Changes in nasopharyngeal airway following orthopedic and surgically assisted rapid maxillary expansion.

INTRODUCTION: The aim of this study was to compare changes in soft-palate morphology and nasopharyngeal relations after orthopedic rapid maxillary expansion (RME) and surgically assisted RME (SARME). METHODS: A group of 10 patients received RME, a second group of 10 patients received SARME, and a third group of 10 patients served as an untreated control group. Lateral and posteroanterior cephalograms were obtained for each individual at preexpansion/precontrol and postexpansion/postcontrol. In addition to descriptive parameters, the angulation, length, and thickness of the soft palate and superior and inferior pharyngeal spaces and the ratios of the length of the soft palate to the length of the superior and inferior pharyngeal spaces were evaluated. Paired t-tests were performed to analyze changes within groups, and analysis of variance and Duncan tests were used to compare changes among groups. RESULTS: No statistically significant differences were found in changes in measurements related to soft-palate morphology or nasopharyngeal dimensions among the SARME, RME, and control groups; however, increases in soft-palate angulation and superior and inferior pharyngeal spaces after expansion/control were greater in the SARME group than in other groups. CONCLUSIONS: No statistically significant differences were found between changes in the nasopharyngeal airway after RME and SARME.

Stability of maxillary expansion and tongue posture.

OBJECTIVE: To evaluate the adaptive changes and the stability in tongue posture following rapid maxillary expansion (RME) in patients without any signs or symptoms of respiratory disturbances. MATERIALS AND METHODS: Growing subjects with maxillary constrictions and bilateral buccal crossbites were included in the treatment group (n = 20). A control group (n = 20) comprised subjects with normal dentoskeletal features. RME appliances were used in the treatment group, with an average active expansion of 15 +/- 2 days. Cephalometric radiographs were traced and digitized to evaluate static tongue posture before RME and 6.75 +/- 0.48 months after RME. Follow-up radiographic evaluations of 17 expansion cases were also performed after an average of 29.25 +/- 1.85 months. Independent and paired t-tests were conducted to evaluate changes in tongue posture within and between groups. RESULTS: Results revealed significant reductions of tongue-to-palate (P < .05) as well as hyoid bone-to-mandibular plane (P < .01) distances following RME. The new tongue posture was found to be stable during the follow-up period. CONCLUSIONS: A higher tongue posture can be obtained with RME in children with no reported respiratory disturbances.

Facial soft tissue profile following bimaxillary orthognathic surgery.

OBJECTIVE: To determine the changes in the position and area of nasal and labial soft tissues in adult skeletal Class III patients who underwent bimaxillary orthognathic surgery. MATERIALS AND METHODS: Pretreatment (T1), preoperative (T2), and posttreatment (T3) cephalometric variables and upper-lower lip areas were measured on lateral cephalometric radiographs for 20 individuals (9 male, 11 female; mean age 21.3 years at T1, 22.4 years at T2, and 23.4 years at T3) who had maxillary advancement and mandibular setback. Analysis of variance (ANOVA) and Duncan tests were used to compare the cephalometric and area measurements at the beginning of treatment, and at presurgery and postsurgery, respectively. Paired t-tests were also performed to analyze changes within the periods. RESULTS: The tip of the nose was affected less with the movement of the underlying skeletal structure (0.25%), while the soft tissue B point (B') moved equally with the skeletal B point. As the maxilla related variables increased due to the forward movement, the upper labial areas decreased. With the backward movement of the mandible, the middle and inferior lower labial areas increased, while the superior lower labial area decreased. CONCLUSIONS: The results of our study suggest that the dramatic improvement in the facial profiles of the bimaxillary surgery patients is primarily related to the backward movement of the mandible and the significant reduction in the superior lower lip area.

Skeletal Class II treatment with Twin Force Bite Corrector: case reports.

AIM: To analyze the effectiveness of the Twin Force Bite Corrector in 2 patients requiring anterior advancement of the mandible. METHODS: To correct the imbalanced maxillomandibular relationship, a Twin Force Bite Corrector was inserted in 2 female adolescents (case 1: 12 years 3 months of age; case 2: 12 years 7 months of age) presenting with a skeletal Class II malocclusion. The pretreatment, posttreatment, and follow-up dental and skeletal parameters were evaluated on lateral cephalometric radiographs. Twenty-two reference points were marked and 23 variables measured for each set of lateral cephalograms. RESULTS: The Twin Force Bite Corrector therapy lasted for 3 months in both patients. The total orthodontic treatment duration was 1 year 4 months for case 1 and 1 year 6 months for case 2. In both patients, the overjet reduced, the mandibles advanced, and a Class I molar relationship was achieved. Effective mandibular length (Co-Gn) increased significantly, while the mandibular incisors almost kept their initial positions without a significant change in inclination (L1/ML). The clinical profiles of both girls remarkably improved. CONCLUSIONS: The Twin Force Bite Corrector was effective in the correction of skeletal Class II malocclusion with retrognathic mandible, with negligible anchorage loss in the mandibular arch.

Oculofaciocardiodental syndrome and orthodontics.

Radiculomegaly of a tooth is a rare condition. When it is associated with other dental abnormalities and congenital cataracts, the condition is called oculofaciocardiodental syndrome, which is characterized by congenital cataracts, dental anomalies, many minor facial dysmorphic features, and congenital heart defects. So far, only 20 cases have been reported. In this article, the case of a 14-year-old girl with congenital cataracts, radiculomegaly of the maxillary central incisors and the maxillary and mandibular canines, dilacerations of the mandibular incisors, and open apexes of many teeth is presented. Orthodontic alignment of the dental arches was completed with light forces so as not to cause shortening of the roots or ankylosis.

Prevalence and distribution of dental anomalies in orthodontic patients.

INTRODUCTION: The purpose of this study was to determine the prevalence of developmental dental anomalies in the Turkish population. METHODS: The study was based on the dental casts, intraoral photographs, and panoramic radiographs of 3043 Turkish children (1658 girls, 1385 boys) who had orthodontic treatment at the Department of Orthodontics at the University of Ankara between 1978 and 2003. These patients were examined for 8 developmental dental anomalies: fusion, gemination, microdontia, macrodontia, oligodontia, hypodontia, hyperdontia, and amelogenesis imperfecta. The percentages of these anomalies were assessed in the whole group, and the sexes were compared. RESULTS: It was found that 5.46% of the total group had at least 1 developmental dental anomaly. The distribution by sex was 70 boys (5.05%) and 96 girls (5.79%). CONCLUSIONS: Hypodontia is the most common developmental dental anomaly in the Turkish population, followed by microdontia.

Stability of surgically assisted rapid maxillary expansion and orthopedic maxillary expansion after 3 years' follow-up.

OBJECTIVE: To evaluate the stability of surgically assisted rapid palatal expansion (SARME) and orthopedic maxillary expansion (OME) after 3 years of follow-up, and compare these changes with a control group. MATERIALS AND METHODS: The subjects of the study were divided into three groups. Group 1 was composed of 10 patients (6 males, 4 females) with a mean age of 15.51 years (range: 13.33-17.58 years) and treated with OME, Group 2 comprised 10 patients (7 males, 3 females) with a mean age of 19.01 years (range: 16.25-25.58 years) and treated with SARME. Group 3 was the control group, consisting of 10 untreated, skeletal Class 1 subjects (6 males, 4 females) with a mean age of 15.27 years (range: 13.42-17.00 years) and matched to the OME group for sex and age. Lateral cephalometric and posteroantererior films were taken before expansion (T1), postexpansion (T2), and 3 years after the retention period (T3). RESULTS: After OME and SARME, significant increases were observed for both dental and skeletal transverse widths (P < .01). After 3 years of follow-up, maxillary basal width decreased 1.35 +/- 0.44 mm in the SARME group and 1.19 +/- 0.41 mm in the OME group, while upper molar width decreased 2.23 +/- 1.24 mm in the SARME group and 2.79 +/- 1.01 mm in the OME group. CONCLUSIONS: Both the OME and SARME procedures remained stable after 3 years of follow-up with some amount of postretention relapse, compared with the control group.

Three-dimensional bimetric maxillary distalization arches compared with a modified Begg intraoral distalization system.

The purpose of this study was to compare the dentofacial effects of two intraoral molar distalization techniques [three-dimensional bimetric maxillary distalization arches (3D-BMDA) and a modified Begg intraoral distalization system (MBIDS)] in subjects requiring maxillary molar distalization. Twenty-one patients (12 females and 9 males, mean age pre-treatment: 14.7 +/- 1.50 years) were treated with the 3D-BMDA and 17 (14 females and 3 males, mean age pre-treatment: 14.4 +/- 1.43 years) with the MBIDS. Measurements were recorded from lateral cephalometric radiographs taken at two different points in time: at the start of treatment for the MBIDS group and prior to distalization for the 3D-BMDA group (T1) and post-distalization (T2). Student's t- and paired t-tests were used to determine differences between and within the groups. The total amount of distalization for the 3D-BMDA and MBIDS groups was similar (3.55 and 3.27 mm, respectively). However, there were statistically significant differences in the length of the distalization period (3.4 and 6.5 months, respectively) and the amount monthly of distalization (1.11 and 0.54 mm, respectively). The most significant differences were observed in the mandibular dental arches and vertical facial dimensions. Anchorage loss in the mandible was greater in the 3D-BMDA group, whereas increases in facial dimensions were greater in the MBIDS group. Both 3D-BMDA and MBIDS techniques were found to be effective to obtain distal movement of the maxillary molars. In order to achieve successful results, the side-effects of each treatment modality on dentofacial structures need to be taken into consideration.