Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical Oral Investigations
Published in: Clinical Oral Investigations 7/2022

Open Access 10-03-2022 | Original Article

Impact of rapid maxillary expansion on palatal morphology at different dentition stages

Authors: Gero Stefan Michael Kinzinger, Jörg Alexander Lisson, Charlotte Buschhoff, Jan Hourfar, Heike Korbmacher-Steiner

Published in: Clinical Oral Investigations | Issue 7/2022

Login to get access

Abstract

Objective

Rapid maxillary expansion (RME) is an established and frequently used procedure to overcome maxillary constriction. In-depth studies about morphological changes of the alveolar process and its immediate surroundings are missing. Therefore, the aim of the present study was to examine the treatment effects of a dentally anchored, rapid maxillary expander at different dentition stages upon palatal width, height and shape.

Material and methods

The dental casts of 114 patients—taken immediately before and after RME—were three-dimensionally analysed. Depending on the dentition stage, the patients were divided into two groups (each n = 57, group 1, early mixed dentition; group 2, late mixed or permanent dentition).

Results

The width increases were highly significant, both in the overall and in the individual groups (p < 0.001). While the width increase was greater in the posterior area than anteriorly in the early group, the widening in the late group happened significantly greater anteriorly than posteriorly. Palatal height increased anteriorly and posteriorly in both groups to a significant extent (p < 0.001). The height increase was more pronounced in the anterior region than in the posterior region in the late group. The palatine index according to Kim revealed a change in palatal morphology both anteriorly and posteriorly in the early group but only anteriorly in the late group.

Conclusions

Maxillary expansion occurs more parallel in early treatment compared to V-shaped opening in the later treatment approach.

Clinical relevance

RME is more advantageous in an early dentition.
Literature
1.
Angell EC (1860) Treatment of irregularities of the permanent adult teeth. Dent Cosmos 1:540–545
2.
Korbmacher H, Huck L, Merkle T, Kahl-Nieke B (2005) Clinical profile of rapid maxillary expansion – outcome of a national inquiry. J Orofac Orthop 66:455–468PubMedCrossRef
3.
Grabowski R, Hinz R, Stahl de Castrillon F (eds) (2009) Das kieferorthopädische Risikokind: Gebissentwicklung und Funktionsstörungen - KFO-Prävention und Frühbehandlung. Zahnärztlicher Fach-Verlag, Herne
4.
Biederman W (1973) Rapid correction of class III malocclusion by midpalatal expansion. Am J Orthod 63:47–55PubMedCrossRef
5.
Haas AJ (1961) Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthod 31:73–90
6.
Lee KJ, Park YC, Park JY, Hwang WS (2010) Miniscrew-assis-ted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop 137:830–839PubMedCrossRef
7.
Ludwig B, Glasl B, Zorkun B, Wilmes B, Kinzinger G, Lisson J (2009) Forcierte Gaumennahterweiterung mit skelettalem Kraftansatz: Die Hybrid-GNE. Kieferorthop 23:267–274
8.
Harzer W, Schneider M, Gedrange T (2004) Rapid maxillary expansion with palatal anchorage of the hyrax expansion screw–pilot study with case presentation. J Orofac Orthop 65:419–424PubMedCrossRef
9.
Winsauer H, Vlachojannis J, Winsauer C, Ludwig B, Walter A (2013) A bone-borne appliance for rapid maxillary expansion. J Clin Orthod 47:375–381PubMed
10.
Bazargani F, Feldmann I, Bondemark L (2013) Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: a systematic review. Angle Orthod 83:1074–1083PubMedPubMedCentralCrossRef
11.
Ghoneima A, Abdel-Fattah E, Hartsfield J, El-Bedwehi A, Kamel A, Kula K (2011) Effects of rapid maxillary expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop 140:510–519PubMedPubMedCentralCrossRef
12.
Jain V, Shyagali TR, Kambalyal P, Rajpara Y, Doshi J (2017) Comparison and evaluation of stresses generated by rapid maxillary expansion and the implant-supported rapid maxillary expansion on the craniofacial structures using finite element method of stress analysis. Prog Orthod 18:3PubMedPubMedCentralCrossRef
13.
Priyadarshini J, Mahesh CM, Chandrashekar BS, Sundara A, Arun AV, Reddy VP (2017) Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion - a finite element method study. Prog Orthod 18:17PubMedPubMedCentralCrossRef
14.
Chaconas SJ, Caputo AA (1982) Observation of orthopedic force distribution produced by maxillary orthodontic appliances. Am J Orthod Dentofacial Orthop 82:492–501CrossRef
15.
Gardner GE, Kronman JH (1971) Cranioskeletal displacements caused by rapid palatal expansion in the rhesus monkey. Am J Orthod Dentofacial Orthop 59:146–155CrossRef
16.
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 81:36–41PubMedPubMedCentralCrossRef
17.
Shetty V, Caridad JM, Caputo AA, Chaconas SJ (1994) Biomechanical rationale for surgical-orthodontic expansion of the adult maxilla. J Oral Maxillofac Surg 52:742–749PubMedCrossRef
18.
Starnbach H, Bayne D, Cleall J, Subtelny JD (1966) Facioskeletal and dental changes resulting from rapid maxillary expansion. Angle Orthod 36:152–164PubMed
19.
Garib DG, Henriques JFC, Janson G, Freitas MR, Coelho RA (2005) Rapid maxillary expansion - tooth tissueborne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects. Angle Orthod 75:548–557PubMed
20.
21.
Baratieri C, Alves MJR, Gomes de Souza MM, Araujo M, Maia LC (2011) Does rapid maxillary expansion have long-term effects on airway dimensions and breathing? Am J Orthod Dentofacial Orthop 140:146–156PubMedCrossRef
22.
Maspero C, Galbiati G, Del Rosso E, Farronato M, Giannini L (2019) RME: effects on the nasal septum. A CBCT evaluation. Eur J Paediatr Dent 20:123–126PubMed
23.
Podesser B, Williams S, Crismani AG, Bantleon HP (2007) Evaluation of the effects of rapid maxillary expansion in growing children using computer tomography scanning: a pilot study. Eur J Orthod 29:37–44PubMedCrossRef
24.
Kim SJ, Donovan DM, Blanchard SB, Kowolik JE, Eckert GJ (2008) The relationship between acute otitis media and the anatomic form of the hard palate. Pediatr Dent 30:9–14PubMed
25.
Dahlberg G (ed) (1940) Statistical methods for medical and biological students. Interscience Publications, New York
26.
Baldini A, Nota A, Santariello C, Caruso S, Assi V, Ballanti F, Gatto R, Cozza P (2018) Sagittal dentoskeletal modifications associated with different activation protocols of rapid maxillary expansion. Eur J Paediatr Dent 19:151–155PubMed
27.
Bucci R, D’Antò V, Rongo R, Valletta R, Martina R, Michelotti A (2016) Dental and skeletal effects of palatal expansion techniques: a systematic review of the current evidence from systematic reviews and meta-analyses. J Oral Rehabil 43:543–564PubMedCrossRef
28.
Haas AJ (1965) The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod 35:200–217PubMed
29.
Tausche E, Deeb W, Hansen L, Hietschold V, Harzer W, Schneider M (2009) CT analysis of nasal volume changes after surgically-assisted rapid maxillary expansion. J Orofac Orthop 70:306–317PubMedCrossRef
30.
Wertz R (1970) Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod 58:41–66PubMedCrossRef
31.
32.
Liu S, Xu T, Zou W (2015) Effects of rapid maxillary expansion on the midpalatal suture: a systematic review. Eur J Orthod 37:651–655PubMedCrossRef
33.
Christie KF, Boucher N, Chung CH (2010) Effects of bonded rapid palatal expansion on the transverse dimensions of the maxilla: a cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 137:79–85CrossRef
34.
Habersack K, Karoglan A, Sommer B, Benner KU (2007) High-resolution multislice computerized tomography with multiplanar and 3-dimensional reformation imaging in rapid palatal expansion. Am J Orthod Dentofacial Orthop 131:776–781PubMedCrossRef
35.
Cross DL, McDonald JP (2000) Effect of rapid maxillary expansion on skeletal, dental, and nasal structures: a postero-anterior cephalometric study. Eur J Orthod 22:519–528PubMedCrossRef
36.
Kajan ZD, Nasab NK, Eghrari N (2018) Quantitative evaluation of midpalatal suture opening and its relation with zygomaticomaxillary suture status in patients aged 7–25 years using cone beam computed tomography images: in an Iranian population. Contemp Clin Dent 9:89–94CrossRef
37.
Knaup B, Yildizhan F, Wehrbein H (2004) Age-related changes in the midpalatal suture. A histomorphometric study. J Orofac Orthop 65:467–474PubMedCrossRef
38.
Persson M, Thilander B (1977) Palatal suture closure in man from 15 to 35 years of age. Am J Orthod Dentofacial Orthop 72:42–52CrossRef
39.
40.
Korbmacher H, Schilling A, Püschel K, Amling M, Kahl-Nieke B (2007) Age-dependent three-dimensional microcomputed tomography analysis of the human midpalatal suture. J Orofac Orthop 68:364–376PubMedCrossRef
41.
Wehrbein H, Yildizhan F (2001) The mid-palatal suture in young adults. A radiological-histological investigation. Eur J Orthod 23:105–114PubMedCrossRef
42.
Holberg C (2005) Effects of rapid maxillary expansion on the cranial base – an FEM-Analysis. J Orofac Orthop 66:54–66PubMedCrossRef
43.
Bell RA (1982) A review of maxillary expansion in relation to rate of expansion and patient’s age. Am J Orthod 81:32–37PubMedCrossRef
44.
Majourau A, Nanda R (1994) Biomechanical basis of vertical dimension control during rapid palatal expansion therapy. Am J Orthod Dentofacial Orthop 106:322–328PubMedCrossRef
45.
Weissheimer A, de Menezes LM, Mezomo M, Dias DM, de Lima EM, Rizzatto SM (2011) Immediate effects of rapid maxillary expansion with Haas-type and hyrax-type expanders: a randomized clinical trial. Angle Orthod 140:366–376
46.
Heiser W, Niederwanger A, Bancher B, Bittermann G, Neunteufel N, Kulmer S (2004) Three-dimensional dental arch and palatal form changes after extraction and nonextraction treatment. Part 3. Transversal and sagittal palatal form. Am J Orthod Dentofacial Orthop 126:91–99PubMedCrossRef
47.
Jimenez P, Martinez-Insua A, Franco-Vazquez J, Otero-Cepeda XL, Santana U (2012) Maxillary changes and occlusal traits in crania with artificial fronto-occipital deformation. Am J Phys Anthropol 147:40–51PubMedCrossRef
48.
Yang ST, Kim HK, Lim YS, Chang MS, Lee SP, Park YS (2013) A three dimensional observation of palatal vault growth in children using mixed effect analysis: a 9 year longitudinal study. Eur J Orthod 35:832–840PubMedCrossRef
49.
Gautam P, Valiathan A, Adhikari R (2007) Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion: a finite element method study. Am J Orthod Dentofacial Orthop 132:5.e1-11CrossRef
50.
Volk J, Kadivec M, Mušič MM, Ovsenik M (2010) Three-dimensional ultrasound diagnostics of tongue posture in children with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop 138:608–612PubMedCrossRef
Metadata
Title
Impact of rapid maxillary expansion on palatal morphology at different dentition stages
Authors
Gero Stefan Michael Kinzinger
Jörg Alexander Lisson
Charlotte Buschhoff
Jan Hourfar
Heike Korbmacher-Steiner
Publication date
10-03-2022
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2022
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-022-04434-9

Other articles of this Issue 7/2022

Clinical Oral Investigations 7/2022 Go to the issue

Original Article

Safety and tolerability of cinnamaldehyde in orabase for oral candidiasis treatment: phase I clinical trial

Original Article

Chemical and mechanical properties of dual-polymerizing core build-up materials

Original Article

Maintenance requirements and marginal bone loss associated with implant-retained overdentures: a retrospective cohort study

Original Article

Peri-implant bone microstructural analysis and comparison of resonance frequency analysis before prosthetic placement: a retrospective study

Original Article

Association between cumulative smoking exposure, span since smoking cessation, and peri-implantitis: a cross-sectional study

Original Article

Cytokine co-stimulation effect on odontogenic differentiation of stem cells