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Follow-up control of patients with unilateral posterior cross-bite treated with expansion plates or the quad-helix appliance

Nachuntersuchung von Patienten mit unilateralem seitlichem Kreuzbiß behandelt mit Expansionsplatten oder Quadhelix-Apparatur

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Abstract

The aim of this study was to evaluate the long-term stability of the occlusion after correction of posterior cross-bite with either a removable expansion plate or a quad-helix appliance and to compare the transversal development of the jaws in the plate group, the quad-helix group and a control group.

At the start of treatment there were 22 children in each of the treated groups. Two children in the plate group and 1 child in the quad-helix group discontinued the treatment. Two children treated with the quad-helix appliance and 1 child in the plate group could not be reached for the follow-up registration, so the collective finally consisted of 30 boys and 27 girls: 19 subjects in the plate group, 19 in the quad-helix group and 19 controls.

The treatment groups were studied with the help of plaster models before treatment, immediately after treatment and at the last registration about 5.5 years after treatment. The control group was studied with the help of plaster models on 2 occasions, at the mean age of 8.8 years and 15.9 years respectively. This was about the same age as the first and the last registrations in the treatment groups.

In all children, the posterior cross-bite was corrected by the end of the treatment. At the last registration, the corrected posterior cross-bite had relapsed in 1 child in the plate group and in 3 children in the quad-helix group.

The degree of expansion was similar for both groups. The mean treatment time was longer in the plate group than in the quad-helix group: 12.5 months and 7.7 months respectively.

Despite a transversal expansion in the treatment groups, the width of the maxillary dental arch did not reach the mean width in the control group, and even at the last registration the width of the maxillary dental arch was significantly greater in the control group than in the treated groups.

The conclusions of this study are: 1. The long-term treatment effect in children with posterior cross-bite was somewhat better when they were treated with the removable expansion plate in comparison with treatment with the quad-helix appliance. 2. Both immediately after treatment and at the last registration 5.5 years later, the width of the maxillary dental arch was significantly greater in the control group than in the plate group or the quad-helix group while the width of the mandibular dental arch was equal in all 3 groups.

Zusammenfassung

Das Ziel dieser Studie war die Untersuchung der Langzeitstabilität der Okklusion nach Behandlung eines seitlichen Kreuzbisses mit herausnehmbaren Expansionsplatten einerseits oder mit Quadhelix-Apparaturen andererseits, weiter wurde die transversale Entwicklung der Kiefer in drei Gruppen, einer Platten-Gruppe, einer Quadhelix-Gruppe und einer Kontrollgruppe, verglichen.

Am Anfang der Therapie waren 22 Kinder in jeder Behandlungsgruppe. Zwei Kinder in der Platten-Gruppe und ein Kind in der Quadhelix-Gruppe unterbrachen die Behandlung. Zwei der mit Quadhelix behandelten Kinder und ein Kind in der Platten-Gruppe konnten nicht nachuntersucht werden, so daß die Probanden in der Studie schließlich aus 30 Jungen und 27 Mädchen bestanden; 19 Probanden in der Quadhelix-Gruppe, 19 Probanden in der Platten-Gruppe und 19 in der Kontrollgruppe.

Die Behandlungsgruppen wurden mit Hilfe von Gipsmodellen vor der Therapie, unmittelbar nach der Therapie und bei der letzten Untersuchung fünfeinhalb Jahre nach Behandlung dokumentiert. Die Kontrollgruppe wurde anhand von Gipsmodellen zweimal im Alter von durchschnittlich 8,8 Jahren und 15,9 Jahren untersucht, dies entspricht ungefähr dem Alter bei der ersten und letzten Erfassung der Behandlungsgruppen.

Bei allen Kindern war der seitliche Kreuzbiß am Ende der Behandlung überstellt. Bei der letzten Untersuchung war der behandelte Kreuzbiß bei einem Kind in der Platten-Gruppe und bei drei Kindern in der Quadhelix-Gruppe rezidiviert.

Das Maß der Expansion was für beide Gruppen ähnlich. Die durchschnittliche Behandlungszeit war in der Platten-Gruppe länger als in der Quadhelix-Gruppe: 12,5 bzw. 7,7 Monate. Trotz transversaler Erweiterung in den Behandlungsgruppen erreichte deren Oberkieferzahnbogenbreite nicht die durchschnittliche Breite der Kontrollgruppe, bei der letzten Untersuchung war die obere Zahnbogenbreite in der Kontrollgruppe sogar signifikant größer als in den Behandlungsgruppen.

Die Schlußfolgerungen dieser Studie sind: 1. Das Langzeitergebnis bei Behandlung von Kindern mit seitlichem Kreuzbiß war im Vergleich zur Quadhelix etwas besser, wenn sie mit herausnehmbaren Expansionsplatten behandelt wurden. 2. Bei beiden Gruppen war die obere Zahnbogenbreite unmittelbar nach der Behandlung und bei der letzten Erfassung fünfeinhalb Jahre später signifikant kleiner als in der Kontrollgruppe, während die Zahnbogenbreite im Unterkiefer in allen drei Gruppen gleich war.

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Authors and Affiliations

  1. Department of Orthodontics, The Institute for Postgraduate Dental Education, Klubbhusgatan 15, SE-553 15, Jönköping, Sweden

    Krister Bjerklin

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Bjerklin, K. Follow-up control of patients with unilateral posterior cross-bite treated with expansion plates or the quad-helix appliance. J Orofac Orthop/Fortschr Kieferorthop 61, 112–124 (2000). https://doi.org/10.1007/BF01300353

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