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Soft tissue changes in the orofacial region after rapid maxillary expansion

A cone beam computed tomography study

Orofaziale Weichgewebeveränderungen nach forcierter Gaumennahterweiterung

Eine Studie mit digitaler Volumentomographie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objective

Rapid maxillary expansion (RME) is usually used for expanding the maxillary bony segments. Many studies have assessed the dental and skeletal effects of the expansion treatment but few studies evaluated soft tissue changes using cone beam computed tomography (CBCT) images. This study aims to compare soft tissue changes after RME in prepubertal and postpubertal subjects using CBCT images. The null hypothesis of this study is there is no difference between prepubertal and postpubertal patients in soft tissue changes after RME treatment.

Materials and methods

A total of 28 patients (10 males, 18 females) with a bonded type of rapid maxillary expander were included in this study. The patients were divided into two subgroups according to cervical vertebral maturation stage. Prepubertal and postpubertal groups were obtained. Following the selection of CBCT images from the archive, pretreatment (T0) and postretention measurements (T1) were performed. Nine linear and one angular measurement for a total of 10 measurements were evaluated on each CBCT image. The mean differences between T0 and T1 measurements were compared by using the paired-samples t test and significance was set at P < 0.05.

Results

The largest median increase was found in cheek projection of the prepubertal group. Changes in soft tissue nasal base, philtrum width, upper lip length, columella width, columella height, and cheek projection were statistically significant (P < 0.001) in both groups. No significant differences were observed in soft tissue alar base, nostril width, nostril height, and nasolabial angle.

Conclusion

Some significant changes in facial soft tissues were observed after RME treatment but there were no significant differences between prepubertal and postpubertal subjects. The null hypothesis is accepted because there were no significant differences between the groups.

Zusammenfassung

Ziel

Die forcierte Gaumennahterweiterung (GNE; “rapid maxillary expansion”, RME) wird in der Regel eingesetzt, um knöcherne Anteile der Maxilla zu verändern. Zahlreiche Studien haben sich mit den dentalen und skelettalen Effekten einer Expansionsbehandlung ausgeinandergesetzt, aber nur in wenigen wurden auch die Weichgewebeveränderungen mittels digitaler Volumentomographie (DVT; “cone beam computed tomography”, CBCT) bildgebend untersucht. In der vorgestellten Untersuchung sollten mögliche durch die forcierte Gaumennahterweiterung induzierte Weichteilveränderungen bei präpuberalen und postpubertären Probanden anhand von DVT-Aufnahmem ermittelt werden. Die Nullhypothese war, dass zwischen beiden Gruppen kein Unterschied hinsichtlich Weichteilveränderungen nach RME-Behandlung besteht.

Material und Methoden

Insgesamt 28 Patienten (10 Männer, 18 Frauen) mit einer direkt geklebten GNE-Apparatur wurden in die Studie aufgenommen. Je nach CVM (“cervical vertebral maturation”)-Stadium wurden sie in 2 Untergruppen eingeteilt, sodass sich präpuberale und postpubertäre Gruppen ergaben. An den aus dem Archiv ausgewählten DVT-Aufnahmen wurden Messungen vor (T0) und nach (T1) Behandlung vorgenommen: auf jeder DVT-Aufnahme wurden 9 lineare Messungen und eine Winkelbestimmung evaluiert. Die Mittelwerte der Unterschiede zwischen den T0- und T1-Messungen wurden mit dem t Test für gepaarte Stichproben verglichen, das Signifikanzniveau wurde bei p < 0,05 festgelegt.

Ergebnisse

Die im Mittel deutlichste Vergrößerung bestand bei der Wangenprojektion in der Gruppe präpuberaler Patienten. In beiden Gruppen waren statistisch signifikante Veränderungen (p < 0,001) zu beobachten bei den Parametern Nasenbasis, Philtrumbreite, Oberlippenlänge, Breite und Höhe der Columella nasi sowie “cheek projection”. Bei den Parametern Flügelbasis (Weichgewebe), Nasenlochweite und -höhe sowie nasolabialer Winkel waren keine signifikanten Unterschiede zu beobachten.

Schlussfolgerungen

Nach RME-Behandlung ließen sich Veränderungen in fazialen Weichgeweben beobachten, es bestanden jedoch keine statistisch signifikanten Unterschiede zwischen präpuberalen und postpubertären Patienten. Die fehlenden statistisch signifikanten Unterschiede zwischen den beiden Gruppen bestätigten die Nullhypothese.

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Acknowledgements

I would like to thank Dr. Delal Dara Kılınc for his kindly help in final checking of the article.

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Authors and Affiliations

  1. Department of Orthodontics, School of Dentistry, Istanbul Medipol University, Atatürk Bulvarı No:27, Unkapanı-Fatih, 34083, Istanbul, Turkey

    Gülşilay Sayar Torun

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Correspondence to Gülşilay Sayar Torun.

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This article does not contain any studies with human participants or animals performed by the author.

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GS. Torun states that there are no conflicts of interest.

Additional information

G. S. Torun: Assistant Professor, DDS, PhD.

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Torun, G.S. Soft tissue changes in the orofacial region after rapid maxillary expansion. J Orofac Orthop 78, 193–200 (2017). https://doi.org/10.1007/s00056-016-0074-9

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