Objective: This study aimed to compare the skeletal and dentoalveolar effects of the expansion force created by the semi-rapid and rapid activation protocols. Material and Methods: The study comprised 54 patients (26 female and 28 male) with transverse maxillary insufficiency. Of these patients, 22 were treated with semi-rapid maxillary expansion (SRME) and 32 with rapid maxillary expansion (RME). The SRME group consisted of 6 prepubertal, 8 pubertal, and 8 postpubertal patients, and the RME group consisted of 11 prepubertal, 11 pubertal, and 10 postpubertal patients. Treatment effects with both protocols were evaluated with 11 different measurements on posteroanterior cephalograms and plaster models taken before treatment and after a retention period of 3 months. Kruskal-Wallis analysis was used for comparisons between different maturation periods. Independent sample t-test and Mann-Whitney U test with Bonferroni correction were used for pairwise comparisons between two different activation protocols. Results: The increases in nasal and dental widths in the SRME group were found to be higher than in the RME group in the prepubertal patient group (p0.05). No statistically significant difference was found among prepubertal, pubertal, and postpubertal groups for all skeletal and dental measurements (p>0.05). Conclusion: The current study represented some evidence that the SRME activation protocol might cause less tissue resistance than the conventional RME. The efficiency of maxillary expansion therapy is similar in prepubertal, pubertal, and postpubertal patients in whom sutural resistance is resolved.
Keywords: Orthopedics; dentofacial deformities; palatal expansion technique
Amaç: Bu çalışmanın amacı, yarı hızlı ve hızlı aktivasyon protokollerinin oluşturduğu genişleme kuvvetinin iskeletsel ve dentoalveolar etkilerini karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya transversal maksiller yetersizliği olan 54 hasta (26 kadın ve 28 erkek) dâhil edildi. Bu hastalardan 22'si yarı hızlı üst çene genişletmesi [semirapid maxillary expansion (SRME)] ve 32'si hızlı üst çene genişletmesi [rapid maxillary expansion (RME)] ile tedavi edilmişti. SRME grubu 6 prepubertal, 8 pubertal ve 8 postpubertal hastadan ve RME grubu 11 prepubertal, 11 pubertal ve 10 postpubertal hastadan oluşuyordu. Her iki protokolün de tedavi etkileri, tedaviden önce ve ortalama 3 aylık retansiyon döneminden sonra her hastadan alınan posteroanterior sefalogramlar ve alçı modelleri üzerinde 11 farklı ölçümle değerlendirildi. Farklı maturasyon dönemleri arasındaki karşılaştırmalar için KruskalWallis analizi kullanıldı. İki farklı aktivasyon protokolü arasında ikili karşılaştırmalar için bağımsız örnek t-testi ve Bonferroni düzeltmeli Mann-Whitney U testi kullanıldı. Bulgular: Prepubertal hasta grubunda, SRME grubundaki nazal ve dental genişlik artışları RME grubuna göre daha yüksek bulundu (p0,05). Tüm iskeletsel ve dental ölçümler için prepubertal, pubertal ve postpubertal gruplar arasında istatistiksel olarak anlamlı bir fark bulunmadı (p>0,05). Sonuç: Mevcut çalışma, SRME aktivasyon protokolünün geleneksel RME'den daha az doku direncine neden olabileceğine dair bazı kanıtlar sundu. Sütüral direncin çözüldüğü prepubertal, pubertal ve postpubertal hastalarda maksiller genişletme tedavisinin etkinliği benzerdir.
Anahtar Kelimeler: Ortopedi; dentofasiyal deformiteler; palatal genişletme tekniği
- Mehta S, Wang D, Kuo CL, Mu J, Vich ML, Allareddy V, et al. Long-term effects of mini-screw-assisted rapid palatal expansion on airway. Angle Orthod. 2021;91(2):195-205. [Crossref] [PubMed] [PMC]
- Algharbi M, Bazargani F, Dimberg L. Do different maxillary expansion appliances influence the outcomes of the treatment? Eur J Orthod. 2018;40(1):97-106. [Crossref] [PubMed]
- Gunyuz Toklu M, Germec-Cakan D, Tozlu M. Periodontal, dentoalveolar, and skeletal effects of tooth-borne and tooth-bone-borne expansion appliances. Am J Orthod Dentofacial Orthop. 2015;148(1):97-109. [Crossref] [PubMed]
- Mosleh MI, Kaddah MA, Abd ElSayed FA, ElSayed HS. Comparison of transverse changes during maxillary expansion with 4-point bone-borne and tooth-borne maxillary expanders. Am J Orthod Dentofacial Orthop. 2015;148(4):599-607. [Crossref] [PubMed]
- 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(3):366-76. [Crossref] [PubMed]
- Işeri H, Ozsoy S. Semirapid maxillary expansion--a study of long-term transverse effects in older adolescents and adults. Angle Orthod. 2004;74(1):71-8. [PubMed]
- Zimring JF, Isaacson RJ. Forces produced by rapid maxillary expansion. 3. forces present during retention. Angle Orthod. 1965;35:178-86. [PubMed]
- Işeri H, Tekkaya AE, Oztan O, Bilgiç S. Biomechanical effects of rapid maxillary expansion on the craniofacial skeleton, studied by the finite element method. Eur J Orthod. 1998;20(4):347-56. [Crossref] [PubMed]
- Ramoglu SI, Sari Z. Maxillary expansion in the mixed dentition: rapid or semi-rapid? Eur J Orthod. 2010;32(1):11-8. [Crossref] [PubMed]
- Perillo L, De Rosa A, Iaselli F, d'Apuzzo F, Grassia V, Cappabianca S. Comparison between rapid and mixed maxillary expansion through an assessment of dento-skeletal effects on posteroanterior cephalometry. Prog Orthod. 2014;15(1):46. [Crossref] [PubMed] [PMC]
- Grassia V, d'Apuzzo F, Jamilian A, Femiano F, Favero L, Perillo L. Comparison between rapid and mixed maxillary expansion through an assessment of arch changes on dental casts. Prog Orthod. 2015;16:20. [Crossref] [PubMed] [PMC]
- Baldini A, Nota A, Santariello C, Assi V, Ballanti F, Cozza P. A comparative assessment of changes in dental arches associated with different activation protocols of rapid maxillary expansion. Eur J Paediatr Dent. 2018;19(1):35-9. [PubMed]
- Alkhal HA, Wong RW, Rabie AB. Correlation between chronological age, cervical vertebral maturation and Fishman's skeletal maturity indicators in southern Chinese. Angle Orthod. 2008;78(4):591-6. [Crossref] [PubMed]
- Yılmaz A, Arman-Özçırpıcı A, Erken S, Polat-Özsoy Ö. Comparison of short-term effects of mini-implant-supported maxillary expansion appliance with two conventional expansion protocols. Eur J Orthod. 2015;37(5):556-64. [Crossref] [PubMed]
- Çörekçi B, Göyenç YB. Dentofacial changes from fan-type rapid maxillary expansion vs traditional rapid maxillary expansion in early mixed dentition. Angle Orthod. 2013;83(5):842-50. [Crossref] [PubMed] [PMC]
- Olmez H, Akin E, Karaçay S. Multitomographic evaluation of the dental effects of two different rapid palatal expansion appliances. Eur J Orthod. 2007;29(4):379-85. [Crossref] [PubMed]
- Pangrazio-Kulbersh V, Wine P, Haughey M, Pajtas B, Kaczynski R. Cone beam computed tomography evaluation of changes in the naso-maxillary complex associated with two types of maxillary expanders. Angle Orthod. 2012;82(3):448-57. [Crossref] [PubMed] [PMC]
- Baccetti T, Franchi L, Cameron CG, McNamara JA Jr. Treatment timing for rapid maxillary expansion. Angle Orthod. 2001;71(5):343-50. [PubMed]
- Sayar G, Kılınç DD. Rapid maxillary expansion outcomes according to midpalatal suture maturation levels. Prog Orthod. 2019;20(1):27. [Crossref] [PubMed] [PMC]
.: İşlem Listesi