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Cross, David Logan. "Transverse dimensional changes following rapid maxillary expansion." Thesis, University of Edinburgh, 1998. http://hdl.handle.net/1842/27841.
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The purpose of this study was to determine the effects of RME on skeletal, dental and nasal structures in a transverse plane and to relate these changes to nasal cavity function as determined by nasal airway resistance measurements. Twenty-five subjects exhibiting transverse maxillary dental deficiency were compared with 25 age and sex match controls. A number of skeletal, dental and nasal transverse widths and area measurements were selected and subjected to method error analysis. A nasal template was developed that allowed measurement of linear transverse widths and areas within the nasal cavity at different levels. As a result, six skeletal, five dental and seven nasal transverse widths and two nasal cavity area variables were measured and compared between the control group and the anomaly group before and after expansion with RME. Results indicate that there was little difference between the anomaly and control groups before treatment with the exception of maxillary skeletal and dental narrowness. Expansion using RME resulted in increased upper molar width, maxillary width, nasal cavity width and separation of the anterior nasal spine; however all patients did not respond uniformly. Whereas some patients demonstrated large increases in maxillary width, others experienced only moderate or little change. These differences may be related to the degree of ossification of the median palatine suture and to other aspects of maxillofacial maturity. Intranasal changes as a result of RME were restricted generally to the lower half of the nasal cavity and were highly variable, as were changes in nasal airway resistance. Twelve patients experienced improvements in either anterior NAR, posterior NAR or both. Five patients had little or no change in either resistance and only two patients experienced increases in both anterior and posterior NAR. Maxillary dental transverse deficiency was successfully treated in all cases at the end of the retention period.
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Payne, Jacqueline, Audrey Yoon, Heeyeon Suh, Joorok Park, and Heesoo Oh. "Complications Reported in Maxillary Skeletal Expansion." Scholarly Commons, 2021. https://scholarlycommons.pacific.edu/dugoni_etd/18.
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Introduction: The aim of this study was to determine the types and prevalence of complications following MARPE protocol at University of the Pacific and to investigate the complication of asymmetry using CBCT analysis. Methods: In the first portion of this study, 97 patients who started treatment prior to July 2020 and who had MARPE expander treatment at the University of the Pacific were included. Chart review and evaluation of progress clinical photographs were used to report the following complications: inflammation, pain, appliance malfunction, broken microscrew, and pulpitis. In the second portion of this study, 77 patients from a private practice orthodontist who started treatment prior to January 2021 were included in this study. The complication of asymmetry was measured using CBCT measurements from T1 (prior to treatment start) and T2 (immediately following MARPE expansion). The change in U6 molar angulation changes was also assessed. Results: It was determined in the first portion of this study that the most common complication was inflammation around the MARPE site, with 82% of the study population exhibiting any severity of inflammation. 3 patients exhibited severe inflammation requiring removal of MARPE. 18% reported pain in the MARPE area. 9 patients exhibited appliance malfunction, 1 patient exhibited broken microscrew, and 1 patient exhibited pulpitis. It was determined in the second portion of this study that 47% of patients exhibited asymmetry greater than 1 mm and the average asymmetry at ANS was 1.47 mm. No correlation was exhibited between amount of asymmetric expansion and the following measures: age, molar inclination, palatal thickness, posterior screw expansion and palatal vault height. 3 Conclusions: Inflammation of the MARPE is the most common complication that can result in early removal of the expander. Other complications such as asymmetry and pain are common as well.
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Koudstaal, Maarten Jan. "Surgically asisted rapid maxillary expansion; surgical and orthodontic aspects." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2008. http://hdl.handle.net/1765/12608.
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Christensen, Samuel James. "Adolescent skeletal and dental changes with rapid maxillary expansion." Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6075.
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Introduction
A constricted maxilla can be associated with a unilateral or bilateral posterior cross bite, CR-CO shift, maxillary or mandibular growth asymmetry, and dental crowding. Correction of adolescent maxillary constriction typically includes rapid maxillary expansion (RME). However, maxillary skeletal expansion becomes more difficult with age due to increasing facial, and mid-palatal, skeletal resistance. The purpose of this study is to evaluate the age and maturation at which a successful split of the maxillary midpalatal suture (MPS) can be achieved. A secondary aim is to assess the dental arch changes that are associated with a MPS split or no split.
Material and Methods
In this retrospective study, 39 (13 M, 26 F) consecutively treated subjects exhibiting maxillary skeletal constriction underwent orthodontic treatment with RME to alleviate unilateral or bilateral posterior cross bites. Subjects were divided into pre-pubertal and post-pubertal groups based on maturation. Evidence of a MPS split was confirmed by development of a diastema between upper central incisors and using a maxillary occlusal radiograph. Measurements were made on initial and post-expansion maxillary models to assess dental changes.
Results
Average age of pre-pubertal and post-pubertal subjects was 11.9± 1.1 years (n=13) and 14.6 ± 1.4 years (n=26) respectively. A MPS split occurred for 100% of pre-pubertal group compared with 65% of the post-pubertal group (p < 0.05). No significant differences were seen in dental movements between the pre-pubertal and post-pubertal groups while significant differences were seen for arch perimeter, crowding, intercanine width, and intermolar width in the split and no-split groups. There was a significantly strong negative correlation between age and percent ability to get a MPS split.
Conclusions
These results demonstrate that MPS separation is more likely to occur pre-pubertally than post-pubertally but that MPS separation after puberty is still possible. This finding supports the importance of appropriate timing in the use of rapid maxillary expanders.
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Aynaciyan, Raffi J. "Rapid maxillary expansion long-term hard tissue profile and dental arch width changes /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0025/MQ30661.pdf.
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Ciambotti, Christopher. "A comparison of dental and skeletal changes between rapid palatal expansion and nickel titanium palatal expansion." Morgantown, W. Va. : [West Virginia University Libraries], 1999. http://etd.wvu.edu/templates/showETD.cfm?recnum=515.
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Thesis (M.S.)--West Virginia University, 1999.Title from document title page. Document formatted into pages; contains x, 135 p. : ill. Includes abstract. Includes bibliographical references (p. 88-91).
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Ayub, Priscila Vaz. "Analysis of the maxillary dental arch after rapid maxillary expansion in patients with unilateral complete cleft lip and palate." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/61/61132/tde-14012015-094508/.
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Objective: The aim of this study was to evaluate the dentoalveolar effects of rapid maxillary expansion in children with unilateral complete cleft lip and palate in comparison with non-cleft patients. Methods: The experimental group (EG) was composed of 25 patients with unilateral and complete cleft lip and palate (9 males and 15 females) with a mean age of 10.6 years. The control group (CG) comprised of 27 patients without cleft lip and palate (14 males and 13 females) with a mean age of 9.1 years. Dental models of the maxillary dental arch were obtained immediately preexpansion (T1) and 6 months post-expansion (T2) at the time of appliance removal. Digital dental models were obtained using the 3Shape R700 3D laser scanner (3Shape A/S, Copenhagen, Denmark). Transversal widths, arch perimeter, arch length, palatal depth, palatal volume, canine and posterior tooth inclination were digitally measured. Paired t-test was used to perform interphase comparisons and independent t-test to perform intergroup comparisons (p<0.05). Results: In the experimental group, the expansion produced a ignificant increase of all maxillary transverse measurements, palatal volume, arch perimeter and palatal depth while decreased the arch length. RME caused a buccal tip of posterior teeth in patients with UCLP. No differences were observed between experimental and control groups for all the measurements performed except for the intermolar distance (6-6), which showed a greater increase in patients with cleft. Conclusion: Rapid maxillary expansion showed similar dentoalveolar effects in children with UCLP and without oral clefts.Objective: The aim of this study was to evaluate the dentoalveolar effects of rapid maxillary expansion in children with unilateral complete cleft lip and palate in comparison with non-cleft patients. Methods: The experimental group (EG) was composed of 25 patients with unilateral and complete cleft lip and palate (9 males and 15 females) with a mean age of 10.6 years. The control group (CG) comprised of 27 patients without cleft lip and palate (14 males and 13 females) with a mean age of 9.1 years. Dental models of the maxillary dental arch were obtained immediately preexpansion (T1) and 6 months post-expansion (T2) at the time of appliance removal. Digital dental models were obtained using the 3Shape R700 3D laser scanner (3Shape A/S, Copenhagen, Denmark). Transversal widths, arch perimeter, arch length, palatal depth, palatal volume, canine and posterior tooth inclination were digitally measured. Paired t-test was used to perform interphase comparisons and independent t-test to perform intergroup comparisons (p<0.05). Results: In the experimental group, the expansion produced a ignificant increase of all maxillary transverse measurements, palatal volume, arch perimeter and palatal depth while decreased the arch length. RME caused a buccal tip of posterior teeth in patients with UCLP. No differences were observed between experimental and control groups for all the measurements performed except for the intermolar distance (6-6), which showed a greater increase in patients with cleft. Conclusion: Rapid maxillary expansion showed similar dentoalveolar effects in children with UCLP and without oral clefts.
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McGuinness, Niall John Patrick. "The influence of rapid maxillary expansion on craniocervical angulations one year after treatment." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/28580.
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Rapid maxillary expansion (RME) has been shown to increase nasal permeability and reduce nasal airway resistance. A sample of 42 adolescent patients with a narrow upper dental arch and unilateral or bilateral crossbite in the permanent dentition underwent RME as part of normal orthodontic treatment. Cephalograms in natural head position were taken before, immediately after, and one year after RME. No significant changes in the craniofacial angles were found immediately after expansion. One year post-expansion, however, NSL/VER had reduced by 3.14°, (p<0.01), indicating a drop in head position, while OPT/HOR reduced by 2.13° (p<0.05), and CVT/HOR had reduced by 2.55° (p<0.05), indicating a more forward inclination of the cervical spine. The results of this study suggest that when the nasal airway resistance decreases as a result of RME, this causes an initial slight increase in pharyngeal airway resistance. This is due to the increased nasal airflow, which results in a more forward inclination of the cervical spine in order to increase the cross-sectional area of the pharynx. This in turn reduces the pharyngeal airway resistance and results in an ongoing change in head posture due to alteration in the mode of breathing as a result of RME, thereby contributing to a change in craniofacial development, according to the soft-tissue stretching hypothesis of Solow and Krieborg (1977). This work adds to this hypothesis, and a supplementary hypothesis is proposed to augment the theory of Solow and Krieborg: it is that total airway resistance can be compartmentalised into nasal and pharyngeal portions, and that the two are in a state of dynamic equilibrium with each other and the factors controlling the relationship between head + posture, airway adequacy, and craniofacial morphology.
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Granillo, Nathan. "Three-Dimensional Photographic Evaluation of Immediate Soft Tissue Changes Following Rapid Maxillary Expansion." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2504.
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The skeletal and dental changes associated with rapid maxillary expansion (RME) are well documented. Effects on the soft tissues and the potential impact on facial esthetics have not been well researched. The purpose of this study was to evaluate immediate changes in facial soft tissues as a result of RME by comparing threedimensional digital photogrammetric images before and after RME treatment. The 3dMDface System was used to obtain photographic images of 21 patients (mean age = 11.8 years) before and after RME treatment for transverse maxillary deficiency. A control group of 13 patients (mean age = 12.7 years) also had two images taken at a similar time interval. Mean expansion was 6.5 mm in the RME patients. Intercanthal distance, nose width, and intercommissural width changed significantly in the RME patients from T0 to T1 (P = 0.011, P = 0.050, and P = 0.003, respectively). Intercommissural width, however, was the only measure that significantly changed as compared with the control group (P = 0.041). Changes in intercanthal distance and nose width were significantly related to the amount of expansion achieved (R2 = 0.428, P = 0.0013 and R2 = 0.501, P = 0.0003, respectively).
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Belli, Stephen J. "Long term anteroposterior, transverse, and vertical skeletal changes following rapid maxillary expansion in adults." The Ohio State University, 1992. http://rave.ohiolink.edu/etdc/view?acc_num=osu1412936018.
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Gregorio, Leonardo Vieira Lima. "Slow and rapid maxillary expansion in patients with bilateral complete cleft lip and palate: a cephalometric evaluation." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/61/61132/tde-19102016-151304/.
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Introduction: The objective of this study was to compare the dentoskeletal effects of the slow (SME) and rapid maxillary expansion (RME) in patients with bilateral complete cleft lip and palate (BCLP). Methods: The sample comprised 46 patients with BCLP (34 male and 12 female) with a mean age of 9,2 years. They were randomly assigned into two groups: Group RME comprised 23 patients with posterior crossbites treated with Hyrax or Haas appliances. Group SME comprised 23 patients with posterior crossbites treated with quad-helix appliance. Both expansion modalities were performed prior to secondary alveolar bone graft procedure. Conebeam computed tomography (CBCT) was performed before expansion (T1) and after appliance removal at the end of a 6-month retention period (T2). Sagittal and vertical changes were evaluated using the cephalometric reformatted images that were obtained from the CBCT. Cephalometric analysis was performed using Dolphin Imaging Software (Chatsworth, CA, USA). Intraclass correlation coefficient (ICC) was used to calculate intraexaminer agreement. Intragroup changes were evaluated using paired t test. Intergroup comparisons were performed using t test (p<0.05). Results: The intraexaminer agreement was excellent (ICC varied from 0.88 to 0.96). RME group showed a significant increase of lower anterior facial height (p=0.042), mandibular length (p= 0.003) and maxillomandibular difference (p=0.006). SLM group demonstrated an increase of mandibular length (p<0.001) and maxillomandibular difference (p<0.001) and a decrease of the ANB angle (p=0.034). No significant differences between RME and SME were found. Conclusions: Rapid and slow maxillary expansion produced similar sagittal and vertical changes in patients with BCLPIntrodução: O objetivo desse estudo foi comparar os efeitos dentoesqueléticos da expansão lenta (ELM) e expansão rápida (ERM) da maxila em pacientes com fissuras labiopalatinas completa e bilateral (FLPCB). Métodos: A amostra compreendeu 46 pacientes com FLPCB (34 do sexo masculino e 12 do feminino) com idade média de 9,2 anos. Eles foram aleatoriamente alocados em dois grupos: Grupo ERM compreendeu 23 pacientes com mordida cruzada posterior (MCP) tratados com aparelho Hyrax ou Haas. Grupo ELM compreendeu 23 pacientes com MCP e tratados com aparelho quadrihélice. Ambas as modadlidades de expansão foram realizadas previamente ao enxerto ósseo alveolar secundário. Tomografia computadorizada de feixe cônico (TCFC) foi realizada antes da expansão (T1) e após a remoção do aparelho, no fim do período de contenção de 6 meses (T2). Alterações anteroposteriores e verticais foram mensuradas em imagens cefalométricas reformatadas a partir da TCFC. A análise cefalométricas foi realizada usando o Software Dolphin Imaging® (Chatsworth, CA, EUA). O coeficiente de correlação intraclasse (CCI) foi usado para calcular o erro do método. Alterações intragrupo foram calculadas usando teste t pareado. Alterações intergrupo foram calculadas usando teste t (p<0,05). Resultados: A confiabilidade foi considerada excelente (CCI variou entre 0,88 a 0,96). O grupo ERM demonstrou aumento significativo na altura facial anterior inferior (p=0,042), no comprimento mandibular (p<0,003) e na diferença maxilo-mandibular (p=0,006). O grupo ELM mostrou aumento no comprimento mandibular (p<0,001) na diferença maxilomandibular (p<0,001) e uma redução do ângulo ANB (p=0,034). Não foram encontradas diferenças entre ERM e ELM. Conclusões: Expansão rápida e lenta da maxila produziram alterações cefalométricas sagitais e verticais semelhantes em pacientes com FLPCB
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Charoenworaluck, Nongluck. "A Cephalometric Comparison of Pharynx and Soft palate in Subjects treated with Rapid Maxillary Expansion." Diss., lmu, 2006. http://nbn-resolving.de/urn:nbn:de:bvb:19-59538.
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Thiradilok, Sasipa. "Changes in Dental Arch Dimension among Dental Class II Patients after Rapid Maxillary Expansion Therapy." Diss., lmu, 2008. http://nbn-resolving.de/urn:nbn:de:bvb:19-85316.
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Kotinas, Anastasios. "A study of the Rapid Maxillary Expansion with the use of the finite element method." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/24792.
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Katz, Robert Adam. "The Long Term Stability of Mandibular Arch Length and Width Changes Following Rapid Maxillary Expansion." The Ohio State University, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=osu1383819575.
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McDonald, James Peter. "The effect of rapid maxillary expansion on nasal airway resistance, craniofacial morphology and head posture." Thesis, University of Edinburgh, 1995. http://hdl.handle.net/1842/20673.
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Palaisa, Jacqueline. "Use of conventional tomography to evaluate changes in the nasal cavity with rapid palatal expansion." Morgantown, W. Va. : [West Virginia University Libraries], 2005. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=3809.
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Thesis (M.S.)--West Virginia University, 2005Title from document title page. Document formatted into pages; contains vii, 57 p. Vita. Includes abstract. Includes bibliographical references (p. 46-52).
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Swanson, Erik. "Three dimensional analysis of the effects of rapid maxillary expansion using either Hyrax, Haas, or SARPE approaches." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1465494.
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Shimizu, Kevin. "Facial Tissue Changes with Microimplant Assisted Rapid Palatal Expanders." Scholarly Commons, 2019. https://scholarlycommons.pacific.edu/dugoni_etd/1.
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Introduction: Skeletal expansion has been a treatment modality in orthodontics and orthopedics to correct skeletal transverse discrepancies with maxillary constriction. The utilization of microimplants in conjunction with these palatal expanders offers a higher degree of pure skeletal expansion and minimizes the dental side effects. The purpose of this study is to evaluate the changes of the hard and soft tissues of the face after skeletal expansion for orthodontics. Methods: 36 patients who had received successful expansion with a microimplant assisted rapid palatal expander were compared to their pre-expansion records. All patients received CBCTs from which a 3-D analysis configuration was created to trace hard and soft tissue landmarks of the midface and nasal cavity regions. 3 judges analyzed each set of records and the average was used to calculate the amount of expansion experienced at each anatomical region. A paired T-test and Wilcoxon signed-rank test were used for statistical comparison between time points. Results: Expansion can affect all of the midfacial hard tissues that support the overlying soft tissues. Increases in skeletal width from the Frontozygomatic suture down to the maxillary alveolar bone were all significant. The nasal cavity increased in width in all locations measured. Soft tissue changes were significant at the base of the ala suggesting a widening of the nose with expansion therapy. Conclusion: Maxillary expansion with microimplant assisted expanders can have skeletal changes throughout the entire midface and may affect the width of the nasal cavity. Soft tissue changes were less pronounced, and though a widening of the base of the nose may be expected this may not be noticed by the patient.
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Santana, Denise Meira de Castro. "A expansão rápida da maxila é efetiva a longo prazo nas dimensões das vias aéreas e na respiração em crianças com distúrbios respiratórios?" Botucatu, 2020. http://hdl.handle.net/11449/192286.
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Orientador: Silke Anna Theresa WeberResumo: Introdução: O crescimento craniofacial é modificado pela respiração oral crônica. A expansão rápida da maxila (ERM) promove a separação da sutura palatino mediana, melhorando a oclusão e a dimensão da via aérea superior. Objetivo: Avaliar a efetividade terapêutica da ERM em crianças com respiração oral e distúrbios respiratórios a longo prazo, em relação à melhora no padrão respiratório e classificar a qualidade da evidência das informações. Método: Foi realizada a busca nas plataformas PUBMED, LILACS, EMBASE, SCOPUS, WEB OF SCIENCE e COCHRANE, bem como a literatura cinza. Os artigos foram selecionados e avaliados quanto aos riscos de viés (ROBINS-I) e feita a avaliação da qualidade da evidência (GRADE). Resultados: De 309 estudos encontrados, 26 artigos foram selecionados para leitura completa, dos quais 22 foram excluídos, restando quatro artigos para análise e compilamento dos dados, sendo dois ensaios clínicos não-randomizados controlados e dois ensaios clínicos não-randomizados e não-controlados. Nenhum ensaio clínico randomizado foi encontrado. Conclusões: As meta-análises mostraram aumento de distância internasal, interzigomática e volume orofaríngeo após a ERM. A qualidade da evidência de cada desfecho foi considerada muito baixa. Palavras-chave: Crianças, Expansão rápida da maxila, Deficiência maxilar transversa, Respirador bucal, meta-análise.
Abstract: Introduction: The craniofacial growth is modified by the chronic oral breathing. The maxillary rapid expansion promotes the separation of the median palatal suture, improving the occlusion and the dimensions of the upper airways. Aim: To evaluate the therapeutic effectiveness of RME in children with oral breathing and long-term respiratory disorders, in relation to the improvement in breathing pattern and to classify the quality of evidence of information. Methods: Searches on PUBMED, LILACS, EMBASE, SCOPUS, WEB OF SCIENCE and COCHRANE, as well as in the grey literature were performed. The works found were selected and evaluated for Risk of Bias (ROBINS-I), and the evaluation of quality of evidence (GRADE). Results: From 309 works found, 26 papers were selected for full reading, from it 22 were excluded. Data compilation and analysis were performed in four papers, being two controlled non-randomized clinical trials and two non-randomized and uncontrolled clinical trials. No randomized clinical trial was found. Conclusions: The meta-analyses found an increase of the internasal, interzygomatic distance and oropharyngeal volume after the RME. The quality of the evidence of each outcome was considered very low. Keywords: child, Maxillary Rapid Expansion, transverse maxillary deficiency, meta-analyses; mouth breather.
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Almuzian, Mohammed Ahmed Younis. "The immediate impact of bonded rapid maxillary expansion on the naso-pharyngeal airway patency : a prospective CBCT study." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/6252/.
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Introduction: Recent studies have utilised cone beam computed tomography (CBCT) for the assessment of the volume of the nasopharyngeal airway space (Guijarro-Martínez and Swennen, 2013, Lenza et al., 2010, Woodside and Linder-Aronson, 1979, Chang et al., 2013). Some of these investigations are based on the analysis of slice data obtained from three dimensional (3D) radiographic images. The usage of a CBCT scan to measure the nasopharyngeal airway volume has drawbacks which include the effect of respiration and tongue position (Abbott et al., 2004), the impact of head posture, lordosis (cranio-cervical inclination) and mandibular morphology on the accuracy of measuring air oro-pharyngeal airways. In addition, published figures to date has not considered the detailed anatomical boundaries of the nasal cavity space, paranasal airway space and other pharyngeal sections collectively (Chang et al., 2013). Aims and objectives: The aim of the study was to assess the validity of the free access software package like ITK Snap in measuring the airways spaces, investigate, using CBCT, the three-dimensional effect of rapid maxillary expansion on the maxillary sinus, the lower part of the nasal cavity, the upper nasopharynx and the upper oropharynx (upper and lower retropalatal spaces), and to correlate the changes in these anatomical spaces with the measured RME appliance split, the dentoalveolar expansion and the gender of the subjects. Materials and methods: This study was carried out on seventeen patients (8 boys, 9 girls; mean age 12.6 + 1.8 years) who required maxillary expansion for the management of narrow upper dental arch. Sample size was calculated using the Researcher’s Toolkit calculator and this indicated that a sample size of 14 patients would produce an Alpha error level or confidence level at 95% and a Beta error level at 20%. Therefore, it was decided to recruit 17 subjects to overcome potential exclusion due to irreproducibility in the head orientation and lordosis. Pretreatment (T1) and immediate post-RME (T2) CBCT images were taken for all the patients. In all CBCT images, head orientation and lordosis were measured using OnDemand 3D software packages. Cases were excluded from the study if the difference in the head orientation and lordosis between the CBCT of T1 and CBCT of T2 was more than 5 degrees. The two scans, T1, T2, were orientated according to a specific protocol and superimposed on the cranial base to standarise the volumteric segemtation and measurements. The impact of RME was assessed by measuring, using ITK snap and OnDemand 3D software packages, the changes in the distance between the intermolar dentoalveolar width at level of molar alveolar crest (IMD), the magnitude of appliance expansion (AE), the volume of respiratory region or the lower part of the nasal cavity (LNC), the volume of the right and left maxillary sinus (RMS and LMS), the volume of the upper nasopharynx (UNP), the subdivisions of the upper oropharynx including the upper and lower retropalatal space (URP and LRP) at T1 and T2. Segmentation of the oro-naso-pharyngeal spaces into multiple segments allows a deailed localisation of the changes and aids in exclusion of any potential masking change of one airway space on adjacent or remote airway space as each segment is associated anatomically and physiologically to different function and/or disorder. The normality of the data was tested using Kolmogorov–Smirnov test. The reproducibility of meaurements was analysed using Paired t-test and interclass correlation coefficient. The volumteric and linear changes was assessed using Student t-test (P < 0.05) and Pearson correlation coefficients was used to test the correlation of these changes. Results: Bonded RME has an effective dentoalveolar expansion effect in growing patients (P=0.001) and produced a significant increase in UNP (P=0.045). There was a statistically significant reduction on the URP space (P=0.042), especially in males. There was strong correlation between the increase of the volume of the right and left maxillary sinuses (PCC=0.86) and between appliance expansion and dentolavelar expansion (PCC=0.75). Conclusions: ITK-SNAP software is a reliable package and a single threshold value (-450 grey) is an accurate value. Additionally, this software can be used to measure the size of bony defect in patient with cleft palate before secondary alveolar bone grafting. Bonded RME was an effective dentoalveolar expander in growing patients and the immediate expansion of LNC and UNP might be associated with a reduction in nasal resistance, improvement in the nasal breathing and it can be considered as an option for treatment of Paediatric Obstructive Sleep Apnea Syndrome. Findings of this dtudy showed that there is a sexual dysmorphisim secondary to RME but did not reach the statistical significance. Generally, the effect of the RME on the upper naso-oro-pharyngeal airway spaces followed a mushroom like pattern with the upper parts expanded, the middle part was significantly narrowed while the lower part was mildly, but insignificantly statistically, reduced. However, it is essential to consider that regardless of the benefit of the increase nasal patency of this orthopeadic procedure, it should not done merely for the above purposes solely but only when it is linked to a right indication for RME. A future studies could include a colour mapping for detailed assessment of changes in different part of the oro-naso-pharyngeal space, as the shape changes of the airway space is as important as volumetric changes. Finally, a further randomised clinical trial or comparative study with larger sample size and long term follow up would be beneficial in estimating the real impact of the RME on the airway confirm the findings of this study.
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Magnusson, Anders. "Evaluation of surgically assisted rapid maxillary expansion and orthodontic treatment : Effects on dental, skeletal and nasal structures and rhinological findings." Doctoral thesis, Linköpings universitet, Käkkirurgi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-91700.
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Surgically Assisted Rapid Maxillary Expansion (SARME) is frequently used to treat skeletal maxillary transverse deficiency (MTD) in skeletally mature and non-growing individuals. Despite previous research in the field, questions remain with respect to the long-term stability of SARME and its effects on hard and soft tissue. The overall aim of the present doctoral work was to achieve a greater understanding of SARME, using modern image technology and a multidisciplinary approach, with special reference to effects on the hard and soft tissues and respiration. A more specific aim was to evaluate the long-term stability in a retrospective sample of patients treated with SARME and orthodontic treatment and to compare the results with a matched, untreated control group. The studies in this doctoral project are thus based on two different samples and study designs. The first sample, Study I (Paper I), is a retrospective, consecutive, long-term follow-up material of study models from 31 patients (17 males and 14 females) treated with SARME and orthodontic treatment between 1991 and 2000. The mean pre-treatment age was 25.9 years (SD 9.6) with a mean follow-up time of 6.4 years (SD 3.3). Direct measurements on study models were made with a digital sliding caliper at reference points on molars and canines. To evaluate treatment outcome and long-term stability, the results were compared with study models from an untreated control group, matched for age, gender and follow-up time. The second sample, Study II (Papers II-IV), is a prospective consecutive, longitudinal material of 40 patients scheduled to undergo SARME and orthodontic treatment between 2006 and 2009. In Paper II, one patient was excluded because of a planned adenoidectomy. The final sample comprised 39 patients (16 males and 23 females). The mean age at treatment start was 19.9 years (range 15.9 – 43.9). Acoustic rhinometry, rhinomanometry and a questionnaire were used to assess the degree of nasal obstruction at three time-points; pre-treatment, three months after expansion and after completed treatment (mean 18 months). In Papers III–IV, three patients declined to participate and two had to be excluded because their CT-records were incomplete. The final sample comprised 35 patients (14 males and 21 females). The mean age at treatment start was 19.7 years (range 16.1 – 43.9). Helical CT-images were taken pre-treatment and eighteen months’ post-expansion. 3D models were registered and superimposed at the anterior cranial base. The automated voxel-based image registration method allows precise, accurate measurements in all areas of the maxilla. In Papers II–IV, the treatment groups constituted their own control groups. The main findings in the retrospective, long-term follow-up study were that SARME and orthodontic treatment normalized the transverse discrepancy and was stable for a mean of 6 years post-treatment. Pterygoid detachment did not entirely eliminate the side effect of buccal tipping of the posterior molars. Relapse is time-related and is most pronounced during the first 3 years after treatment. Thus the retention period should be extended and should be considered for this period. The main rhinological findings in the prospective longitudinal study were that SARME had a shortterm, favourable effect on nasal respiration, but the effect did not persist in the long-term. However, subjects with pre-treatment nasal obstruction reported a lasting sensation of improved nasal function. SARME and orthodontic treatment had a significant but non-uniform skeletal treatment effect, with significantly greater expansion posteriorly than anteriorly. The expansion was parallel anteriorly but not posteriorly. The lateral tipping of the posterior segment was significant, despite careful surgical separation. No correlation was found between tipping and the patient's age. Furthermore, SARME and orthodontic treatment significantly affected all dimensions of the external features of the nose. The most obvious changes were at the most lateral alar-bases. The difference in lateral displacement profoundly influenced the perception of a more rounded nose. There were no predictive correlations between the changes. Patients with narrow and constrained nostrils can benefit from these changes with respect to the subjective experience of nasal obstruction. It is questionable whether an alar-cinch suture will prevent widening at the alar-base. The 3D superimposition applied in Study II is a reliable method, circumventing projection and measurement errors. In conclusion, SARME and orthodontic treatment normalize the transverse deficiency, with long-term stability. SARME has a favourable effect on the subjective perception of nasal respiration. SARME significantly affects dental, skeletal and nasal structures.
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Lazzari, Christiane Moraes. "A EXPANSÃO RÁPIDA DAMAXILA COM HAAS E A FALA NA FISSURA." Universidade Federal de Santa Maria, 2007. http://repositorio.ufsm.br/handle/1/6411.
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The aim of this study was verify the effects of rapid maxillary expansion (RME) with Haas, in speech of the pacient with transforamen cleft lip and palate. The sample consisted of 12 individuals with cleft lip and palate (CLP), being 6 boys and 6 girls, with age between 7 and 14 years, carriers of cleft lip and palate corrected with surgery. From these, 6 individuals, 3 boys and 3 girls, were submited to conventional activation ERM protocol (Group 1). The other 6 individuals, 3 boys and 3 girls, were submited to activation ERM protocol in agreement with Liou and Tsai (2005) of alternate expansions and constrictions (Group 2). The subjects were submited to fonoaudiologic evaluation of orofacial organs; nasal air capacity evaluation; perceptual analysis and spectographic evaluation of speech. The results obtained showed that RME produces changes on speech and orofacial organs in individuals with CLP. However, in some subjects, the changes did not happened in spite of RME structure changes. The increase of the nasal air capacity was statistically relevant. No statistically relevant was found between the groups in evaluations. The presente study indicated that RME produces changes on lips and tongue posture and breathing. These changes probably happen because an increase on intra-oral space, however the results showed that changes not always happen in a spontaneous way.O objetivo deste estudo foi verificar os efeitos da Expansão Rápida da Maxila, com aparelho Haas, na fala do paciente com Fissura Labiopalatia Transforame. A amostra foi composta por 12 indivíduos com fissura lábiopalatina (FLP), sendo 6 do sexo masculino e 6 do sexo feminino, com faixa etária entre 7 e 14 anos de idade, com cirurgias primárias de reparo de lábio e palato. Do total de sujeitos, 6 indivíduos, 3 meninos e 3 meninas, foram submetidos à Expansão Rápida da Maxila (ERM) de acordo com protocolo de ativação convencional (Grupo 1). Os outros 6 indivíduos, 3 meninos e 3 meninas, foram submetidos à ERM com protocolo de ativação preconizado por Liou e Tsai (2005) com expansões e constrições alternadas (Grupo 2). Os sujeitos realizaram avaliações fonoaudiológicas das estruturas e funções orofaciais; avaliação da aeração nasal; e avaliação da fala através de análise perceptivo auditiva e análise acústica. Os resultados da pesquisa mostram que a ERM traz mudanças à fala e às estruturas orofaciais e respiração do indivíduo com FLP. Em muitos casos, porém, não houve modificações mesmo tendo havido mudanças do ponto de vista estrutural advindas da ERM. Não houve diferença estatisticamente significativa entre os dois grupos nos aspectos avaliados. Concluiuse que a ERM traz modificações como posicionamento de lábios, língua e, respiração. Esse fato foi atribuído ao aumento do espaço intraoral e espaço aéreo nasal, porém, os resultados mostram que as modificações nem sempre ocorrem de maneira espontânea.
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Yamaji, Marco Aurélio Kenichi. "Avaliação das dimensões transversal, vertical e anteroposterior em tomografias computadorizadas do feixe cônico de pacientes com deficiência maxilar transversal submetidos à expansão rápida de maxila assistida cirurgicamente." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/58/58136/tde-11122014-143322/.
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O objetivo deste estudo foi uma avaliação tridimensional as mudanças nas dimensões transversais, verticais e anteroposterior das estruturas dentais e dentoalveolares em pacientes com deficiência maxilar transversal (DMT) submetidas à expansão rápida de maxila assistida cirurgicamente (ERMAC) através do uso de tomografias computadorizadas do feixe cônico (TCFC). Trinta e oito pacientes com DMT foram submetidos à ERMAC sob anestesia geral, as TCFC foram realizadas no pré-operatório (T1), após a expansão desejada (T2) e seis meses após a expansão (T3). Quarenta e sete marcações tridimensionais foram realizadas como pontos de referência e marcadas em cada tempo. As distâncias e ângulos foram medidas a fim de se avaliar as alterações ocorridas após a expansão. Os resultados demonstraram diferenças estatísticas significantes na dimensão transversal através do teste ANOVA ao nível da câmara pulpar (P≤0.001) em T2-T1 e T3-T1; e ao nível do ápice dental com diferença estatisticamente significante (P<0.005) em T2-T1 e T3-T1 e ao nível do processo dentoalveolar com diferença estatísticamente significante de (P<0.05) em T2-T1e T3-T1. A inclinação dentária apresentou diferença estatísticamente significante somente no incisivo central esquerdo (P< 0.05) em T3-T1. As dimensões vertical e anteroposterior não apresentaram diferenças estatísticamente significante. As maiores mudanças ocorreram na dimensão transversal na maioria das estruturas avaliadas, alterações verticais e anteroposteriores não foram encontradas. O índice de recidiva após seis meses da realização da ERMAC é baixa e podemos considerar como um tratamento estável para pacientes com DMT.The objective of this study was evaluate three-dimensional changes on transversal, vertical and anteroposterior dimensions of dental and dentoalveolar structures in patients with maxillary transverse deficiency (MTD) submitted to surgically assisted rapid maxillary expansion (SARME) using by CBCT. Thirty eight subjects with MTD was submitted to SARME under general anesthesia, CBCTs was taken preoperative (T1), after desired expansion (T2) and six months after expansion (T3). Fourth seven three-dimensional landmarks were determinate as reference points and marked at each time. The distances and angles were measured regarding the changes occurred after expansion.The results showed statistical significance difference in transverse dimension by ANOVA test at level of pulp chamber (P≤0.001) at T2-T1 and T3-T1; at level of dental apex had statistical difference (P<0.005) at T2-T1 and T3-T1, at level of dentoalveolar processes had statistical difference (P<0.05) at T2-T1 and T3-T1. Dental tipping showed statistical difference only left central incisors (P< 0.05) at T3-T1 Vertical and anteroposterior dimensions do not have statistical difference. The greater changes occurred in transversal dimensions and most of structures evaluated, no vertical and anteroposterior changes were found. The index relapse after six months is low and SARME can be consider stable to treatment of MTD.
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Ribeiro, Annelise Nazareth Cunha. "Avaliação das vias aeríferas superiores, antes e após expansão rápida da maxila, utilizando Tomografia Computadorizada por Feixe Cônico." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/23/23151/tde-20092011-170219/.
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A respiração predominantemente oral é constantemente citada como um dos fatores associados ao desenvolvimento da deficiência transversal da maxila. A Expansão Rápida da Maxila (ERM) é um excelente método para a correção desta alteração, por meio da abertura da sutura palatina. A tomografia computadorizada por feixe cônico é tem sido descrita como um método preciso de exame de imagens e diante das limitações dos métodos radiográficos convencionais o objetivo deste estudo é avaliar as alterações morfológicas imediatas, decorrentes da ERM, na cavidade nasal e na região da naso e orofaringe, por meio da TCFC. Foram avaliadas 15 pares de imagens tomográfica, correspondentes a 15 pacientes portadores deficiência transversal da maxila, tratados com ERM, que realizaram a TCFC ao início e após o período de contenção de 4 meses. Os resultados encontrados mostram que a cavidade nasal apresenta aumento transversal significativo em seu terço inferior, nas regiões anterior (p=0,045), média (p=0,009) e posterior (p=0,001). Não há alteração significativa do volume (p=0,11), área sagital mediana (p=0,33) e menor área axial (p=0,29) decorrente da ERM na nasofaringe. Há alteração significativa do volume (p=0,05), área sagital mediana (p=0,01) e menor área axial (p=0,04) nos momentos antes e imediatamente após a ERM, na orofaringe. Após análise dos resultados concluímos que a ERM é capaz de aumentar a largura transversal da cavidade nasal, não tendo o mesmo efeito na região da nasofaringe, e que as alterações encontradas na orofaringe podem ser decorrentes de falta de padronização o posicionamento da cabeça e lingual no momento da aquisição da imagem.The predominantly oral breathing is constantly cited as an etiological factor for the transverse maxillary deficiency. Rapid Maxillary Expansion is an excellent method for the correction of malocclusion, through the opening of the midpalatal sutures. The literature shows that the benefits of this procedure are beyond the dental benefits, and could have repercussions in the upper airways, due to its close relationship with the maxilla. The cone beam computed tomography has been described as is an accurate method of taking pictures and before the limitations of conventional radiographic methods the aim of this study is to evaluate the immediate morphological changes resulting from the ERM, the nasal cavity and the nasal region and oropharynx, through the CBCT. We evaluated 15 patients with maxillary width deficiency were treated with RME, which hosted the CBCT to the beginning and after the retention period of 3 months. The results show that the nasal cavity presents significant increase in cross their lower third, in the anterior (1.08 mm ± 0.15), medium (1.28 mm ± 0.15) and posterior (0.77 mm ± 0.12). No significant change in volume (p=0.11), median sagittal area (p=0.33) and lower axial area (p=0.29) resulting from the RME in nasopharynx. There is significant change in volume (p = 0.05), median sagittal area (p = 0.01) and lower axial area (p = 0.04) before and immediately after the RME in the oropharynx. After analysis and discussion of results in this study, we concluded that RME is able to increase the transverse width of the nasal cavity, not having the same effect in the nasopharynx, and that the changes found in the oropharynx may be due to the lack of positioning standardization of the head and tongue at the time of image acquisition.
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Zambon, Camila Eduarda. "Estudo da variação das medidas ortodônticas e da função respiratória nasal por rinometria acústica e rinomanometria em pacientes submetidos à expansão palatina cirurgicamente assistida." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5143/tde-27052010-160219/.
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Introdução: A atresia transversa da maxila é a discrepância volumétrica existente entre a maxila e a mandíbula no plano transversal que, além de alterações dento-esqueléticas, gera mudanças craniofaciais importantes, como o estreitamento das cavidades nasais, a diminuição da permeabilidade nasal e a respiração bucal. A expansão palatina cirurgicamente assistida (EPCA) é a técnica cirúrgica indicada para a correção da atresia maxilar em pacientes adultos, com o crescimento ósseo finalizado. A rinometria acústica é uma técnica objetiva de estudo da respiração nasal, com a qual se avalia a geometria e o volume nasal. Já a rinomanometria trata-se de um método aerodinâmico que quantifica a pressão transnasal e a resistência ao fluxo aéreo. Objetivos: O objetivo deste estudo foi avaliar subjetiva e objetivamente a função respiratória nasal, em pacientes com atresia maxilar, submetidos à EPCA e determinar o tipo de correlação existente entre as medidas ortodônticas e as alterações de área, volume, resistência, e fluxo aéreo nasal. Casuística e Métodos: Para a realização do estudo foram avaliados 27 pacientes adultos, por meio da rinometria acústica, rinomanometria, medidas ortodônticas (perímetro e comprimento do arco maxilar, distância transversa entre caninos, prés-molares e molares superiores) em modelos de estudos e escala visual analógica da função respiratória apenas nasal, no pré-operatório, após a ativação do expansor maxilar do tipo Hyrax, instalado previamente à cirurgia, e após quatro meses da EPCA, realizada sob anestesia geral. Os exames otorrinolaringológicos foram realizados em sala ambientalizada, com e sem o uso de vasoconstritor nasal, em ambas as cavidades nasais. Resultados: Os resultados demonstraram que 59,3% da casuística era do gênero feminino, com idade média de 25,33 anos. Todas as medidas ortodônticas obtiveram um aumento estatisticamente significante (p<0,001), que mantiveram-se ao longo da tempo (p<0,001). Todas as medidas avaliadas apresentaram melhores resultados com o uso de vasoconstritor nasal. A área da cavidade nasal como um todo aumentou após a cirurgia (p<0,036). O volume médio é 2,75 maior com o uso de vasoconstritor (p < 0,001), porém não houve alterações estatisticamente significantes entre os momentos avaliados. Os fluxos expiratórios e inspiratórios aumentaram ao longo do tempo (p<0,001, para ambos). A pressão expiratória diminui no decorrer dos momentos avaliados (p<0,004). A análise subjetiva da sensação respiratória apenas pelo nariz aumentou significantemente de um momento para o outro (p<0,05). Houve correlação estatística entre perímetro do arco aumentado e resistência aérea diminuída (p=0,004) e entre o aumento de uma medida transversa com o aumento do fluxo inspiratório e expiratório, sem o uso de vasoconstritor (p=0,023 e p=0,004 respectivamente). Apenas o fluxo respiratório apresentou comportamento diferente entre os lados. Conclusões: Assim, conclui-se que o procedimento cirúrgico de EPCA promove alterações importantes nas cavidades oral e nasais que, associadas, geram melhor qualidade respiratória ao paciente e demonstram a relevância clínica otorrinolaringológica de tal procedimento cirúrgico bucomaxilofacialIntroduction: Transverse atresia of maxilla is a volumetric discrepancy existing between the maxilla and the mandible on the transversal plan that, besides dentoskeletal alterations, generates important craniofacial changes, such as nasal cavities constriction, diminution of nasal permeability and buccal breathing. The surgically assisted rapid maxillary expansion (SARME) is the surgical technique indicated for correcting maxillary atresia in adult patients, whose bone development was concluded. Acoustic rhinometry is a technique of nasal breathing, with which the nasal geometry and volume are assessed. As for rhinomanometry, it is an aerodynamic method that quantifies the transnasal pressure and resistance to aerial flow. Objectives: The purpose of this paper was evaluating subjectively and objectively the nasal respiratory function in patients with maxillary atresia, who have undergone SARME and determining the type of correlation existing between the orthodontic measures and the alterations of area, volume, resistance, and nasal aerial flow. Casuistic and Methods: For the paper accomplishment were assessed 27 adult patients, through acoustic rhinometry, rhinomanometry, orthodontic measures (perimeter and length of maxillary arch, transverse distance among canines, premolars and superior molars) in models of studies and analogical visual scale of only nasal respiratory function, on pre-surgical, after the activation of Hyrax-type maxillary expander, installed previously to the surgery, and after four months of SARME, accomplished under general anesthesia. The otorhinolaryngological tests were accomplished in an environmentally adapted room, with and without the use of nasal vasoconstrictor, in both nasal cavities. Results: The results have demonstrated that 59.3% of the casuistic was of female gender, with an average age of 25.33 years. All the orthodontic measures have obtained a statistically significant growth (p<0.001), which have maintained along the time (p<0.001). All the assessed measures have presented better results with the use of nasal vasoconstrictor. The nasal cavity area as a whole augmented after the surgery (p<0.036). The average volume is 2.75 larger with the vasoconstrictor use (p < 0.001), however, there was any statistically significant alterations between the moments assessed. The expiratory and inspiratory flows have grown along the time (p<0.001, for both). The expiratory pressure is reduced in the course of the moments assessed (p<0.004). The subjective analysis of respiratory sensation only through nose has increased significantly from one moment to the other (p<0.05). There was a statistic correlation between perimeter of augmented arch and aerial resistance diminished (p=0.004) and between the increase of a transverse measure with the growth of inspiratory and expiratory flow, with and without the use of vasoconstrictor (p=0.023 and p=0.004 respectively). Only the respiratory flow presented a different behavior between the sides. Conclusions: Thus, it is concluded that the SARME promotes important alterations on oral and nasal cavities that, associated, generate a better respiratory quality to the patient and demonstrate a clinical otorhinolaryngological relevance of such bucomaxillofacial surgical procedure
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Arnez, Maya Fernanda Manfrin. "Diabetes mellitus altera a sinalização osteogênica e atrasa o processo de reparo ósseo após expansão rápida da maxila." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/58/58135/tde-03022015-094136/.
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Introdução: O diabetes mellitus (DM) é uma doença crônica caracterizada pela hiperglicemia associada a diversas alterações sistêmicas e uma das suas complicações é o processo de reparo ósseo comprometido. Entretanto, ainda não há estudos utilizando análises celulares e biomoleculares que avaliem o processo de reparo ósseo desta desordem metabólica quando associada à expansão rápida da maxila (ERM). Objetivo: O objetivo deste estudo foi avaliar a remodelação óssea e sinalização osteogênica durante a aplicação de mecânica ortodôntica para ERM em ratos diabéticos tipo1- induzidos. Material e Métodos: Cento e cinquenta ratos Wistar, machos, foram divididos aleatoriamente em seis grupos de estudo. Grupos: controle (C, n=30), veículo (V, n=15), diabetes mellitus tipo 1 induzido com estreptozotocina (D, n=30), controle submetido à ERM (Cd, n=30), veículo submetido à ERM (Vd, n=15) e diabetes mellitus tipo 1 induzido com estreptozotocina submetido à ERM (Dd, n=30). Os animais foram eutanasiados aos 3, 7 e 10 dias após ERM . Análises histológicas, mudanças no padrão de expressão gênica e proteica de osteoprotegerina, (OPG), RANK, RANKL, osteonectina (ONC), osteocalcina (OCC), sialoproteína óssea (BSP), osteopontina (OPN) e proteína morfogenética óssea 2 (BMP2), assim como as mudanças no peso corporal, na ingestão de água na glicemia foram avaliadas. A análise da expressão gênica e proteica foram realizadas por qRT-PCR e Western Blotting, respectivamente. Os dados foram submetidos ao teste estatístico ANOVA de duas vias e pós-teste de Tukey (α= 0,05). Resultados: Histologicamente no grupo Dd foi notado maior reabsorção óssea, com diversas áreas em degradação com ausência de osteoblastos, intensa atividade de reabsorção óssea solapante, presença de osteoclastos, células inflamatórias associada ao comprometimento da formação óssea quando comparado aos grupos D e Cd. Estes resultados foram confirmados também nos achados moleculares, uma vez que algumas sinalização gênicas e proteicas relacionadas a osteogênese foram reduzidas, ao passo que a sinalização osteoclastogênica foi estimulada, principalmente no período inicial de reparo ósseo. No grupo D, o processo de formação ósseo estava atrasado comparado ao grupo C, devido a alteração da expressão dos genes e proteínas que regulam o catabolismo e anabolismo ósseo, haja vista que havia maior presença de tecido ósseo imaturo e maior quantidade de áreas de remodelação ativa até o período mais tardio de estudo. No grupo Cd foi observado remodelação óssea, caracterizada por um tecido desorganizado na região da sutura palatina mediana, com intensas áreas inflamatórias, hemorrágicas e reabsortivas comparado ao grupo C. Contudo, até o período de 10 dias pós abertura da sutura, não foi possível observar o completo preenchimento do gap sutural por tecido ósseo. Estes resultados histológicos foram observados na sinalização de genes e proteínas no grupo Cd, uma vez que estes biomarcadores de formação e reabsorção óssea estavam alterados quando comparados aos grupos C e Dd. Conclusões: O DM alterou a sinalização para o metabolismo ósseo e atrasou o processo de reparo após ERM. Estes resultados reforçam a necessidade de avaliar o status do metabolismo ósseo dos pacientes durante tratamento ortopédico e/ ou ortodôntico, visto que a aplicação destas forças na presença do DM podem promover efeitos indesejáveis.Background: Diabetes mellitus (DM) is a disease associated with several disorders of health in humans and one of the most important is the jeopardizing of bone formation. However, to the best of our knowledge there is no information about the influence of diabetes on orthodontic and orthopedic treatment at cellular and molecular levels. Objective: The aim of this study was to evaluate bone remodeling process in palatal suture during orthopedic mecanotherapy in rats with type 1-induced diabetes mellitus. Material and Methods: One hundred and fifty Wistar male rats were randomly assigned to six groups. Groups: control (C, n=30), vehicle (B, n=15), type 1-induced diabetes mellitus using streptozotocin (D, n=30), control with RME (C+RME, n=30), vehicle with RME (C+RME, n=15) and type 1-induced diabetes mellitus using streptozotocin with RME (D+RME, n=30). The animals were euthanized at 3, 7 and 10 days after RME. Histologic evaluations, changes in genes and proteins expression of osteoprotegerin (OPG), RANK, RANKL, osteonectin (ONC), osteocalcin (OCC), bone sialoprotein (BSP), osteopontin (OPN) and bone morphognetic protein 2 (BMP2) were evaluated along with the changes in body weight, water intake and glycemic profile. Real-Time RT-PCR and Western Blotting were used to evaluate gene and the protein expression. Data were submitted to statistical analysis using two-way ANOVA followed by Tukey test ( α= 0,05). Results: On group D+RME it was observed an increased bone resorption, serveral undermining and tissue degradation areas. On the suture gap there were mainly inflammatory and osteoclasts cells associated with compromised bone formation compared to groups D and Cd. These results were observed also in molecular levels, since there were a reduced osteogenesis and an upregulation of osteoclastogenesis, mainly in early period of healing. On group D, bone formation was compromised compared to group C, due to changes on genes and proteins expression which regulates bone metabolism, considering that there was more immature bone and incresead active remodeling areas until late periods. On group Cd it was observed bone remodeling, characterized by desorganized tissue on the gap of midpalatal suture, with intense inflammatory hemorhagic and resorptive areas compared to group C. However until 10 days after RME, on group D the gap was not completely filled with bone tissue. These results were observed on the signaling of molecular biomarkers on group Cd, since they were changed compared to groups C and Dd. Conclusions: DM modify the signaling for bone metabolism and compromise bone repair after RME. During orthopedic and orthodontic treatment is necessary to evaluate metabolism status of subjects, since the application of these forces have been shown to promote undesirable effects mostly when associated with DM.
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Pimentel, Diego Jesus Brandariz. "Análise dos ruídos das articulações temporomandibulares e da atividade eletromiográfica de músculos mastigatórios em crianças submetidas ao tratamento da mordida cruzada posterior funcional." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/58/58133/tde-23022018-142802/.
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O objetivo deste estudo foi analisar os ruídos das articulações temporomandibulares (ATM) e a atividade eletromiográfica (EMG) dos músculos masseteres (MM) e temporais anteriores (TA) nos momentos pré e pós correção da mordida cruzada posterior funcional (MCPF) por meio da expansão rápida da maxila (ERM) com o uso do aparelho ortopédico Haas modificado. A amostra foi composta por 20 crianças (entre 6 e 12 anos de idade, de ambos gêneros) portadoras de MCPF. A eletrovibratografia (EVG) avaliou a presença de ruídos articulares. A eletromiografia (EMG) foi analisada nas situações clínicas de máxima contração voluntária em máxima intercuspidação habitual e mastigação habitual, direita e esquerda nos momentos pré tratamento (T1) e após três meses da finalização da ERM (T2). Os resultados mostraram que: não houve diferença estatística nos ruídos articulares entre o lado afetado e não afetado pela MCPF nos momentos T1 e T2, houve uma melhora do ruído articular com diminuição no pico de amplitude da vibração do lado da MCPF na comparação dos lados não afetados pela MCPF. No teste da EMG a avaliação em repouso e no teste funcional não mostrou diferenças estatisticamente significantes entre lado afetado e não afetado pela MCPF. Houve diferença estatística nas mastigações direita e esquerda tanto para MM como para os TA na mastigação do lado da MCPF sendo que atividade EMG aumentou para estes músculos no T1 do lado não afetado. Na comparação entre o lado afetado e não afetado, os MM e os TA aumentaram sua atividade EMG no T1 na mastigação do lado da MCPF e somente o MM apresentou aumento da atividade EMG na mastigação do lado não afetado pela MCPF. Na comparação entre os lados de MCPF no T1 com T2 e na comparação entre os lados não afetados pela MCPF na avaliação da mastigação de ambos os lados o MM apresentou aumento da atividade EMG nos momentos T1 e T2, com diferenças estatísticas significantes. Em conclusão, o tratamento precoce da ERM diminui a intensidade dos ruídos articulares do lado afetado pela MCPF e gera um equilíbrio nas funções mastigatórias após tratamento ortopédico da MCPF. Estes achados indicam que o tratamento precoce da MCPF favorece a obtenção de condições morfológicas e funcionais adequadas para um melhor desenvolvimento do sistema estomatognático.The objective of this study was to analyze the temporomandibular joint (TMJ) noise and the electromyographic (EMG) activity of the masseter (MM) and anterior temporal (TA) muscles at the moments before and after correction of functional posterior crossbite (MCPF) by rapid expansion of the maxilla (ERM) with the use of the modified Haas orthopedic device. The sample consisted of 20 children (between 6 and 12 years of age, of both genders) with MCPF. Electrovibratography (EVG) evaluated the presence of joint noises. Electromyography (EMG) was analyzed in the clinical situations of maximum voluntary contraction in maximal habitual intercuspation and habitual chewing, right and left at the pre-treatment (T1) moments and after three months of the completion of ERM (T2). The results showed that: there was no statistical difference in articular noise between the affected and unaffected side of the MCPF at moments T1 and T2, there was an improvement in articular noise with a decrease in the peak of vibration amplitude on the MCPF side in the comparison of the non- affected side of the MCPF. In the EMG test, the evaluation at rest and in the functional test did not show statistically significant differences between the affected and non-affected side of the MCPF. There was a statistically significant difference in right and left chewing for both MM and TA in chewing on the MCPF side and EMG activity increased for these muscles in T1 on the unaffected side. In the comparison between the affected and unaffected side, MM and TA increased their EMG activity in T1 in chewing on the MCPF side and only MM showed increased EMG activity in chewing on the side not affected by MCPF. In the comparison between the MCPF sides in T1 with T2 and in the comparison between the sides not affected by MCPF in the chewing evaluation of both sides, the MM showed an increase in EMG activity at moments T1 and T2, with significant statistical differences. In conclusion, early treatment of MRE reduces the intensity of articular noises on the MCPF affected side and generates a balance in masticatory functions after orthopedic treatment of MCPF. These findings indicate that the early treatment of MCPF favors the achievement of morphological and functional conditions adequate for a better development of the stomatognathic system.
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Josgrilbert, Luiz Felipe Viegas. "AVALIAÇÃO DAS ALTERAÇÕES FACIAIS DECORRENTES DA EXPANSÃO RÁPIDA DA MAXILA ASSISTIDA CIRURGICAMENTE." Universidade Metodista de São Paulo, 2008. http://tede.metodista.br/jspui/handle/tede/1258.
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Previous issue date: 2008-02-26The objective of this research was to evaluate the facial alterations of surgically assisted rapid maxillary expansion (SARME). The sample consisted of 15 patients with 24,1 years old (average), 10 female and 5 male, that shown transverse discrepancy of the maxillary arch, the patients didn t have any orthodontic treatment before, they had complete clinical documentation and photographs in frontal view in the pre-treatment step (T1) and 6 months after the (SARME) (T2). Linear measurements were taken by reference points marked in acetate sheets fixed over the photographs, to avoid the anatomic drawing execution. The conclusion was that it is extremely important to standardize the photographs in all treatment phases to trust the obtained measurements. When T1 and T2 were compared by Student t test, there weren t any significant statistics alterations in: intercantal distance (Ind Ine); medium facial length (N - SN), right eye width (Exd Ind), left eye width (Exe Ine); facial length (N Me ), Upper face width (Zid Zie ), mouth width (Cbd Cbe) and mouth length (Ls Li). Inferior facial length (Sn - Me ) and noise width (Ald Ale) measurements showed significant statistics alterations after (SARME).
O objetivo desta pesquisa foi avaliar as alterações faciais decorrentes da Expansão Rápida da Maxila Assistida Cirurgicamente (ERM-AC). A amostra foi composta por 15 pacientes com idade média de 24 anos e 1 mês, sendo 10 do sexo feminino e 5 do sexo masculino, que apresentavam deficiência transversal da maxila, não tinham sido submetidos a tratamento ortodôntico prévio, apresentavam ficha clínica completa e fotografias em norma frontal nas fases pré-tratamento (T1) e 6 meses após a ERM-AC (T2). Mediadas lineares foram obtidas a partir da marcação de pontos de referência em folhas de acetato fixadas sobre as fotografias, para evitar a necessidade de execução de desenho anatômico. Concluiu-se que a padronização de fotografias em todos os tempos da pesquisa é de fundamental importância para que as medidas avaliadas sejam confiáveis. Quando comparados T1 com T2 por meio do teste t de Student não se verificou alteração estatisticamente significante na: largura intercantal (Ind Ine), altura facial média (N - SN), largura do olho direito (Exd Ind), largura do olho esquerdo (Exe Ine), altura facial (N - Me ), largura facial superior (Zid - Zie ), largura da boca (Cbd Cbe) e altura da boca (Ls Li). As medidas altura facial inferior (Sn - Me ) e a largura do nariz (Ald Ale) apresentaram alteração estatisticamente significante após a ERM-AC.
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Stuani, Adriana Sasso. "Avaliação da remodelação óssea após disjunção da sutura palatina mediana experimental e laserterapia de baixa potência, em ratos Wistar." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/9/9136/tde-26062012-142802/.
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INTRODUÇÃO: O uso da laserterapia concernente ao estímulo da formação óssea e da revascularização tem tornado objeto de estudo na área de saúde. OBJETIVO: O presente trabalho in vivo teve como objetivo avaliar quantitativamente os efeitos do laser de baixa potência (LBP) na remodelação óssea após a expansão rápida da maxila (ERM) em ratos jovens, através da expressão do RNAm dos genes RANK, RANK-L, Osteoprotegerina (OPG), e o Fator do Crescimento do Endotélio Vascular (VEGF) bem como a análise histológica. MATERIAL E MÉTODO: Utilizou-se 105 ratos Wistar (Rattus norvegicus, albinus), machos, divididos em 4 grupos: Grupo Controle (n=10) animais não tratados (sem ERM e sem aplicação do LBP; Grupo Experimental I (n=40) animais que tiveram apenas a ERM; sendo 25 animais sacrificados nos dias 1, 2, 3, 7, e 10 dias após a ERM para análise com RT-PCR e western blotting e 15 animais foram sacrificados nos dias 0, 7 e 10 dias para análise histológica; Grupo Experimental II (n=40) animais que tiveram ERM + LBP com diodo de Ga-Al-As (Gálio-Alumínio-Arsênio:160J/cm2) no primeiro dia do experimento; os animais foram sacrificados nos mesmos períodos que o Grupo Experimental I; Experimental III (n=15) animais que receberam 3 aplicações de LBP após ERM, totalizando 480J/cm2. Os animais foram sacrificados nos dias 3, 7 e 10 dias após a ERM para análise com RT-PCR e western blotting. A extração do RNAt da maxila foi feita com trizol. A síntese da fita de DNA complementar (cDNA) foi feita a partir de 1µg de RNA, por meio de uma reação de transcrição reversa, com a utilização da enzima transcriptase reversa, e a análise da expressão gênica foi realizada pela reação em cadeia pela polimerase em tempo real (qRT-PCR) no sistema TaqMan®. A análise protéica do VEGF, RANK, RANK-L e OPG foi realizada por meio da técnica western blotting. O teste de variância (ANOVA) foi usado comparando os grupos entre si e inter-grupos seguida pelo teste complementar de Tukey, com nível de significância de 5%. RESULTADOS: A separação dos incisivos induzida pela ERM foi semelhante nos grupos experimentais I e II, o espaço entre os incisivos foi mantido durante toda a fase experimental, e não houve diferença significativa entre os grupos laser e não-laser (p<0,05), demostramdo a eficiência da metodologia usada para abertura da sutura palatina mediana. Para o grau de abertura da sutura, foi quantificada, a área de abertura sutural em todos os grupos após a ERM, e observou-se aumentou significativo comparado com o grupo controle, sendo que no grupo de laser o grau de abertura final foi significativamente menor no grupo laser do que não-laser aos 7 e 14 dias, mostrando que a formação óssea no grupo laser foi mais acelerada, o que pode ser comprovado com os dados histológicos, demonstrando que o laser acelerou o processo de formação óssea. Em relação à expressão relativa dos genes RANK/RANK-L/OPG tanto o grupo com laser quanto o sem-laser mostraram um aumento significativo da expressão comparado ao grupo controle (p < 0,05), principalmente nos períodos iniciais e quando comparou-se o grupo irradiado com o não irradiado observou-se que no grupo com laser houve uma maior expressão desses genes do que no grupo sem laser. CONCLUSÃO: Os resultados sugerem que a formação óssea após a ERM foi observada dentro da sutura palatina e o uso do LBP influenciou a formação óssea acelerando o processo de osteogênese durante a fase inicial do experimento.BACKGROUND: The use of low-level laser terapy with bone stimulation has been studied in the health science field. OBJECTIVE: The aim of the present in vivo study was to quantitatively evaluate the effects of low-level laser therapy (LLLT) on bone healing after rapid maxillary expansion (RME) in young rats, and the RANK, RANK-L, OPG and VEGF gene expressions; and histological analyses. MATERIALS and METHODS: A total of 105 rats Wistar (Rattus norvegicus, albinus), male were assigned tofour groups: Control Group (n=10) with no treatment (no RME and no LLLT); Experimental I (n=40) with RME without LLLT: 25 animals were euthanized at days 1, 2, 3, 7 and 10 after RME for real time reverse transcriptase polymerase chain reaction (RT-PCR) and western blotting analysis and 15 animals were euthanized at days 0, 7 and 10 after RME for histological evaluation; Experimental II (n=40) with RME and LLLT (160J/cm2): animals were euthanized at the same periods described for Experimental I. Experimental III (n=15) with RME and 3 aplication of LLLT (480J/cm2): animals were euthanized at days 3, 7 and 10 after RME for real time reverse transcriptase polymerase chain reaction (RT-PCR) and western blotting analysis. Part of the sample was kept at -80°C for genes expression and protein production, and another for histological analysis. The total RNA was extracted using trizol. Complementary DNA (cDNA) was synthesized using 1µg of RNA in a reverse transcription reaction and for genes expression we used RT-PCR in the TaqMan® system. The RANK, RANK-L, OPG, and VEGF and proteins analysis was made using western blotting. The ANOVA and Tukey tests were used and significance level was set at 5%. RESULTS: The expansion-induced opening of the incisors was similar among the groups, the space between the incisors was kept during all the experimental phase and there was no difference between laser and no laser therapy groups (p<0,05) showing that this methodology was efficient to open the palatine suture. The the opened along the suture was quantified, the area in all RME groups significantly increased compared with control group. Following laser therapy, the palatal suture opening decreased at 7 and 14 days, showing that bone formation in laser group was accelerate, and it was proved with histological analysis, that showed that LLLT accelerated bone formation. Regarding RANK/RANK-L/OPG gene expression, both laser and no-laser therapy groups showed a significant increased in these genes expression, compared to the control group, mainly at the initial periods of healing. Laser therapy group showed a higher expression of these genes than no laser group. CONCLUSIONS: The results suggest that bone formation after RME was observed within palatal suture and the application of the LLLT influenced bone formation accelerating the process of bone mineralization during the initial experimental phase.
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Oliveira, Thais Feitosa Leitão de. "Avaliação da influência do septo nasal na expansão de maxila cirurgicamente assistida por meio de tomografia computadorizada de feixe cônico." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/25/25149/tde-10102014-163019/.
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A expansão da maxila cirurgicamente assistida (EMCA) é um procedimento cirúrgico indicado para a correção da atresia maxilar em pacientes que já atingiram a maturação óssea. Os efeitos da EMCA são observados não só nos arcos dentários, maxilas e mandíbula, mas também na cavidade nasal, já que o septo nasal encontra-se localizado no centro do assoalho nasal, apoiado sobre a sutura palatina mediana. O objetivo deste estudo foi identificar a posição do septo nasal antes e após a separação cirúrgica das maxilas e avaliar sua influência na movimentação da maxila do lado que foi deslocado. Foram avaliadas 56 tomografias computadorizadas de feixe cônico (TCFC) adquiridas no tomográfo i-CAT Classic®, com voxel de 0,3mm, de 14 indivíduos submetidos à EMCA nos períodos préoperatório e pós-operatório de 15, 60 e 180 dias. Inicialmente, as imagens pósoperatórias foram visualizadas nas reformatações multiplanares, para identificar a qual maxila, direita ou esquerda, o septo nasal permaneceu ligado após a EMCA. Numa segunda etapa, foram realizadas medidas lineares nas imagens correspondentes aos períodos pré e pósoperatórios. Essas medidas foram realizadas na reformatação axial imediatamente acima do aparelho expansor, de forma padronizada para cada paciente, e consistiram da distância entre uma linha de referência central, que passava na espinha nasal anterior e no centro do forame incisivo, dividindo o paciente em lado direito e esquerdo, até os caninos e molares direitos e esquerdos. O índice kappa intraexaminador foi > 0,9. Para comparar as diferenças entre as médias dos dois grupos (lado ligado ao septo nasal e não ligado ao septo nasal) foi utilizado o teste t. Em 78,6% dos pacientes o septo nasal permaneceu ligado à maxila esquerda e em 21,4%, ligado à maxila direita. Em relação às medidas lineares, tanto na região de caninos como na região de molares, observouse que, no período pré-operatório, não havia diferença entre os lados direito e esquerdo. Após a EMCA, houve diferença estatisticamente significante (p<0,05), observando que houve menor movimentação da maxila a qual o septo nasal permaneceu ligado. Portanto, podese concluir que a expansão maxilar ocorre de forma assimétrica, pois a maxila que permanece ligada ao septo nasal, após a EMCA, movimenta-se menos do que a maxila não ligada ao septo nasal.The Surgically assisted rapid palatal expansion (SARPE) is a surgical procedure indicated for the correction of maxillary constriction in adult patients. The effects of EMCA are observed not only in dental, maxillary, and mandibular arches, but also in the nasal cavity, since the septum is located in the center of the nasal floor and rests on the median palatine suture. The purpose of this study the position of the nasal septum before and after surgical separation of the maxillary, was to identify and evaluate their influence on the movement of the jaw which remained attached. Fifty six cone beam computed tomography (CBCT) scanner acquired i-CAT Classic, with 0.3 mm voxel. Fourteen individuals submitted to SARPE in the preoperative and postoperative periods of 15, 60, and 180 days which were evaluated. Initially, postoperative images were visualized using multiplanar reformatting to identify which jaw, right or left, the nasal septum remained bound after the SARPE. In a second step, linear measurements in the images corresponding to the pre- and postoperative periods were performed. These measurements were performed in the axial immediately above the expander reformatting, standardized form for each patient, and consisted of the distance from a central reference line, passing the anterior nasal spine and the center of the incisive foramen, dividing the patient\'s right side and left to the canines and molars on the right and left. The intraobserver kappa index was > 0.9. To compare the differences between the means of two groups (side connected to the nasal septum and not connected to the nasal septum) a t test was used. In 78.6% of patients, the nasal septum remained attached to the left maxilla and 21.4% on right jaw. Regarding linear measurements, both in the region of canines as in the molar region, it was observed that, in the preoperative period, there was no difference between the right and left sides. After the SARPE, a statistically significant difference (p < 0.05) was observed, noting that there was less movement of the maxilla which the nasal septum remained connected. Therefore, it can be concluded that the expansion jaw is asymmetrical because the jaw remains on the nasal septum after SARPE and moves less than maxilla not connected to the nasal septum.
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Vinha, Pedro Pileggi. "Efeitos da expansão rápida da maxila cirurgicamente assistida na síndrome da apneia obstrutiva do sono, na sonolência diurna e na morfologia da via aérea." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/17/17151/tde-07072015-080513/.
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A apneia obstrutiva do sono é uma síndrome que produz múltiplas comorbidades, aumentando significativamente a taxa de mortalidade dos seus portadores. A atresia maxilar vem sendo descrita como um dos fatores etiológicos da SAOS, entretanto não existem estudos que demonstrem a eficácia no tratamento em adultos com consequente redução dos eventos obstrutivos durante o sono. Este trabalho tem como objetivo principal a verificação da expansão rápida da maxila cirurgicamente assistida (ERMCA), nos eventos obstrutivos do sono e demais parâmetros polissonográficos, na sonolência diurna e no comportamento morfométrico da via aérea. A amostra foi realizada em indivíduos adultos com apneia obstrutiva do sono (SAOS), atresia maxilar e mordida cruzada. O método adotado foi um ensaio clínico prospectivo com 16 participantes (7 mulheres / 9 homens) com idade de 40,23 ± 10,23, todos portadores de SAOS comprovada por polissonografia (PSG) de noite toda (IDR superior a 5), atresia maxilar e mordida cruzada posterior. Previamente todos participantes foram submetidos a uma tomografia computadorizada (TC) da via aérea superior e foi aplicado o teste da Escala de Sonolência de Epworth (ESE). Todos os pacientes foram então submetidos à ERMCA, e posteriormente, todos os exames foram refeitos para comparação. Foi constatada uma redução no IDR de 35,46 ± 38,54 para 16,07 ± 19,73, uma redução média de 54,68% (p=0,0013) e no IAH em 56,24% (33,23 ± 39,54 para 14,54 ± 19,48: p=0,001), uma redução dos índices de microdespertares e dessaturação, além da melhora de diversos parâmetros polissonográficos. O ESE apresentou uma melhora de 12,50 ± 5,32 para 7,25 ± 3,53 (p<0,001). A via aérea total ampliou em média 23,99% (p=0,016), mas de uma maneira mais expressiva na sua metade inferior (28,63% p=0,008). Em relação aos resultados obtidos por meio da ERMCA observou-se uma melhora da SAOS, redução dos índices relacionados aos distúrbios respiratórios durante o sono, de microdespertar e de dessaturação, ampliação da via aérea, principalmente na metade inferior, além de melhorar a sonolência diurna, devolvendo- a para a normalidade.Obstructive sleep apnea syndrome (OSAS) is a condition that produces multiple comorbidities, significantly increasing the mortality rate of affected individuals. Maxillary atresia is being described as one of the etiological factors of OSAS, although there are no studies demonstrating the efficacy of treatment in adults with a consequent reduction of obstructive events during sleep. The main objective of the present study was to determine the effects of surgically assisted rapid maxillary expansion (SARME) on obstructive sleep events and all other polysomnography (PSG) parameters, on daytime sleepiness and on the morphometric behavior of the airways. The study was conducted on adult individuals with OSAS, maxillary atresia and crossbite. The method involved a prospective clinical assay with 16 participants (7 women/9 men) aged 40.23 ± 10.23 years, with OSAS confirmed by all-night PSG (respiratory disorder index (RDI) higher than 5), maxillary atresia and posterior crossbite. All participants were first submitted to computed tomography of the upper airways and to the Epworth Sleepines Scale (ESS) test. All patients were then submitted to SARME and all exams were later repeated for comparison. RDI was reduced from 35.46 ± 38.54 to 16.07 ± 19.73, (a mean reduction of 54.68%, p=0.0013), the apnea-hypopnea index (AHI) was reduced from 33.23 ± 39.54 to14.54 ± 19.48 (a mean reduction of 56.24%, p=0.001), and micro-awakenings and desaturation were also reduced. The ESS score improved from 12.50 ± 5.32 to 7.25 ± 3.53 (p<0.001). Mean total airway area was increased by 23.99% (p=0.016), although in a more expressive manner in the lower half (28.63%, p=0.008). The results obtained by SARME revealed an improvement of OSAS, a reduction of the indices related to respiratory disorders during sleep, of micro-awakennings and of desaturation, as well as airway expansion, especially in the lower half, and improvement of daytime sleepiness with a return to normality.
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Melo, Maria de Fatima Batista de. ""Avaliação da densidade óptica da sutura palatina mediana por meio do sistema de radiografia digital por placa fotoativada em pacientes submetidos a disjunção palatina"." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-18032004-072513/.
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RESUMO A Expansão Rápida da Maxila é um recurso clínico adotado pelos ortodontistas no tratamento das más oclusões com deficiência transversa real ou relativa da maxila. Esta, inclui uma fase ativa, promovendo a desarticulação dos ossos maxilares por meio da sutura, e uma fase passiva, onde uma série de eventos levam à remodelação óssea e restauração da sutura, com o aumento clínico na largura do palato. Discute-se qual a melhor época para a disjunção e o tempo necessário para que haja a perfeita remodelação óssea. A radiografia oclusal assume aqui um importante papel, pois é por meio desta que se obtém a imagem da sutura palatina mediana permitindo uma análise descritiva de suas condições em todas as etapas do tratamento A nossa proposta no presente estudo, foi a de medir as densidades ópticas da sutura palatina mediana antes da disjunção (Fase I), imediatamente após a disjunção, (Fase II) e após contenção de três meses (Fase III), usando um sistema de imagem digital, comparando-as e correlacionando-as com a radiografia oclusal convencional. A amostra, constituída por 31 (trinta e um) pacientes que se submeteriam à disjunção palatina e que se encontravam em fase de crescimento, foi dividida em:grupo I, constituído pelos pacientes de dentadura mista e grupo II, pelos pacientes de dentadura permanente. Foram obtidas radiografias oclusais e imagens digitais nas fases Fase I, Fase II e na Fase III. Áreas de interesse foram demarcadas nas radiografias digitais, procedendo-se a leitura das densidades ópticas pelo programa Digora for Windows-2.1, e comparando os resultados entre si e com a avaliação subjetiva feita nas radiografias oclusais. Após a análise dos dados pelo teste t de Student pareado, pode-se concluir que 1) as densidades ópticas da sutura palatina mediana na fase final, mostram valores inferiores aos da fase inicial nos pacientes do grupo I; 2) as densidades ópticas da sutura palatina mediana na fase final, mostram valores semelhantes aos da fase inicial nos pacientes do grupo II; 3) as densidades ópticas finais da sutura palatina mediana não correspondem às iniciais nos pacientes do sexo feminino do grupo I; 4) as densidades ópticas finais da sutura palatina mediana são semelhantes às iniciais nos pacientes do sexo masculino do grupo II; 5) para os pacientes do grupo II não houve diferença significante entre os valores de densidade óptica inicial e final, tanto no sexo masculino como feminino; 6) os resultados encontrados nas imagens digitais são compatíveis com os encontrados nas radiografias oclusais convencionais.SUMMARY The Fast Expansion of the Jaw is a clinical resource adopted by the ortodontists in the treatment of the bad occlusions with real or relative deficiency transversal, of the jaw. This, includes a phase, promoting the disarticulation of the maxilarys bones by means of the suture, and a passive phase, where a series of events takes to the bone remodelling and restoration of the suture, with the clinical increase in the width of the palate. The best time for the disjunction and the necessary time is argued which so that it has the perfect bone remodelling. The oclusal radiography assumes an important role here, therefore it is for way of this that if gets the image of the medium palatine suture allowing to a descriptive analysis of its conditions in all the stages of the treatment our proposal in the present study, was to measure the optic densities of the medium palatine suture before the disjunction (Phase I), immediately after the disjunction, (Phase II) and after containment three months (Phase III), using a system of digital image, comparing and correlating them with the conventional oclusal radiography. The sample, consisting of 31 (thirty one) patient that would submitted the palatine disjunction and that found in growth phase, divided in Grave I, constituted of the patients of mixing set of teeth and group II, for the permanent set of teeth patients. Oclusal radiography and digital images in the phases had been gotten Phase I, Phase II and in Phase III. Areas of interest had been demarcated in the digital x-rays, proceeding it reading from the optic densities for the Digora program for Windows-2.1, and comparing the results among themselves. With the subjective evaluation in the oclusal radiographies.(After the analysis of the data by student T test could be concluded that1) the opitic densities of the medium palatine suture in the final phase, show inferior values to the ones of the initial phase in the patients of group I;2) the optic densities of the medium palatine suture in the final phase, show similar values to the ones of the initial phase in the patients of group II;3) the final optic densities of the medium palatine suture do not correspond to the initials in the patients of the female groupI;4) the final opitic densities of the medium palatine suture are similar to the initials in the patients of the male group II;5) for the patients of group II it did not have significant difference betweenthe values of initial and final opitic density, as much in the male and female groups6) the results found in the digital images are compatible wit those found in the conventional oclusal radiographics.
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Abrahão, Tatiana Sumie Kawahara. "AVALIAÇÃO CEFALOMÉTRICA DAS ALTERAÇÕES SAGITAIS E VERTICAIS EM PACIENTES SUBMETIDOS À EXPANSÃO RÁPIDA DA MAXILA ASSISTIDA CIRURGICAMENTE." Universidade Metodista de São Paulo, 2006. http://tede.metodista.br/jspui/handle/tede/1228.
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Previous issue date: 2006-03-08This current study aims at cephalometrically evaluating the skeletal,dental, and soft tissues sagittal and vertical alterations in patients who underwent surgically assisted rapid maxilla expansion. The sample comprised 17 teleradiographs in lateral norm of 17 Brazilian adult subjects, being 6 male subjects and 11 female subjects, with average age of 24 years and 1 month, presenting a severe transverse deficiency of the maxilla. Teleradiographs were taken at the beginning of treatment (T1), after SARME (T2), and after three months in retention with the disjunctive appliance (T3). According to the analysis and discussion of the results achieved, it was seen a clock-wise rotation of both the maxilla and mandible, presenting, as consequence, an increase of the AFAI. After three months in retention therapy, there was a relapse of this behavior. It was also seen an extrusion of the upper incisors, in which was kept during the retention period. During retention, there was also a retrusion of the upper incisors. As for the upper molars, there was an extrusion after expansion, followed by a minor relapse when compared to the effect of the expansion achieved. There was no alteration of the soft tissues regarding the nasal thickness. And, there was a retrusion of the upper and lower lips, and the soft pogonion, following the skeletal part. There was an increase of the nasolabial angle.
O presente estudo teve como objetivos avaliar cefalometricamente as alterações esqueléticas, dentárias e de tecidos moles, no sentido sagital e vertical em pacientes submetidos à expansão rápida da maxila assistida cirurgicamente. A amostra constituiu-se de 51 telerradiografias em norma lateral de 17 pacientes adultos, brasileiros, sendo 6 do sexo masculino e 11 do sexo feminino, com idade média de 24 anos e 1 mês e severa deficiência transversa da maxila. As telerradiografias foram obtidas no início do tratamento (T1), após o procedimento de ERMAC (T2), e após três meses de contenção com o próprio aparelho disjuntor (T3). A partir da análise e discussão dos resultados, observouse rotação da maxila e da mandíbula no sentido horário, havendo, como conseqüência, aumento da AFAI. Após 3 meses de contenção, houve recidiva considerando-se o aumento da AFAI. Houve extrusão dos incisivos superiores, na qual foi mantida no período de contenção. Durante a contenção, houve também retrusão dos incisivos superiores. Considerando-se aos molares superiores, houve extrusão após a expansão, acompanhada de uma recidiva com menor magnitude quando comparada ao efeito da expansão obtida. Não houve alteração dos tecidos moles quanto a espessura nasal e houve retrusão do lábio superior, lábio inferior e pogônio mole, acompanhando a parte esquelética. Houve aumento do ângulo nasolabial.
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Silvano, Paula Regina Avila. "Efeito do laser de baixa potência na vascularização da sutura palatina mediana, após a expansão rápida da maxila, em ratos wistar." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/58/58135/tde-14122015-094927/.
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INTRODUÇÃO: O laser de baixa potencia vem sendo utilizado em Odontologia com diversos objetivos, como diminuir o tempo de reparação de tecidos moles e duros. OBJETIVO: O presente trabalho in vivo teve como objetivo avaliar quantitativamente os efeitos do laser de baixa potência (LBP) com diodo de GaAlAs (Galio-aluminioarsenieto), na vascularização dos tecidos da sutura palatina mediana após a expansão rápida da maxila (ERM) em ratos jovens, através da expressão do RNAm do gene Fator do Crescimento do Endotélio Vascular (VEGF) e da expressão protéica bem como a análise histológica. MATERIAL E MÉTODO: Utilizou-se 70 ratos Wistar (Rattus norvegicus, albinus), machos, pesando em media 220g, divididos em 3 grupos: Grupo Controle (n=10) animais não tratados (sem ERM e sem aplicação do LBP; Grupo Experimental I (n=30) animais que tiveram apenas a ERM. Grupo Experimental II (n=30) animais que receberam 3 aplicações de LBP (nos primeiros 3 dias do experimento) após ERM, totalizando 160J/cm2. Os animais do Grupo Controle foram sacrificados no dia 0 e os os animais dos Grupos Experimentais I e II sacrificados nos dias 3, 7, e 10 dias após a ERM, sendo 15 animais destinados a analise com RT-PCR e western blotting e 15 animais a analise histológica. A extração do RNAt da maxila foi feita com trizol. A síntese da fita de DNA complementar (cDNA) foi feita a partir de 1μg de RNA, por meio de uma reação de transcrição reversa, com a utilização da enzima transcriptase reversa, e a analise da expressão gênica foi realizada pela reação em cadeia pela polimerase em tempo real (qRT-PCR) no sistema TaqMan®. A análise protéica do VEGF, foi realizada por meio da técnica western blotting. Os dados foram agrupados e apresentados como médias e desvios-padrão (continuas variáveis) ou medianas, intervalos interquartil, e os valores mínimos (variáveis ordinais) e máximo. O teste de variância (ANOVA) foi usado comparando os grupos entre si e inter-grupos seguida pelo teste complementar de Tukey, com nível de significância de 5%. O teste Kruskal-Wallis, testes de Dunn (p <0,05) foram utilizados para mediana, amplitude interquartil, valores máximos e mínimos dos escores do número de células inflamatórias. RESULTADOS: Em relação a expressão relativa do gene VEGF tanto o grupo com laser quanto o sem-laser mostraram um aumento significativo da expressão comparado ao grupo controle (p<0,05), principalmente nos períodos iniciais e quando se comparou o grupo irradiado com o não irradiado observou-se que no grupo com laser houve uma maior expressão desses genes do que no grupo sem laser. CONCLUSÃO: Os resultados sugerem que a formação óssea após a ERM foi observada dentro da sutura palatina e o uso do LBP influenciou a formação óssea acelerando o processo de osteogênese e a vascularização durante a fase inicial do experimento.BACKGROUND: The low-level laser terapy (LLLT) has been used in Dentistry with many objectives. OBJECTIVE: The aim of the present in vivo study was to quantitatively evaluate the effects of low-level laser therapy (LLLT) Gallium- Aluminum-Arsenide (GaAlAs) on the vascularization after rapid maxillary expansion (RME) in young rats, and the VEGF gene and protein expressions; and histological analyses. MATERIALS and METHODS: A total of 70 rats Wistar (Rattus norvegicus, albinus), male, weighing 220g, were assigned to three groups: Control Group (n=10) with no treatment (no RME and no LLLT); Experimental I (n=30) with RME without LLLT; Experimental II (n=30) with RME and and 3 aplication of LLLT (160J/cm2). The rats of Control Group were euthanized at day 0 and the animals of Experimental I and II Groups were euthanized at days 3, 7 and 10 after RME for real time reverse transcriptase polymerase chain reaction (RT-PCR) and western blotting analysis and for histological evaluation. Part of the sample was kept at -80°C for genes expression and protein production, and another for histological analysis. The total RNA was extracted using trizol. Complementary DNA (cDNA) was synthesized using 1μg of RNA in a reverse transcription reaction and for genes expression we used RT-PCR in the TaqMan® system. The VEGF and proteins analysis was made using western blotting. Data were grouped and presented as means and standard deviations (continuous variables) or medians, interquartile ranges, and maximum and minimum values (ordinal variables). The ANOVA and Tukey tests were used and significance level was set at 5%. Medians, interquartile ranges, and maximum and minimum values of the numbers scores for cells inflamatory (P<0.05; KruskalWallis, Dunn tests). RESULTS: Regarding VEGF gene and protein expression, both laser and nolaser therapy groups showed a significant increased in these genes expression, compared to the control group, mainly at the initial periods of healing. Laser therapy group showed a higher expression of these genes than no laser group. CONCLUSIONS: The results suggest that bone formation after RME was observed within palatal suture and the application of the LLLT influenced bone formation accelerating the process of bone mineralization during the initial experimental phase.
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Chen-HsuanFu and 傅晨軒. "Mechanical Effects of Nonsurgical Rapid Maxillary Expansion." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/76709618765964233284.
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碩士國立成功大學
生物醫學工程學系
104
Rapid maxillary expansion is an orthodontic method to correct skeletal Class III, posterior cross-bite, narrow nasal cavity and maxillary width deficiency. Increasing maxillary arch circumference and posterior cross-bite may improve nasal respiration as well. The procedure produces forces to disrupt connective tissue and cause suture separation. There are few reports on evaluation of the effects of bone-borne expanders with or without surgical assistance rapid maxillary expansion. None of them was focused on the effects of bone-borne expanders with different position of mini-screws. The purpose of this study is to study the mechanical effects of nonsurgical rapid maxillary expansion with different locations of mini-screws. It is using a finite difference model to study the applied incremental displacements and stress distribution of the craniofacial structures. The study includes clinical follow up, finite element simulation and 3D printing model experiment. In this study, the patient is a 15-year old girl with maxillary transverse deficiency. She was subjected to the Bone-borne expander treatment from September, 2014 to March, 2015 in the Division of Orthodontics, Department of Stomatology of the National Cheng Kung University Hospital in Tainan, Taiwan. The finite element model is based on the digitized geometry of the cone-bean computer tomography scan. It includes teeth, alveolar bone, maxillary plane, mini-screws and mid-palatal suture. Four mini-screws are symmetrically implanted at the maxillary. The boundary condition is mini-screws displacement and the foramen magnum is fixed. The 3D co-ordinates origin point is on the end of suture. All materials were considered to be linearly elastic, homogeneous and isotropic. In the results, the mini-screws implanted near tooth significant influence the tooth displacement; The screws implanted near suture, the suture have expanded a partial. However, the whole suture expanding and tooth expanding is inconsistent. Screws implant near tooth, the type B, recommended for clinical application. In the experiment, we find the displacement of screw close to the expander when the screws and the expander are approaching separation. The material of mid-palatal suture is an important parameter; the suture is complex connective tissue and it cannot be simplified to a gap. This research provides the framework of maxillary expansion for future study. It uses computer-aided engineering to analysis the mechanical effect of the expander, mid-palatal suture and mini-screws, and also gives suggestion of mini-screws position to the dentist.
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Huang, Chien Tah, and 黃建達. "Maxillary Displacement after Expansion by Rapid Maxillary Expanders- an Animal Study." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/xfrcvj.
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碩士長庚大學
顱顏口腔醫學研究所
96
One of the contemporary techniques for maxillary protraction is combined use of hyrax-typed rapid maxillary expander and face mask. It is hypothesized that maxillary expansion disarticulates maxilla and makes maxillary protraction easier for facemask. However, the possible backward displacement of maxilla after expansion may reduce its effects. To overcome these disadvantages, we modified the hyrax-typed expander into a double-hinged configuration that is postulated to have a better anterior displacement of maxilla through expansion. The purpose of this animal study was to evaluate the effects of a new double-hinged rapid maxillary expander on the maxillary displacement. Twelve inbred 12-month-old cats were used and divided into two groups, each included six cats. The two groups were assigned respectively for comparison the patterns of maxillary displacement between the Hyrax and double-hinged expanders of underwent seven days of expansion and 1 mm per day. The maxillary displacements in sagittal and transverse planes were analyzed by using amalgam metallic implants and submental cephalograms. The intra-group changes were evaluated with Wilcoxon non-parametric signed rank t test while Mann-Whitney U test for inter-group differences. The maxilla showed anterior displacement in both the hyrax and the double-hinged expander groups. However, the amount of anterior displacement was significantly greater in the double-hinged expander groups （3.54 ± 0.89 mm vs. 1.62 ± 0.96 mm, P＝0.010）. The expansion patterns between the two groups were also different. The hyrax expander separated two maxillary halves in a more parallel way. The double-hinged expander expanded anterior part of maxilla more than its posterior part. Both results reflected the differences between expansion mechanics of the two type expanders. The double-hinged expander could displace cats’ maxilla forward effectively after expansion.
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Morra, Amani. "Long term skeletal effects of rapid maxillary expansion." 2006. http://hdl.handle.net/1993/20897.
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Francois, Camille. "3D evaluation of condylar changes after rapid maxillary expansion." Thesis, 2018. https://hdl.handle.net/2144/29854.
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INTRODUCTION: Orthopedic maxillary expansion, also commonly referred to as Rapid Maxillary Expansion (RME) is a widely used orthodontic technique for early treatment of skeletal transverse deficiencies1. Condylar changes in response to RME have been observed using a variety of imaging techniques such as tomograms2, magnetic resonance imaging3-4 and cone beam computerized tomography5. To this day, most of the studies have focused on changes in condylar position after RME but to best our knowledge, no study has examined the changes in condylar shape and volume in addition to position.
OBJECTIVES: The aim of this retrospective cohort study is to determine the long term effect of Rapid Maxillary Expansion (RME) on condylar shape, volume and orientation as well as on mandibular rotation.
METHOD: Pre- and post-expansion cone beam computerized tomography (CBCT) images of forty-four healthy subjects (mean age=11.8±2.06) who previously had undergone banded RME were selected from a CBCT repository. Due to extensive time range existing between the pre- and post-CBCTs (0.7-4.7y, average time = 2.4y ± 0.97), a stratified analysis was run to account for the subject’s growth. Two subgroups were created according to the Baccetti Cervical Maturation stage : a “growing” group (n=37, mean age=11.86y, diff CVM>1) and a “non-growing” group (n=7, mean age=11.73y, diff CVM<1). Linear, angular and volumetric changes as well as condylar surface area differences and changes in mandibular rotation were assessed on isolated 3D condyles using Mimics version 20.0 software (Materialise, Leuven, Belgium). The condyles were segmented by a plane passing through the sigmoid notch (Snp) and parallel to a Frankfort Horizontal derivative plane (FHD). Changes in mandibular rotation were evaluated by analyzing the alterations in the angle between mandibular plane and FHD plane before and after RME. Paired T test was performed to compare pre- and post- expansion for all variables stated above. Statistical significance was set at <0.05.
RESULTS: In the “growing” group, the right and left condylar heights and widths significantly increased by 0.61mm±1.19mm (p=0.0035), 0.80±1.26 (p=0.0005) and 1.01mm±0.95mm (p<0.0001), 0.89±0.93 (p<0.0001) respectively. The right and left condylar volumes significantly increased by 117.7mm3±149.3mm3 (p<0.0001) and 106.7mm3±133.5mm3 (p<0.0001), respectively. In the “non growing” group, the right condylar height and the right condylar width statistically increased by 1.56mm±1.65 and 0.42mm±0.42 respectively. The right and left condylar volumes also increased by 114.1mm3±104.3 and 141.5mm3±89.1 respectively. No statistically significant changes were found in condylar orientation and mandibular plane angle for either of the two sub-groups.
CONCLUSION: Right condylar height, width, and right and left volumes were significantly increased after rapid maxillary expansion. No statistically significant effect on condylar orientation and mandibular plane was found. Condylar growth still remains to be an important co-founding factor which potentially affected the results of our study. A control group will be required to assess the effects of growth in our current findings to limit the effects of growth on our results.
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Karaiskos, Nicholas. "Quantification of forces dissipated through bone when using rapid maxillary expansion." 2008. http://hdl.handle.net/1993/21196.
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Sicilia, Marco. "Correção da discrepância transversal do maxilar superior com expansão rápida." Master's thesis, 2019. http://hdl.handle.net/10284/8347.
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A deficiência transversal da maxila é uma componente muito frequente das maloclusões, tanto dentárias
como esqueléticas, geralmente acompanhadas de mordida cruzada posterior uni ou bilateral. Nestas
condições clínicas, a abordagem terapêutica de eleição é a expansão palatina, uma técnica que ganhou
um papel de liderança na ortodontia moderna como um método seguro, previsível e eficaz para corrigir
os déficits transversais da maxila numa ampla gama de condições clínicas.
Este trabalho tem como objetivo estudar os efeitos do uso do expansor rápido do palato sobre as
anomalias causadas pela discrepância transversal da maxila.Transverse maxillary deficiency is a very frequent component of malocclusions, both dental and skeletal, usually accompanied by uni or bilateral posterior crossbite. In these clinical conditions, the therapeutic approach of choice is palatal expansion, a technique that has gained a leading role in modern orthodontics as a safe, predictable and effective method to correct transverse maxillary deficits in a wide range of clinical conditions. This study aims to study the effects of the use of the rapid palatal expander on the anomalies caused by the transverse maxillary discrepancy.
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DiCosimo, Charles. "Analysis of nasal airway symmetry and pharyngeal airway following rapid maxillary expansion." Thesis, 2018. https://hdl.handle.net/2144/30019.
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OBJECTIVES: This retrospective cohort study tested the effect of Rapid Maxillary
Expansion (RME) on symmetrical volumetric changes in the nasal cavity. Volumetric
changes in overall nasal cavity, nasopharynx, and oropharynx were also assessed as well
as minimum cross-sectional width changes and molar angulation in association with
RME.
METHODS: CBCT scans of before and after RME treatment for 28 subjects (17 females,
11 males, average age 9.85 ± 2.42 years) were collected from a previously de-identified
database. All subjects were treated for maxillary constriction using banded hyrax
expanders. Mimics software was utilized to segment the nasal and pharyngeal airways
and create various compartments (left and right nasal cavity, nasopharynx, and
oropharynx) for volumetric analysis. Minimum cross-sectional width measurements and
maxillary first molar angulation were also assessed. Paired T-test was used to quantify
the changes brought about by expansion. Statistical significance was set at the 0.05 level.
RESULTS: Posterior expansion as measured between right and left greater palatine foramen
(GPF) averaged 2.41 mm (SD = 1.03 mm). There were statistically significant differences
in overall nasal cavity (2249.6 ± 2102.5 mm3), right nasal cavity (968.8 ± 1082.7), left
nasal cavity (1197.3 ± 1587.0), nasopharyngeal (1000.6 ± 917.7), and oropharyngeal
(2349.2 ± 2520.8) volumes. In comparing the right to left nasal cavity, no significant
changes were noted for initial volume, post-expansion volume, or pre to post-expansion
changes (T2-T1). For cross-sectional analysis, the right nasal cavity (0.13 ± 0.07 mm)
and left nasal cavity (0.11 ± 0.06 mm) showed significant increases in minimum crosssectional
width measurements. Initial maxillary molar angulation had no significant
correlation to initial nasal cavity volume on either side.
CONCLUSIONS: RME has significant benefits to increasing nasal and pharyngeal airway
cavity volumes in all segments of the airway. Nasal cavity expands symmetrically.
Minimum cross-sectional width of the left and right nasal cavities showed highly
symmetrical improvements. Initial maxillary molar angulation has no relationship to
initial nasal cavity volume.
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Grislain, Marie Anne Christine. "Effects of rapid maxillary expansion on nasal cavity: an evidence-based analysis." Master's thesis, 2021. http://hdl.handle.net/10284/10580.
Full textAbstract:
Today, rapid maxillary expansion (RME) is a practice commonly used by orthodontists. It corrects transverse deficiencies of the palate by separating the mid-palatal suture. However, RME does not only influence the palate. There are consequences on the anatomic components of the face including the nasal cavity.
A literature search was performed, in the databases such PubMed, Sage Journals, Trip Database, Science Direct and Research Gate, of articles published between 2012 and 2020, in English.
The present systematic review of the literature aims to assess the recent scientific evidence concerning the effects of RME on the nasal cavity and the consequences on the respiratory function.
Regardless of the means of radiological evaluation used, the results are all the same: the nasal cavity expands. However, the results on the effects of respiratory function differ depending on additional means of assessment such as rhinomanometry. It is this difference that will be discussed.Hoje, a expansão rápida da maxila (ERM) é uma prática comumente utilizada pelos ortodontistas. Ela corrige as deficiências transversais do palato, separando a sutura palatina mediana. No entanto, a ERM não tem efeito apenas no palato. Existem consequências nos componentes anatômicos da face, incluindo a cavidade nasal. Foi realizada uma pesquisa bibliográfica, nas bases de dados PubMed, Sage Journals, Trip Database, Science Direct e Research Gate, de artigos publicados entre 2012 e 2020, em inglês. A presente revisãosistemática da literatura tem como objetivo de avaliar as evidências científicas recentes sobre os efeitos da ERM na cavidade nasal e o impacto sobre a função respiratória. Independentemente do meio de avaliação radiológico utilizado, os resultados são todos iguais: a cavidade nasal se expande. No entanto, os resultados sobre os efeitos da função respiratória diferem dependendo de meios adicionais de avaliação, como a rinomanometria. É essa diferença que será discutida.
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Geran, Renée E. "Long-term stability of rapid maxillary expansion in the mixed dentition a report submitted in partial fulfillment ... for the degree of Master of Science in Orthodontics ... /." 1998. http://catalog.hathitrust.org/api/volumes/oclc/68801849.html.
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Gordon, Jillian Madeline. "Exploratory work on the effects of rapid maxillary expansion on nasal airway dimensions." Master's thesis, 2009. http://hdl.handle.net/10048/832.
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Thesis (M.Sc.)--University of Alberta, 2010.A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Medical Sciences - Orthodontics. Title from pdf file main screen (viewed on November 29, 2009). Includes bibliographical references.
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Wendling, Lisa K. "Short-term skeletal and dental effects of the acrylic-splint rapid maxillary expansion appliance a thesis submitted in partial fulfillment ... for the degree of Master of Science in Orthodontics ... /." 1997. http://catalog.hathitrust.org/api/volumes/oclc/68799895.html.
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Wen-Ching, Tsai, and 蔡文卿. "Dentofacial changes of combined double-hinged rapid maxillary expansion and protraction facemask therapy." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/13585570733507575166.
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碩士長庚大學
顱顏口腔醫學研究所
92
Objective: This study was designed to measure the dentofacial changes after using double-hinged rapid maxillary expander, which was designed to force the forward movement of teeth and maxilla, and protraction face mask. In order to move maxilla forward and enhance the results of the protraction facemask, alternate rapid maxillary expansions and constructions was used. Methods: Twenty consecutive subjects with unilateral cleft lip and palate (male: 14, female: 6) were included in this prospective study. Their average age was 12 year-old. All of the subjects were under gone rapid maxillary expansion and maxillary protraction treatment using double-hinged rapid maxillary expander and protraction facemask devices in a six months treatment duration. Pre-treatment (T1), post maxilla expansion (T2), and post maxilla protraction (T3) dental casts and lateral cephalograms were taken in order to measure the dentofacial changes of all the subjects. Results: In terms of dental changes, the results indicated that, during the expansion phase (T1-T2), the dental arch revealed V-shape expansion because the increasing degree of intercanine width was larger than intermolar width. Base on the reference line, the entire teeth were pushed forward. In terms of skeletal changes, a 1.70 mm forward movement of A point was observed at T1-T2 phase. During the protraction phase (T2-T3), A point moved forward 3.31 mm. During the total six months treatment (T1-T3), a total 5.01 mm of A point forward movement, and the mandible clockwise rotated was observed in this study. Conclusion: The application of double-hinged rapid maxillary expander and protraction facemask was an effective treatment course for the patients with unilateral cleft lip and palate. This course not only effectively created an anterior movement of maxilla but also pushed the entire teeth forward.
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Cameron, Christopher. "Short-term and long-term effects of rapid maxillary expansion a postanterior cephalometric and morphometric evaluation : a thesis submitted in partial fulfillment ... for the degree of Master of Science in Orthodontics ... /." 2000. http://catalog.hathitrust.org/api/volumes/oclc/68896416.html.
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Abbott, Diana Wolf. "Nasal cross-sectional area and nasal resistance before and after rapid maxillary expansion a thesis submitted in partial fulfillment ... in orthodontics ... /." 1986. http://books.google.com/books?id=lJo9AAAAMAAJ.
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McGill, Jean Seibold. "Orthodontic and orthopedic treatment effects induced by rapid maxillary expansion and facial mask therapy thesis submitted in partial fulfillment ... for the degree of Master of Science in Orthodontics ... /." 1995. http://catalog.hathitrust.org/api/volumes/oclc/68798510.html.
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