Alveolar defects before and after surgically assisted rapid palatal expansion (SARPE): a CBCT assessment.

INTRODUCTION: Surgically Assisted Rapid Palatal Expansion (SARPE) promote maxillary expansion in skeletally mature patients. This technique is effective; however, some side effects are still unknown. OBJECTIVES: evaluate the presence of alveolar defects (dehiscences and fenestrations) in patients submitted to the SARPE. The null hypothesis tested was: SARPE does not influence the number of dehiscences and fenestrationss. METHODS: A retrospective quasi-experiment study of a convenience sample of 279 maxillary teeth, in 29 patients evaluated with Cone Beam Computed Tomography (CBCT) at T1 (before SARPE), T2 (after expansion) and T3 (after retention), was performed. The examined teeth were: canines, first and second premolars, first and second molars. in axial, coronal, and cross-sectional views. The evaluations involved viewing slices from mesial to distal of the buccal roots. RESULTS: All statistical analyses were performed using SAS 9.3 and SUDAAN softwares. Alpha used in the study was 0.05. Alveolar defects increased statistically from T1 (69.0%) to T2 (96.5%) and T3 (100%). Dehiscences increased 195% (Relative Risk 2.95) at the end of expansion (T2). After retention (T3), individuals were on average 4.34 times more likely to develop dehiscences (334% increase). Fenestrations did not increase from T1 to T2 (p = 0.0162, 7.9%) and decreased from T2 to T3 (p = 0.0259, 4.3%). Presence of fenestrations at T1 was a significant predictor for the development of dehiscences in T2 and T3. Dehiscences increased significantly in all teeth, except second molars. CONCLUSION: The null hypothesis was rejected. After SARPE the number of dehiscences increased and fenestrations decreased. Previous alveolar defects were predictor for dehiscences after SARPE.

Alveolar defects before and after surgically assisted rapid palatal expansion (SARPE): a CBCT assessment

ABSTRACT Introduction: Surgically Assisted Rapid Palatal Expansion (SARPE) promote maxillary expansion in skeletally mature patients. This technique is effective; however, some side effects are still unknown. Objectives: evaluate the presence of alveolar defects (dehiscences and fenestrations) in patients submitted to the SARPE. The null hypothesis tested was: SARPE does not influence the number of dehiscences and fenestrationss. Methods: A retrospective quasi-experiment study of a convenience sample of 279 maxillary teeth, in 29 patients evaluated with Cone Beam Computed Tomography (CBCT) at T1 (before SARPE), T2 (after expansion) and T3 (after retention), was performed. The examined teeth were: canines, first and second premolars, first and second molars. in axial, coronal, and cross-sectional views. The evaluations involved viewing slices from mesial to distal of the buccal roots. Results: All statistical analyses were performed using SAS 9.3 and SUDAAN softwares. Alpha used in the study was 0.05. Alveolar defects increased statistically from T1 (69.0%) to T2 (96.5%) and T3 (100%). Dehiscences increased 195% (Relative Risk 2.95) at the end of expansion (T2). After retention (T3), individuals were on average 4.34 times more likely to develop dehiscences (334% increase). Fenestrations did not increase from T1 to T2 (p = 0.0162, 7.9%) and decreased from T2 to T3 (p = 0.0259, 4.3%). Presence of fenestrations at T1 was a significant predictor for the development of dehiscences in T2 and T3. Dehiscences increased significantly in all teeth, except second molars. Conclusion: The null hypothesis was rejected. After SARPE the number of dehiscences increased and fenestrations decreased. Previous alveolar defects were predictor for dehiscences after SARPE.

RESUMO Introdução: A expansão rápida da maxila assistida cirurgicamente (ERMAC) promove expansão em pacientes esqueleticamente maduros. Essa técnica é efetiva; entretanto, alguns efeitos colaterais ainda são desconhecidos. Objetivos: Avaliar a presença de defeitos alveolares (deiscência e fenestração) em pacientes submetidos à ERMAC. A hipótese nula testada foi que a ERMAC não influenciaria o número de deiscências e fenestrações. Métodos: Foi realizado um estudo quase-experimental de uma amostra de conveniência de 279 dentes superiores, de 29 pacientes que foram avaliados por meio de tomografia computadorizada de feixe cônico (TCFC) em T1 (antes da ERMAC), T2 (após expansão) e T3 (após contenção). Caninos, primeiros e segundos pré-molares, primeiros e segundos molares foram examinados em cortes axiais, coronais e sagitais. As raízes vestibulares desses dentes foram avaliadas da face mesial até a distal. Resultados: Todas as análises estatísticas foram realizadas usando os softwares SAS 9.3 e SUDAAN. O alfa usado no estudo foi de 0,05. Os defeitos alveolares aumentaram significativamente de T1 (69,0%) para T2 (96,5%) e T3 (100%). Deiscências aumentaram 195% (risco relativo de 2,95%) no final da expansão (T2). Após contenção (T3), os pacientes tiveram, em média, 4,34 vezes mais chance de desenvolver deiscência (334% de aumento). As fenestrações não aumentaram de T1 para T2 (p= 0.0162, 7.9%) e diminuíram de T2 para T3 (p = 0.0259, 4,3%). A presença de fenestrações em T1 foi um preditor significativo para o desenvolvimento de deiscências em T2 e T3. Deiscências aumentaram significativamente em todos os dentes, exceto nos segundos molares. Conclusão: A hipótese nula foi rejeitada. Após a ERMAC, o número de deiscências aumentou e o de fenestrações diminuiu. Defeitos alveolares prévios foram preditores de deiscências após a ERMAC.

Cirurgia pré-protética para aumento do sulco mandibular / The depth of the mandibular anterior sulcus after vestibuloplasty

Os autores estudaram 13 pacientes, que receberam aprofundamento de sulco vestibular mandibular anterior pela técnica de inversão de retalhos. A profundidade do sulco obtido foi avaliada clínica e radiograficamente. Os resultados permitem concluir que a técnica é estável, não apresentando perda estatisticamente significativa no período analisado. A média de aprofundamento obtido variou de 87 a 169 por cento dependendo da região considerada.