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Differential treatment effects of two anchorage systems for rapid maxillary expansion: a retrospective cephalometric study

Differenzialtherapeutische Effekte zweier unterschiedlich verankerter Gaumennahterweiterungsapparaturen: Eine retrospektive kephalometrische Studie

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

Abstract

Objectives

The purpose of this study was to compare cephalometric changes resulting from treatment with two appliances for rapid maxillary expansion: (1) a strictly tooth-borne appliance and (2) a combined tooth- and bone-borne appliance.

Patients and methods

Pre- and posttreatment lateral cephalograms of 100 patients were analyzed by cephalometry. Of these patients, 50 were treated with strictly tooth-borne and another 50 with combined tooth- and bone-borne appliances. Mean pretreatment age was 13.04 ± 4.82 years, and mean treatment duration was 7.12 ± 2.37 months. To identify any implications for clinical therapy, additional subgroups were formed based on the pretreatment cephalometric findings for skeletal Class I (0° < ANB ≤ 4°) or Class III (ANB ≤0°). Paired t-tests were used for intragroup and analysis of variance (ANOVA) for intergroup comparisons. Results were considered statistically significant at p ≤ 0.05.

Results

Both appliance types resulted in significant cephalometric changes in the maxilla and mandible. Compared to the strictly tooth-borne appliances, the combined tooth- and bone-borne appliances were found to cause more pronounced advancement of the maxilla (SNA angle) notably among the Class III patients.

Conclusions

Hybrid (combined tooth- and bone-borne) appliances for rapid maxillary expansion might be preferable in the treatment of skeletal Class III patients, since they possibly exert a more pronounced skeletal effect on the sagittal position of the maxilla.

Zusammenfassung

Zielsetzung

Ziel dieser Studie war die vergleichende Untersuchung kephalometrischer Veränderungen durch die Behandlung mittels zweier Gaumennahterweiterungsapparaturen: einer rein zahngetragenen und einer kombiniert zahn- und knochengetragenen Ausführung.

Patienten und Methoden

Prä- und posttherapeutische Fernröntgenseitenaufnahmen von 100 Patienten wurden kephalometrisch ausgewertet. Fünfzig Patienten wurden mit einer rein zahngetragenen, 50 mit einer kombiniert zahn- und knochengetragenen Ausführung behandelt. Das Alter vor Behandlung lag im Mittel bei 13,04 ± 4,82 Jahren, die Behandlungsdauer bei 7,12 ± 2,37 Monaten. Um mögliche Implikationen für die Therapie ableiten zu können, wurden die Patienten über eine prätherapeutisch kephalometrisch diagnostizierte Zughörigkeit zur skelettalen Klasse I (0° < ANB ≤ 4°) bzw. Klasse III (ANB ≤ 0°) weiter unterteilt. Für Intragruppenvergleiche kamen gepaarte t-Tests zum Einsatz, während für Intergruppenvergleiche unabhängige t-Tests respektive die Varianzanalyse (ANOVA) zur Anwendung kamen. Statistische Signifikanz wurde bei p < 0,05 angenommen.

Ergebnisse

Es konnten signifikante kephalometrische Veränderungen in beiden Kiefern nach Behandlung mit beiden Apparaturen verzeichnet werden. Verglichen mit der rein zahngetragenen Gaumenerweiterungsapparatur verursachte die kombiniert zahn- und knochengetragene Ausführung eine stärker ausgeprägte anteriore Verlagerung der Maxilla (SNA-Winkel), insbesondere bei Klasse-III-Patienten.

Schlussfolgerungen

Die kombiniert zahn- und knochengetragenen Gaumennahterweiterungsapparatur könnte bei skelettalen Klasse-III-Patienten aufgrund eines möglicherweise stärkeren skelettalen Effektes auf die sagittale Lage der Maxilla die Behandlung dieser Patientengruppe begünstigen.

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Correspondence to Jörg Alexander Lisson.

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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.

Conflict of interest

J. Hourfar, G. S. M. Kinzinger, B. Ludwig, J. Spindler, and J. A. Lisson state that there are no conflicts of interest.

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Univ.-Prof. Dr. Jörg A. Lisson.

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Hourfar, J., Kinzinger, G.S.M., Ludwig, B. et al. Differential treatment effects of two anchorage systems for rapid maxillary expansion: a retrospective cephalometric study. J Orofac Orthop 77, 314–324 (2016). https://doi.org/10.1007/s00056-016-0037-1

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