[Using the clear aligner system in children with an autism spectrum disorder]. / Toepassen van het clear- alignersysteem bij kinderen met een autismespectrumstoornis.

Oral care for children with autism spectrum disorder requires a distinctive approach often involving a lot of effort, energy, and time. It puts the perseverance of parents and carers severely to the test. This is very recognisable to the orthodontics department of the Erasmus Medical Center. Negative experiences with conventional orthodontic appliances in this group of patients were the reason to start using the clear aligner system in January 2018. This article deals extensively with the treatment process, the advantages of the clear aligner system, and the need for an adapted, autism-friendly management style in orthodontic care for children with autism.

Follow up of surgically-assisted rapid maxillary expansion after 6.5 years: skeletal and dental effects.

Surgically-assisted rapid maxillary expansion (SARME) is a technique used to widen the maxilla, and we present the results of our long-term follow up (6.5 years). Seventeen patients who had been treated with SARME and prospectively followed were invited for long-term follow up using dental casts and posteroanterior cephalograms. The following measurements were made on the dental casts: transverse distances at canine, premolar, and molar level, length of the arch, and width and depth of the palate at premolar and molar level. The distance between the left and right nasal bases and the widening of the inferior maxilla were measured on the posteroanterior cephalograms. Boneborne and toothborne distractors were used in 8 and 9 patients, respectively. In the study of dental casts, there was a significant increase in transverse width in the canine (P<0.001), premolar (P<0.001) and molar (P=0,001) and these remained stable in the long term. The arch length did not increase significantly, but the palatal width increased significantly in the premolar (P<0.001) and molar (P=0.001) regions. No effect was seen in palatal depth. On the posteroanterior cephalograms the width of the inferior part of the maxilla was increased, but not significantly so. There were no significant changes at the nasal base. We conclude that SARME is a predictable technique to widen the maxilla in the long term.