Short-term assessment of pain and discomfort during rapid maxillary expansion with tooth-bone-borne and tooth-borne appliances: randomized clinical trial.

OBJECTIVE: The aim of this randomized clinical trial was to evaluate and compare, during the first week of rapid maxillary expansion (RME), the impact caused by two types of appliances: Hyrax and Hybrid Hyrax. METHODS: Forty-two patients who met the eligibility criteria (aged 11-14 years, with transverse maxillary deficiency, posterior crossbite, and presence of maxillary first premolars and first permanent molars) were selected and randomly divided into two groups: TBB GROUP (tooth-bone-borne expander), treated with Hybrid Hyrax (12 females and 9 males, mean age 13.3 ± 1.3 years), and TB GROUP (tooth-borne expander), treated with Hyrax (5 females and 16 males, mean age 13.3 ± 1.4 years). Pain and discomfort were assessed in two times: after the first day of activation (T1) and four days after, by means of the numerical rate scale and the instrument MFIQ (Mandibular Functional Impairment Questionnaire). Descriptive statistics and the Mann-Whitney test were used for comparison between groups and between sexes. A 5% significance level was adopted. RESULTS: Both appliances had a negative impact, generating pain and discomfort, and reducing functional capacity. However, the scores obtained were of low intensity and no significant differences were observed between the groups. Considering sexes, there were statistically significant differences, with the female sex presenting higher scores for pain and functional limitation. CONCLUSIONS: Despite causing impact in pain and increase in the functional limitation, these changes were of low intensity, with no statistical difference between the groups. Females were more sensitive to the impact caused by the RME.

Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth-borne and tooth-bone-borne expanders: A randomized clinical trial.

OBJECTIVES: To compare, using cone-beam computed tomography, the dentoskeletal changes in rapid maxillary expansion with tooth-bone-borne (Hybrid Hyrax) and tooth-borne (Hyrax) appliances. SETTING AND SAMPLE POPULATION: Forty-two patients who met the eligibility criteria (aged 11-14 years; transverse maxillary deficiency, posterior crossbite, and presence of upper first premolars and molars) were screened and allocated into two groups: HHG (treatment with Hybrid Hyrax) and HG (treatment with Hyrax). MAIN OUTCOME MEASURES: The primary outcomes included nasomaxillary dimensional changes. CBCT was performed before and 3 months after the activation phase. Measurements were performed using Dolphin® . Baseline data were compared using one-way ANOVA. For intergroup comparison, ANCOVA was used to analyze the initial age, appliance activations (mm), and mid-palatal suture maturation data as covariates. Statistical significance was set at 5%. RESULTS: The premolar region in HHG showed increased skeletal changes than in HG, with the difference being 1.5 mm (0.5; 2.6) in the nasal cavity (P = .004), 1.4 mm (0.3; 2.5) in the nasal floor (P = .019), and 1.1 mm (0.2; 2.1) in the maxilla (P = .022). The molar region in HHG showed increased skeletal changes with the difference being 0.9 mm (0.2; 1.5) in the nasal cavity (P = .005), and 0.9 mm (0; 1.8) in the maxilla (P = .042) than in HG. Premolar inclination was higher in HG. CONCLUSION: Hybrid Hyrax showed more skeletal changes and fewer dental side effects, especially in the first premolar region. The amount of activation influenced the higher nasal skeletal changes in the Hybrid hyrax group.

The chromosomes of Afrotheria and their bearing on mammalian genome evolution.

Afrotheria is the clade of placental mammals that, together with Xenarthra, Euarchontoglires and Laurasiatheria, represents 1 of the 4 main recognized supraordinal eutherian clades. It reunites 6 orders of African origin: Proboscidea, Sirenia, Hyracoidea, Macroscelidea, Afrosoricida and Tubulidentata. The apparently unlikely relationship among such disparate morphological taxa and their possible basal position at the base of the eutherian phylogenetic tree led to a great deal of attention and research on the group. The use of biomolecular data was pivotal in Afrotheria studies, as they were the basis for the recognition of this clade. Although morphological evidence is still scarce, a plethora of molecular data firmly attests to the phylogenetic relationship among these mammals of African origin. Modern cytogenetic techniques also gave a significant contribution to the study of Afrotheria, revealing chromosome signatures for the group as a whole, as well as for some of its internal relationships. The associations of human chromosomes HSA1/19 and 5/21 were found to be chromosome signatures for the group and provided further support for Afrotheria. Additional chromosome synapomorphies were also identified linking elephants and manatees in Tethytheria (the associations HSA2/3, 3/13, 8/22, 18/19 and the lack of HSA4/8) and elephant shrews with the aardvark (HSA2/8, 3/20 and 10/17). Herein, we review the current knowledge on Afrotheria chromosomes and genome evolution. The already available data on the group suggests that further work on this apparently bizarre assemblage of mammals will provide important data to a better understanding on mammalian genome evolution.