scholarly journals Early Treatment with a Slow Maxillary Ni–Ti Leaf Springs Expander

2021 ◽  
Vol 11 (10) ◽  
pp. 4541
Author(s):  
Massimiliano Vella ◽  
Paolo Cressoni ◽  
Cinzia Tripicchio ◽  
Eleonora Mainardi ◽  
Luca Esposito

The aim of this brief report is to analyse the available literature on the clinical outcomes of a particular appliance for slow maxillary expansion that consists of one or more nickel–titanium springs. Materials and methods: The main medical databases (Scopus, Web of Sciences, Pubmed and Google Scholar) were scanned up to January 2020 using “slow maxillary expan*”, “slow palatal expan*”, “leaf expander” and “NiTi Palatal Expander” as keywords. Skeletal changes in the maxilla after expansion with the Leaf Expander (L.E.) or similar appliances were taken into consideration while reviewing relevant manuscripts. The review focuses on the comparison between the L.E. and conventional expanders (i.e., Haas and Hyrax) regarding the increase in both the distance between the palatal cusps of the upper first molars and the distance between the palatal cusps of the upper second deciduous molars, as well as the increment of nasal structures and pain connected to expansion procedures. Results: Bibliographic research retrieved 32 articles that were considered eligible for the present study. The limited number of articles currently available in international medical databases is allegedly partly due to the fact that these expanders are currently produced by only one patent holder company, which affects its diffusion. Conclusion: Despite the reduced number of published articles, due to the recent introduction of the L.E. device, most of the authors have found that the effects of the L.E. device are clinically and radiographically comparable to those achievable with the rapid palatal expander.

2018 ◽  
Vol 14 (3) ◽  
pp. 224-236
Author(s):  
Joanna Abramczyk ◽  
Małgorzata Zadurska ◽  
Ewa Czochrowska

Canines, especially upper canines, are the second most frequently impacted permanent teeth, after third molars. Orthodontic extrusion of ectopic impacted canines is often complex, long-lasting and may lead to iatrogenic complications. In children, implementation of interceptive treatment helps to normalise the canine position in the alveolar process and its spontaneous eruption. <b>Aim.</b> The aim of the study was to review the literature regarding the methods of interceptive treatment for impacted maxillary and mandibular canines supported by relevant clinical examples. <b>Material and methods.</b> A review of literature on interceptive treatment of impacted canines has been performed for the period 1961–2018. The medical databases PubMed and Medline were used. <b>Results.</b> Extraction of deciduous maxillary canines and maxillary first deciduous molars, maxillary expansion with rapid maxillary expanders and transpalatal arches, also in combination with extraoral traction and space opening the dental arch with fixed appliances are effective methods of interceptive treatment in patients at the developmental age with impacted upper canines. There is no effective protocol for interceptive treatment for impacted mandibular canines described in the literature. <b>Conclusions.</b> The use of interceptive treatment in growing patients positively influences spontaneous eruption of ectopic impacted maxillary canines. Early clinical and radiological diagnosis of ectopic canine position is very important for success. <b>(Abramczyk J, Zadurska M, Czochrowska E. Impacted canines – interceptive treatment. Orthod Forum 2018; 14: 224-36).</b>


Author(s):  
Ulrike Riede ◽  
Sandra Wai ◽  
Sabrina Neururer ◽  
Bärbel Reistenhofer ◽  
Gregor Riede ◽  
...  

Abstract Objectives To evaluate the precision of aligner (Invisalign®) treatment with the current material (SmartTrack®) in achieving expansion or contraction of the maxilla and occlusal contacts as simulated in the proprietary planning software (ClinCheck®, CC). Materials and methods Thirty patients thus treated were retrospectively evaluated. Four maxillary models were analyzed per patient: a pretreatment model, a scan-based CC model, a posttreatment clinical model, and a CC model reflecting the treatment outcome as initially simulated. Thirteen transverse parameters were measured on each model separately by two investigators. Occlusal contacts were also analyzed. Results The measuring method was validated by both investigators arriving at similar results for the effectiveness by which the simulated treatment goals had been clinically achieved. Significant differences (p < 0.05; Wilcoxon signed-rank test) were observed for transfer precision from the casts to the planning software and between the simulated and clinical outcomes. Intense occlusal contacts in the simulations materialized less common (≈ 2%) than ideal contacts (≈ 60%) in the clinical outcomes. Conclusions The effectiveness of achieving the simulated transverse goals was 45% and was generally not found to be better with SmartTrack® than with the previously used Ex30® material. Out of 100 simulated occlusal contacts, 40 will never materialize, and achieving around 60 will adequately ensure a clinically favorable contact pattern. Clinical relevance With the caveat that any overcorrection will to some extent reduce the precision, it seems perfectly possible to make deliberate use of overcorrection in current aligner therapies for transverse maxillary expansion or contraction.


Author(s):  
Tiziano Baccetti ◽  
Jean S. McGill ◽  
Lorenzo Franchi ◽  
James A. McNamara ◽  
Isabella Tollaro

2011 ◽  
Vol 22 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Moara de Rossi ◽  
Andiara de Rossi ◽  
Jorge Abrão

Bonded maxillary expansion appliances have been suggested to control increases in the vertical dimension of the face after rapid maxillary expansion (RME). However, there is still no consensus in the literature about its real skeletal effects. The purpose of this prospective study was to evaluate, longitudinally, the vertical and sagittal cephalometric alterations after RME performed with bonded maxillary expansion appliance. The sample consisted of 26 children, with a mean age of 8.7 years (range: 6.9-10.9 years), with posterior skeletal crossbite and indication for RME. After maxillary expansion, the bonded appliance was used as a fixed retention for 3.4 months, being replaced by a removable retention subsequently. The cephalometric study was performed onto lateral radiographs, taken before treatment was started, and again 6.3 months after removing the bonded appliance. Intra-group comparison was made using paired t test. The results showed that there were no significant sagittal skeletal changes at the end of treatment. There was a small vertical skeletal increase in five of the eleven evaluated cephalometric measures. The maxilla displaced downward, but it did not modify the facial growth patterns or the direction of the mandible growth. Under the specific conditions of this research, it may be concluded that RME with acrylic bonded maxillary expansion appliance did promote signifciant vertical or sagittal cephalometric alterations. The vertical changes found with the use of the bonded appliance were small and probably transitory, similar to those occurred with the use of banded expansion appliances.


2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jia-Nan Zhang ◽  
Si Chen ◽  
Cheng-Yi Huang ◽  
Chong Zhong ◽  
Jing Jin ◽  
...  

Abstract Background This is a retrospective study that compares mandibular growth changes in skeletal Class II patients treated by rapid maxillary expansion (RME) and following fixed appliance with those patients treated by Twin-Block (TB) and following fixed appliance. Methods Fourteen patients treated by RME and following fixed appliance were included into the RME group. Fifteen patients treated by Twin-Block and following fixed appliance were included into the TB group. Lateral cephalometric radiographs taken before treatment and immediately after fixed appliance treatment were used to evaluate mandibular growth effects. Results The starting forms of the patients in the two groups were examined to be of good comparability. The mandibular length increased significantly in both groups as measured by Co-Gn, Go-Gn and Ar-Gn, but the TB group didn’t show more mandibular growth than the RME group (P > 0.05). Skeletal changes of the mandible in vertical dimension were different in the two groups. The change in FMA was 0.35° in the RME group, while the change was 2.65° in the TB group (P < 0.001). The change in LAFH was 5.14 mm in the RME group, significantly smaller than the change of 10.19 mm in the TB group (P < 0.001). Conclusion The investigated Phase I treatment with RME followed by Phase II treatment of fixed appliance achieved the same increases in sagittal mandibular growth and facial profile improvements as the Twin-Block therapy. The treatment with RME followed by fixed appliance was better for vertical control, while the treatment with Twin-Block followed by fixed appliance significantly increased the mandibular plane angle.


2019 ◽  
Vol 56 (10) ◽  
pp. 1386-1392
Author(s):  
Karel-Bart Celie ◽  
Melissa Yuan ◽  
Christopher Cunniff ◽  
Jarrod Bogue ◽  
Caitlin Hoffman ◽  
...  

Little is currently known about the mechanisms by which pathogenic variants of FGFR2 produce changes in the FGFR protein and influence the clinical presentation of affected individuals. We report on a patient with a de novo pathogenic variant of FGFR2 and a phenotype consistent with Jackson-Weiss syndrome who presented with delayed, rapidly progressive multisutural craniosynostosis and associated medical complications. Using 3-dimensional modeling of the FGFR protein, we provide evidence that this variant resulted in abnormal dimerization and constitutive activation of FGFR, leading to the Jackson-Weiss phenotype. Knowledge regarding the correlation between genotype and phenotype of persons with FGFR2-related craniosynostosis has the potential to allow for anticipation of medical complications, institution of early treatment, and improved clinical outcomes.


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