Abstract
Objective
Changes in soft tissue in various morphological regions of the face immediately after rapid maxillary expansion (RME) were examined using three-dimensional (3D) deviation analyses.
Patients and methods
A total of 50 patients were included in the study; 25 patients (11 female and 14 male) presented with a unilateral or bilateral posterior crossbite malocclusion requiring RME. In addition, 25 patients (13 female and 12 male) were included as a control group. The mean ages of the study group and control group were 9.8 years (range 8.1–12.6 years) and 9.6 years (range 8.3–12.2 years), respectively. The 3D stereophotogrammetric images acquired immediately before the appliance was cemented and after expansion had been completed in the treatment group were compared using Rapidform software. The 3D deviation analyses were made for the complete face and in the upper and lower face, upper and lower lips and nose regions. The amount of negative and positive deviations and the mean deviations were examined on the facial meshes for the 95th percentiles.
Results
Immediately after RME, the mean absolute deviation over the complete face was 0.54 ± 0.16 mm. The mean change for the upper face was 0.42 ± 0.17 mm (mean positive deviation: 0.37 ± 0.17 mm; mean negative deviation: −0.48 ± 0.18 mm). The mean absolute deviation was 0.62 ± 0.28 mm in the upper lip and 0.60 ± 0.34 mm in the lower lip. In the nose area, the absolute deviation was 0.41 ± 0.21 mm (mean positive deviation: 0.39 ± 0.16 mm; mean negative deviation: −0.43 ± 0.26 mm).
Conclusions
Changes in facial soft tissues in the upper face, lower face, nasal soft tissues, and lower and upper lip regions were observed after RME.
Zusammenfassung
Zielsetzung
Mittels dreidimensionaler Abweichungsanalyse wurden Veränderungen unterschiedlicher fazialer Weichgeweberegionen unmittelbar nach forcierter Gaumennahterweiterung (“rapid maxillary expansion”, RME) untersucht.
Patienten und Methoden
Insgesamt 50 Patienten wurden in die Studie aufgenommen, 25 (11 weiblich, 14 männlich) von ihnen mit einem ein- bzw. beidseitigen hinteren Kreuzbiss, der eine RME erforderte, 25 (13 weiblich, 12 männlich) dienten als Kontrollkollektiv. Das Durchschnittsalter lag in der behandelten Gruppe bei 9,8 (8,1–12,6) Jahren, in der Kontrollgruppe bei 9,6 (8,3–12,2). Die sowohl unmittelbar vor Befestigung der Apparatur als auch nach RME aufgenommenen 3-D-Stereofotogrammetriebilder wurden mit der Software Rapidform verglichen. Für das Gesicht insgesamt, für das obere und untere Gesicht, für Ober- und Unterlippe sowie für die Nasenregion wurden dreidimensionale Analysen erstellt. Untersucht wurden das Ausmaß der positiven und negativen Abweichungen sowie die durchschnittliche Abweichung auf fazialen Gitternetzen, ermittelt wurden die 95%-Perzentilen.
Ergebnisse
Unmittelbar nach RME betrugen die durchschnittlichen absoluten Abweichungen über das Gesicht insgesamt 0,54 ± 0,16 mm und die durchschnittliche Änderung in der oberen Gesichtshälfte 0,42 ± 0,17 mm (durchschnittliche positive bzw. negative Abweichung: 0,37 ± 0,17 bzw. −0,48 ± 0,18 mm). Die durchschnittliche absolute Abweichung im Bereich der Oberlippe lag bei 0,62 ± 0,28 mm, im Bereich der Unterlippe bei 0,60 ± 0,34 mm. In der Nasenregion betrug die absolute Abweichung 0,41 ± 0,21 mm (durchschnittliche positive bzw. negative Abweichung: 0,39 ± 0,16 bzw. −0,43 ± 0,26 mm).
Schlussfolgerungen
Nach RME ließen sich Veränderungen in den Weichgeweben sowohl der oberen wie unteren Gesichtshälfte als auch der Nase, Ober- und Unterlippe beobachten.
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References
Ackerman JL, Proffit WR, Sarver DM (1999) The emerging soft tissue paradigm in orthodontic diagnosis and treatment planning. Clin Orthod Res 2:49–52
Adkins MD, Nanda RS, Currier GF (1990) Arch perimeter changes on rapid palatal expansion. Am J Orthod Dentofac Orthop 97:194–199
Akkaya S, Lorenzon S, Uçem TT (1999) A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures. Eur J Orthod 21:175–180
Altındiş S, Toy E, Başçiftçi FA (2015) Assessment of the effects of different rapid maxillary expansion appliances on facial soft tissues using three-dimensional imaging. Angle Orthod. doi:10.2319/051115-319.1
Altorkat Y, Khambay BS, McDonald JP, Cross DL, Brocklebank LM, Ju X (2014) Immediate effects of rapid maxillary expansion on the naso-maxillary facial soft tissue using 3D stereophotogrammetry. Surgeon. doi:10.1016/j.surge.2014.04.005
Bazargani F, Feldmann I, Bondemark L (2013) Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones. Angle Orthod 83:1074–1082
Berger JL, Pangrazio-Kulbersh V, Borgula T, Kaczynski R (1998) Stability of orthopedic and surgically assisted rapid palatal expansion over time. Am J Orthod Dentofac Orthop 114:638–645
Berger JL, Pangrazio-Kulbersh V, Thomas BW, Kaczynski R (1999) Photographic analysis of facial changes associated with maxillary expansion. Am J Orthod Dentofac Orthop 116:563–571
Brons S, van Beusichem ME, Bronkhorst EM et al (2012) Methods to quantify soft-tissue based facial growth and treatment outcomes in children: a systematic review. PLoS One 7:e41898
Chung C-H, Font B (2004) Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofac Orthop 126:569–575
da Silva Filho OG, Boas MC, Capelozza Filho L (1991) Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofac Orthop 100:171–179
Davis WM, Kronman JH (1969) Anatomical changes induced by splitting of the midpalatal suture. Angle Orthod 39:126–132
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 Dentofac Orthop 140:510–519
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 144:398–403
Hajeer MY, Millett DT, Ayoub AF, Siebert JP (2004) Applications of 3D imaging in orthodontics: part I. J Orthod 31:62–70
Kim KB, Adams D, Araújo EA, Behrents RG (2012) Evaluation of immediate soft tissue changes after rapid maxillary expansion. Dental Press J Orthod 17:157–164
Littlefield TR, Kelly KM, Cherney JC, Beals SP, Pomatto JK (2004) Development of a new three-dimensional cranial imaging system. J Craniofac Surg 15:175–181
Maulik C, Nanda R (2007) Dynamic smile analysis in young adults. Am J Orthod Dentofac Orthop 132:307–315
Nada RM, van Loon B, Maal TJJ et al (2013) Three-dimensional evaluation of soft tissue changes in the orofacial region after tooth-borne and bone-borne surgically assisted rapid maxillary expansion. Clin Oral Investig 17:2017–2024
Ong SC, Khambay BS, McDonald JP, Cross DL, Brocklebank LM, Ju X (2015) The novel use of three-dimensional surface models to quantify and visualise the immediate changes of the mid-facial skeleton following rapid maxillary expansion. Surgeon 13:132–138
Sandikçioğlu M, Hazar S (1997) Skeletal and dental changes after maxillary expansion in the mixed dentition. Am J Orthod Dentofac Orthop 111:321–327
Sarver DM (2015) Interactions of hard tissues, soft tissues, and growth over time, and their impact on orthodontic diagnosis and treatment planning. Am J Orthod Dentofac Orthop 148:380–386
Sarver DM, Johnston MW (1989) Skeletal changes in vertical and anterior displacement of the maxilla with bonded rapid palatal expansion appliances. Am J Orthod Dentofac Orthop 95:462–466
Silva Filho OGd, Lara TS, Ayub PV, Ohashi ASC, Bertoz FA (2011) Photographic assessment of nasal morphology following rapid maxillary expansion in children. J Appl Oral Sci 19:535–543
Smith T, Ghoneima A, Stewart K et al (2012) Three-dimensional computed tomography analysis of airway volume changes after rapid maxillary expansion. Am J Orthod Dentofac Orthop 141:618–626
Weinberg SM, Kolar JC (2005) Three-dimensional surface imaging: limitations and considerations from the anthropometric perspective. J Craniofac Surg 16:847–851
Wertz R, Dreskin M (1977) Midpalatal suture opening: a normative study. Am J Orthod 71:367–381
Woller JL, Kim KB, Behrents RG, Buschang PH (2014) An assessment of the maxilla after rapid maxillary expansion using cone beam computed tomography in growing children. Dental Press J Orthod 19:26–35
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F Dindaroğlu, G.S. Duran, and S. Görgülü state declare that there are no conflicts of interest.
All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.
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Dindaroğlu, F., Duran, G.S. & Görgülü, S. Effects of rapid maxillary expansion on facial soft tissues. J Orofac Orthop 77, 242–250 (2016). https://doi.org/10.1007/s00056-016-0033-5
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DOI: https://doi.org/10.1007/s00056-016-0033-5