angle Orthod 75:548–557PubMed
28.
go back to reference Haas AJ (1961) Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthod 31:73–90 Haas AJ (1961) Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthod 31:73–90
29.
30.
go back to reference Agostino P, Ugolini A, Signori A, Silvestrini-Biavati A, Harrison JE, Riley P (2014) Orthodontic treatment for posterior crossbites. The Cochrane Library Agostino P, Ugolini A, Signori A, Silvestrini-Biavati A, Harrison JE, Riley P (2014) Orthodontic treatment for posterior crossbites. The Cochrane Library
31.
go back to reference Petrén S, Bondemark L, Söderfeldt B (2003) A systematic review concerning early orthodontic treatment of unilateral posterior crossbite. Angle Orthod 73:588–596PubMed Petrén S, Bondemark L, Söderfeldt B (2003) A systematic review concerning early orthodontic treatment of unilateral posterior crossbite. Angle Orthod 73:588–596PubMed
32.
go back to reference Mutinelli S, Cozzani M, Manfredi M, Bee M, Siciliani G (2008) Dental arch changes following rapid maxillary expansion. Eur J Orthod 30:469–476CrossRefPubMed Mutinelli S, Cozzani M, Manfredi M, Bee M, Siciliani G (2008) Dental arch changes following rapid maxillary expansion. Eur J Orthod 30:469–476CrossRefPubMed
33.
go back to reference Dahlberg G (1940) Statistical methods for medical and biological students. George Allen and Unwin, Ltd., London Dahlberg G (1940) Statistical methods for medical and biological students. George Allen and Unwin, Ltd., London
34.
go back to reference Zilberman O, Huggare JA, Parikakis KA (2003) Evaluation of the validity of tooth size and arch width measurements using conventional and three-dimensional virtual orthodontic models. Angle Orthod 73:301–306PubMed Zilberman O, Huggare JA, Parikakis KA (2003) Evaluation of the validity of tooth size and arch width measurements using conventional and three-dimensional virtual orthodontic models. Angle Orthod 73:301–306PubMed
35.
go back to reference Figueiredo DSF, Bartolomeo FUC, Romualdo CR, Palomo JM, Horta MCR, Andrade Jr I, Oliveira DD (2014) Dentoskeletal effects of 3 maxillary expanders in patients with clefts: a cone-beam computed tomography study. Am J Orthod Dentofac Orthop 146:73–81CrossRef Figueiredo DSF, Bartolomeo FUC, Romualdo CR, Palomo JM, Horta MCR, Andrade Jr I, Oliveira DD (2014) Dentoskeletal effects of 3 maxillary expanders in patients with clefts: a cone-beam computed tomography study. Am J Orthod Dentofac Orthop 146:73–81CrossRef
36.
go back to reference Zimring JF, Isaacson RJ (1965) Forces produced by rapid maxillary expansion: III. Forces present during retention. Angle Orthod 35:178–186PubMed Zimring JF, Isaacson RJ (1965) Forces produced by rapid maxillary expansion: III. Forces present during retention. Angle Orthod 35:178–186PubMed
37.
go back to reference Isaacson RJ, Wood JL, Ingram AH (1964) Forces produced by rapid maxillary expansion: I. Design of the force measuring system. Angle Orthod 34:256–260 Isaacson RJ, Wood JL, Ingram AH (1964) Forces produced by rapid maxillary expansion: I. Design of the force measuring system. Angle Orthod 34:256–260
38.
go back to reference Bratu DC, Bratu EA, Popa G, Luca M, Bălan R, Ogodescu A (2012) Skeletal and dentoalveolar changes in the maxillary bone morphology using two-arm maxillary expander. Romanian J Morphol Embryol 53:35–40 Bratu DC, Bratu EA, Popa G, Luca M, Bălan R, Ogodescu A (2012) Skeletal and dentoalveolar changes in the maxillary bone morphology using two-arm maxillary expander. Romanian J Morphol Embryol 53:35–40
39.
go back to reference Fleming PS, Marinho V, Johal A (2011) Orthodontic measurements on digital study models compared with plaster models: a systematic review. Orthod Craniofac Res 14:1–16CrossRefPubMed Fleming PS, Marinho V, Johal A (2011) Orthodontic measurements on digital study models compared with plaster models: a systematic review. Orthod Craniofac Res 14:1–16CrossRefPubMed
40.
go back to reference Nouri M, Abdi AH, Farzan A, Mokhtarpour F, Baghban AA (2014) Measurement of the buccolingual inclination of teeth: manual technique vs 3-dimensional software. Am J Orthod Dentofac Orthop 146:522–529CrossRef Nouri M, Abdi AH, Farzan A, Mokhtarpour F, Baghban AA (2014) Measurement of the buccolingual inclination of teeth: manual technique vs 3-dimensional software. Am J Orthod Dentofac Orthop 146:522–529CrossRef
41.
go back to reference Akkaya S, Lorenzon S, Üçm T (1998) Comparison of dental arch and arch perimeter changes between bonded rapid and slow maxillary expansion procedures. Eur J Orthod 20:255–261CrossRefPubMed Akkaya S, Lorenzon S, Üçm T (1998) Comparison of dental arch and arch perimeter changes between bonded rapid and slow maxillary expansion procedures. Eur J Orthod 20:255–261CrossRefPubMed
42.
go back to reference Wong CA, Sinclair PM, Keim RG, Kennedy DB (2011) Arch dimension changes from successful slow maxillary expansion of unilateral posterior crossbite. Angle Orthod 81:616–623CrossRefPubMed Wong CA, Sinclair PM, Keim RG, Kennedy DB (2011) Arch dimension changes from successful slow maxillary expansion of unilateral posterior crossbite. Angle Orthod 81:616–623CrossRefPubMed
43.
go back to reference Susami T, Aikawa S, Motohashi N, Ohyama K, Suzuki S, Amano M, et al. (1988) Three-dimensional analysis of maxillary alveolar process in bilateral cleft lip and palate patients. Nihon Kyosei Shika Gakkai Zasshi 47:757–766PubMed Susami T, Aikawa S, Motohashi N, Ohyama K, Suzuki S, Amano M, et al. (1988) Three-dimensional analysis of maxillary alveolar process in bilateral cleft lip and palate patients. Nihon Kyosei Shika Gakkai Zasshi 47:757–766PubMed
44.
go back to reference Smahel Z (1984) Craniofacial morphology in adults with bilateral complete cleft lip and palate. Cleft Palate J 21:159–169PubMed Smahel Z (1984) Craniofacial morphology in adults with bilateral complete cleft lip and palate. Cleft Palate J 21:159–169PubMed
45.
go back to reference Ciambotti C, Ngan P, Durkee M, Kohli K, Kim H (2001) A comparison of dental and dentoalveolar changes between rapid palatal expansion and nickel-titanium palatal expansion appliances. Am J Orthod Dentofac Orthop 119:11–20CrossRef Ciambotti C, Ngan P, Durkee M, Kohli K, Kim H (2001) A comparison of dental and dentoalveolar changes between rapid palatal expansion and nickel-titanium palatal expansion appliances. Am J Orthod Dentofac Orthop 119:11–20CrossRef
46.
go back to reference Adkins MD, Nanda RS, Currier GF (1990) Arch perimeter changes on rapid palatal expansion. Am J Orthod Dentofac Orthop 97:194–199CrossRef Adkins MD, Nanda RS, Currier GF (1990) Arch perimeter changes on rapid palatal expansion. Am J Orthod Dentofac Orthop 97:194–199CrossRef
47.
go back to reference CAdA C, Abrão J, SAB R, SMd F (2006) Correlation between transverse expansion and increase in the upper arch perimeter after rapid maxillary expansion. Braz Oral Res 20:76–81 CAdA C, Abrão J, SAB R, SMd F (2006) Correlation between transverse expansion and increase in the upper arch perimeter after rapid maxillary expansion. Braz Oral Res 20:76–81
48.
go back to reference Habeeb M, Boucher N, Chung C-H (2013) Effects of rapid palatal expansion on the sagittal and vertical dimensions of the maxilla: a study on cephalograms derived from cone-beam computed tomography. Am J Orthod Dentofac Orthop 144:398–403CrossRef Habeeb M, Boucher N, Chung C-H (2013) Effects of rapid palatal expansion on the sagittal and vertical dimensions of the maxilla: a study on cephalograms derived from cone-beam computed tomography. Am J Orthod Dentofac Orthop 144:398–403CrossRef
49.
go back to reference Staggers J (2001) Why does a midline diastema develop during rapid palatal expansion? Am J Orthod Dentofac Orthop 120:12A–12ACrossRef Staggers J (2001) Why does a midline diastema develop during rapid palatal expansion? Am J Orthod Dentofac Orthop 120:12A–12ACrossRef
50.
go back to reference Leonardi R, Sicurezza E, Cutrera A, Barbato E (2011) Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion. Angle Orthod 81:36–41CrossRefPubMed Leonardi R, Sicurezza E, Cutrera A, Barbato E (2011) Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion. Angle Orthod 81:36–41CrossRefPubMed
51.
go back to reference Krey KF, Borngen J, Dannhauer KH (2009) Three-dimensional analysis of the deciduous dentition of patients with bilateral cleft lip and palate and delayed cleft closure. J Orofac Orthop 70:237–246CrossRefPubMed Krey KF, Borngen J, Dannhauer KH (2009) Three-dimensional analysis of the deciduous dentition of patients with bilateral cleft lip and palate and delayed cleft closure. J Orofac Orthop 70:237–246CrossRefPubMed
52.
go back to reference Braumann B, Keilig L, Bourauel C, Jager A (2002) Three-dimensional analysis of morphological changes in the maxilla of patients with cleft lip and palate. Cleft Palate Craniofac J 39:1–11CrossRefPubMed Braumann B, Keilig L, Bourauel C, Jager A (2002) Three-dimensional analysis of morphological changes in the maxilla of patients with cleft lip and palate. Cleft Palate Craniofac J 39:1–11CrossRefPubMed
53.
go back to reference Prydso U, Holm PC, Dahl E, Fogh-Andersen P (1974) Bone formation in palatal clefts subsequent to palato-vomer plasty. Influence on transverse maxillary growth. Scand J Plast Reconstr Surg 8:73–78CrossRefPubMed Prydso U, Holm PC, Dahl E, Fogh-Andersen P (1974) Bone formation in palatal clefts subsequent to palato-vomer plasty. Influence on transverse maxillary growth. Scand J Plast Reconstr Surg 8:73–78CrossRefPubMed
54.
go back to reference Long RE, Semb G, Shaw WC (2000) Orthodontic treatment of the patient with complete clefts of lip, alveolus, and palate: lessons of the past 60 years. Cleft Palate Craniofac J 37:533–533CrossRef Long RE, Semb G, Shaw WC (2000) Orthodontic treatment of the patient with complete clefts of lip, alveolus, and palate: lessons of the past 60 years. Cleft Palate Craniofac J 37:533–533CrossRef
55.
go back to reference Rune B, Sarnas KV, Selvik G, Jacobsson S (1980) Movement of maxillary segments after expansion and/or secondary bone grafting in cleft lip and palate: a roentgen stereophotogrammetric study with the aid of metallic implants. Am J Orthod 77:643–653CrossRefPubMed Rune B, Sarnas KV, Selvik G, Jacobsson S (1980) Movement of maxillary segments after expansion and/or secondary bone grafting in cleft lip and palate: a roentgen stereophotogrammetric study with the aid of metallic implants. Am J Orthod 77:643–653CrossRefPubMed
56.
go back to reference Weber G (1970) The Hyrax-system according to Biederman. Quintessenz 21:69–70PubMed Weber G (1970) The Hyrax-system according to Biederman. Quintessenz 21:69–70PubMed
57.
go back to reference Garib D, Garcia L, Pereira V, Lauris R, Yen S (2014) A rapid maxillary expander with differential opening. J Clin Orthod 48:430–435PubMed Garib D, Garcia L, Pereira V, Lauris R, Yen S (2014) A rapid maxillary expander with differential opening. J Clin Orthod 48:430–435PubMed
58.
Metadata
Title
Analysis of the dentoalveolar effects of slow and rapid maxillary expansion in complete bilateral cleft lip and palate patients: a randomized clinical trial
Authors
Arthur César de Medeiros Alves
Daniela Gamba Garib
Guilherme Janson
Araci Malagodi de Almeida
Louise Resti Calil
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2016
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-015-1675-1

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