Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial
Objectives The purpose of this “two-arm parallel” trial was to compare the orthopedic, dental, and alveolar bone plate changes of slow (SME) and rapid (RME) maxillary expansions in patients with complete bilateral cleft lip and palate (BCLP). Material and methods Forty-six patients with BCLP and max...
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| Veröffentlicht in: | Clinical oral investigations 2017-06, Vol.21 (5), p.1789-1799 |
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| creator | de Almeida, Araci Malagodi Ozawa, Terumi Okada Alves, Arthur César de Medeiros Janson, Guilherme Lauris, José Roberto Pereira Ioshida, Marilia Sayako Yatabe Garib, Daniela Gamba |
| description | Objectives
The purpose of this “two-arm parallel” trial was to compare the orthopedic, dental, and alveolar bone plate changes of slow (SME) and rapid (RME) maxillary expansions in patients with complete bilateral cleft lip and palate (BCLP).
Material and methods
Forty-six patients with BCLP and maxillary arch constriction in the late mixed dentition were randomly and equally allocated into two groups. Computer-generated randomization was used. Allocation was concealed with sequentially, numbered, sealed, opaque envelopes. The SME and RME groups comprised patients treated with quad-helix and Haas/Hyrax-type expanders, respectively. Cone-beam computed tomography (CBCT) exams were performed before expansion and 4 to 6 months post-expansion. Nasal cavity width, maxillary width, alveolar crest width, arch width, palatal cleft width, inclination of posterior teeth, alveolar crest level, and buccal and lingual bone plate thickness were assessed. Blinding was applicable for outcome assessment only. Interphase and intergroup comparisons were performed using paired
t
tests and
t
tests, respectively (
p
|
| doi_str_mv | 10.1007/s00784-016-1943-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859729513</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1859729513</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-569c04a3aecd23d693a5e43eacad775b688dcf19b8cdd24683415f0883ef8c1d3</originalsourceid><addsrcrecordid>eNp1kU1PHSEYhUnTpn71B7hpSLpxM5UXZvjort5o28SkC3VNuMA0GIaZwoy9-uvlerVpmrgBAs85wDkIHQP5DISI01IH2TYEeAOqZY18g_ahZbxhQsDbpzVtuJKwhw5KuSUEWi7Ye7RHRdcRqug-Cldx_IPvfC5LwdlMweHBbEKMJt9jv5lMKmFMOCS8DtHMPpuIbfT9jGOYsEkOT2a7_wUbvDpbXVeP5MYhPHhXuZCCrYI5BxOP0LvexOI_PM-H6Obi_Hr1vbn8-e3H6utlY5mgc9NxZUlrmPHWUea4YqbzLfPGGidEt-ZSOtuDWkvrHG25ZC10PZGS-V5acOwQnex8pzz-XnyZ9RCK9fVHyY9L0SA7JajqgFX003_o7bjkVF-nQdWwKBBOKwU7yuaxlOx7PeUw1Hw0EL3tQe960LUHve1By6r5-Oy8rAfv_ipegq8A3QGlHqVfPv9z9auujx1vkwY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1901421062</pqid></control><display><type>article</type><title>Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>de Almeida, Araci Malagodi ; Ozawa, Terumi Okada ; Alves, Arthur César de Medeiros ; Janson, Guilherme ; Lauris, José Roberto Pereira ; Ioshida, Marilia Sayako Yatabe ; Garib, Daniela Gamba</creator><creatorcontrib>de Almeida, Araci Malagodi ; Ozawa, Terumi Okada ; Alves, Arthur César de Medeiros ; Janson, Guilherme ; Lauris, José Roberto Pereira ; Ioshida, Marilia Sayako Yatabe ; Garib, Daniela Gamba</creatorcontrib><description>Objectives
The purpose of this “two-arm parallel” trial was to compare the orthopedic, dental, and alveolar bone plate changes of slow (SME) and rapid (RME) maxillary expansions in patients with complete bilateral cleft lip and palate (BCLP).
Material and methods
Forty-six patients with BCLP and maxillary arch constriction in the late mixed dentition were randomly and equally allocated into two groups. Computer-generated randomization was used. Allocation was concealed with sequentially, numbered, sealed, opaque envelopes. The SME and RME groups comprised patients treated with quad-helix and Haas/Hyrax-type expanders, respectively. Cone-beam computed tomography (CBCT) exams were performed before expansion and 4 to 6 months post-expansion. Nasal cavity width, maxillary width, alveolar crest width, arch width, palatal cleft width, inclination of posterior teeth, alveolar crest level, and buccal and lingual bone plate thickness were assessed. Blinding was applicable for outcome assessment only. Interphase and intergroup comparisons were performed using paired
t
tests and
t
tests, respectively (
p
< 0.05).
Results
SME and RME similarly promoted significant increase in all the maxillary transverse dimensions at molar and premolar regions with a decreasing expanding effect from the dental arch to the nasal cavity. Palatal cleft width had a significant increase in both groups. Significant buccal inclination of posterior teeth was only observed for RME. Additionally, both expansion procedures promoted a slight reduction of the alveolar crest level and the buccal bone plate thickness.
Conclusions
No difference was found between the orthopedic, dental, and alveolar bone plate changes of SME and RME in children with BCLP. Both appliances produced significant skeletal transverse gains with negligible periodontal bone changes. Treatment time for SME, however, was longer than the observed for RME.
Clinical relevance
SME and RME can be similarly indicated to correct maxillary arch constriction in patients with BCLP in the mixed dentition.</description><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-016-1943-8</identifier><identifier>PMID: 27550292</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Alveolar bone ; Child ; Children ; Cleft Lip - diagnostic imaging ; Cleft Lip - therapy ; Cleft lip/palate ; Cleft Palate - diagnostic imaging ; Cleft Palate - therapy ; Clinical trials ; Computed tomography ; Cone-Beam Computed Tomography ; Dentistry ; Dentition ; Envelopes ; Female ; Humans ; Male ; Maxilla ; Medicine ; Nose ; Original Article ; Palatal Expansion Technique - instrumentation ; Periodontics ; Teeth ; Treatment Outcome</subject><ispartof>Clinical oral investigations, 2017-06, Vol.21 (5), p.1789-1799</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>Clinical Oral Investigations is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-569c04a3aecd23d693a5e43eacad775b688dcf19b8cdd24683415f0883ef8c1d3</citedby><cites>FETCH-LOGICAL-c372t-569c04a3aecd23d693a5e43eacad775b688dcf19b8cdd24683415f0883ef8c1d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00784-016-1943-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-016-1943-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27550292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Almeida, Araci Malagodi</creatorcontrib><creatorcontrib>Ozawa, Terumi Okada</creatorcontrib><creatorcontrib>Alves, Arthur César de Medeiros</creatorcontrib><creatorcontrib>Janson, Guilherme</creatorcontrib><creatorcontrib>Lauris, José Roberto Pereira</creatorcontrib><creatorcontrib>Ioshida, Marilia Sayako Yatabe</creatorcontrib><creatorcontrib>Garib, Daniela Gamba</creatorcontrib><title>Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objectives
The purpose of this “two-arm parallel” trial was to compare the orthopedic, dental, and alveolar bone plate changes of slow (SME) and rapid (RME) maxillary expansions in patients with complete bilateral cleft lip and palate (BCLP).
Material and methods
Forty-six patients with BCLP and maxillary arch constriction in the late mixed dentition were randomly and equally allocated into two groups. Computer-generated randomization was used. Allocation was concealed with sequentially, numbered, sealed, opaque envelopes. The SME and RME groups comprised patients treated with quad-helix and Haas/Hyrax-type expanders, respectively. Cone-beam computed tomography (CBCT) exams were performed before expansion and 4 to 6 months post-expansion. Nasal cavity width, maxillary width, alveolar crest width, arch width, palatal cleft width, inclination of posterior teeth, alveolar crest level, and buccal and lingual bone plate thickness were assessed. Blinding was applicable for outcome assessment only. Interphase and intergroup comparisons were performed using paired
t
tests and
t
tests, respectively (
p
< 0.05).
Results
SME and RME similarly promoted significant increase in all the maxillary transverse dimensions at molar and premolar regions with a decreasing expanding effect from the dental arch to the nasal cavity. Palatal cleft width had a significant increase in both groups. Significant buccal inclination of posterior teeth was only observed for RME. Additionally, both expansion procedures promoted a slight reduction of the alveolar crest level and the buccal bone plate thickness.
Conclusions
No difference was found between the orthopedic, dental, and alveolar bone plate changes of SME and RME in children with BCLP. Both appliances produced significant skeletal transverse gains with negligible periodontal bone changes. Treatment time for SME, however, was longer than the observed for RME.
Clinical relevance
SME and RME can be similarly indicated to correct maxillary arch constriction in patients with BCLP in the mixed dentition.</description><subject>Alveolar bone</subject><subject>Child</subject><subject>Children</subject><subject>Cleft Lip - diagnostic imaging</subject><subject>Cleft Lip - therapy</subject><subject>Cleft lip/palate</subject><subject>Cleft Palate - diagnostic imaging</subject><subject>Cleft Palate - therapy</subject><subject>Clinical trials</subject><subject>Computed tomography</subject><subject>Cone-Beam Computed Tomography</subject><subject>Dentistry</subject><subject>Dentition</subject><subject>Envelopes</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Maxilla</subject><subject>Medicine</subject><subject>Nose</subject><subject>Original Article</subject><subject>Palatal Expansion Technique - instrumentation</subject><subject>Periodontics</subject><subject>Teeth</subject><subject>Treatment Outcome</subject><issn>1432-6981</issn><issn>1436-3771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1PHSEYhUnTpn71B7hpSLpxM5UXZvjort5o28SkC3VNuMA0GIaZwoy9-uvlerVpmrgBAs85wDkIHQP5DISI01IH2TYEeAOqZY18g_ahZbxhQsDbpzVtuJKwhw5KuSUEWi7Ye7RHRdcRqug-Cldx_IPvfC5LwdlMweHBbEKMJt9jv5lMKmFMOCS8DtHMPpuIbfT9jGOYsEkOT2a7_wUbvDpbXVeP5MYhPHhXuZCCrYI5BxOP0LvexOI_PM-H6Obi_Hr1vbn8-e3H6utlY5mgc9NxZUlrmPHWUea4YqbzLfPGGidEt-ZSOtuDWkvrHG25ZC10PZGS-V5acOwQnex8pzz-XnyZ9RCK9fVHyY9L0SA7JajqgFX003_o7bjkVF-nQdWwKBBOKwU7yuaxlOx7PeUw1Hw0EL3tQe960LUHve1By6r5-Oy8rAfv_ipegq8A3QGlHqVfPv9z9auujx1vkwY</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>de Almeida, Araci Malagodi</creator><creator>Ozawa, Terumi Okada</creator><creator>Alves, Arthur César de Medeiros</creator><creator>Janson, Guilherme</creator><creator>Lauris, José Roberto Pereira</creator><creator>Ioshida, Marilia Sayako Yatabe</creator><creator>Garib, Daniela Gamba</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial</title><author>de Almeida, Araci Malagodi ; Ozawa, Terumi Okada ; Alves, Arthur César de Medeiros ; Janson, Guilherme ; Lauris, José Roberto Pereira ; Ioshida, Marilia Sayako Yatabe ; Garib, Daniela Gamba</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-569c04a3aecd23d693a5e43eacad775b688dcf19b8cdd24683415f0883ef8c1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Alveolar bone</topic><topic>Child</topic><topic>Children</topic><topic>Cleft Lip - diagnostic imaging</topic><topic>Cleft Lip - therapy</topic><topic>Cleft lip/palate</topic><topic>Cleft Palate - diagnostic imaging</topic><topic>Cleft Palate - therapy</topic><topic>Clinical trials</topic><topic>Computed tomography</topic><topic>Cone-Beam Computed Tomography</topic><topic>Dentistry</topic><topic>Dentition</topic><topic>Envelopes</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Maxilla</topic><topic>Medicine</topic><topic>Nose</topic><topic>Original Article</topic><topic>Palatal Expansion Technique - instrumentation</topic><topic>Periodontics</topic><topic>Teeth</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Almeida, Araci Malagodi</creatorcontrib><creatorcontrib>Ozawa, Terumi Okada</creatorcontrib><creatorcontrib>Alves, Arthur César de Medeiros</creatorcontrib><creatorcontrib>Janson, Guilherme</creatorcontrib><creatorcontrib>Lauris, José Roberto Pereira</creatorcontrib><creatorcontrib>Ioshida, Marilia Sayako Yatabe</creatorcontrib><creatorcontrib>Garib, Daniela Gamba</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical oral investigations</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Almeida, Araci Malagodi</au><au>Ozawa, Terumi Okada</au><au>Alves, Arthur César de Medeiros</au><au>Janson, Guilherme</au><au>Lauris, José Roberto Pereira</au><au>Ioshida, Marilia Sayako Yatabe</au><au>Garib, Daniela Gamba</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>21</volume><issue>5</issue><spage>1789</spage><epage>1799</epage><pages>1789-1799</pages><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objectives
The purpose of this “two-arm parallel” trial was to compare the orthopedic, dental, and alveolar bone plate changes of slow (SME) and rapid (RME) maxillary expansions in patients with complete bilateral cleft lip and palate (BCLP).
Material and methods
Forty-six patients with BCLP and maxillary arch constriction in the late mixed dentition were randomly and equally allocated into two groups. Computer-generated randomization was used. Allocation was concealed with sequentially, numbered, sealed, opaque envelopes. The SME and RME groups comprised patients treated with quad-helix and Haas/Hyrax-type expanders, respectively. Cone-beam computed tomography (CBCT) exams were performed before expansion and 4 to 6 months post-expansion. Nasal cavity width, maxillary width, alveolar crest width, arch width, palatal cleft width, inclination of posterior teeth, alveolar crest level, and buccal and lingual bone plate thickness were assessed. Blinding was applicable for outcome assessment only. Interphase and intergroup comparisons were performed using paired
t
tests and
t
tests, respectively (
p
< 0.05).
Results
SME and RME similarly promoted significant increase in all the maxillary transverse dimensions at molar and premolar regions with a decreasing expanding effect from the dental arch to the nasal cavity. Palatal cleft width had a significant increase in both groups. Significant buccal inclination of posterior teeth was only observed for RME. Additionally, both expansion procedures promoted a slight reduction of the alveolar crest level and the buccal bone plate thickness.
Conclusions
No difference was found between the orthopedic, dental, and alveolar bone plate changes of SME and RME in children with BCLP. Both appliances produced significant skeletal transverse gains with negligible periodontal bone changes. Treatment time for SME, however, was longer than the observed for RME.
Clinical relevance
SME and RME can be similarly indicated to correct maxillary arch constriction in patients with BCLP in the mixed dentition.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27550292</pmid><doi>10.1007/s00784-016-1943-8</doi><tpages>11</tpages></addata></record> |
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| ispartof | Clinical oral investigations, 2017-06, Vol.21 (5), p.1789-1799 |
| issn | 1432-6981 1436-3771 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Alveolar bone Child Children Cleft Lip - diagnostic imaging Cleft Lip - therapy Cleft lip/palate Cleft Palate - diagnostic imaging Cleft Palate - therapy Clinical trials Computed tomography Cone-Beam Computed Tomography Dentistry Dentition Envelopes Female Humans Male Maxilla Medicine Nose Original Article Palatal Expansion Technique - instrumentation Periodontics Teeth Treatment Outcome |
| title | Slow versus rapid maxillary expansion in bilateral cleft lip and palate: a CBCT randomized clinical trial |
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