Adult maxillary expansion: CBCT evaluation of skeletal changes and determining an efficiency factor between force-controlled polycyclic slow activation and continuous rapid activation for mini-screw-assisted palatal expansion - MASPE vs. MARPE
Por:
Walter, A, Winsauer, H, Crespo, E, Walter, D, Winsauer, C, Schwärzler, A, Mojal, S, Arcos, I, Puigdollers, A
Publicada:
2 dic 2024
Resumen:
Aim This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before (T1) and after expansion (T2). Materials and methods The Force Controlled PolyCyclic (FCPC) SLOW palatal expansion group (FCPC-MASPE-G) comprised 35 adults aged 18-54 years and received a skeletal expander limiting expansive force only allowing 500 cN at the activation wrench (force control). Discontinuous, polycyclic activations according to the FCPC-protocol were applied. The MARPE-group (n = 6) underwent continuous RAPID activation without FCPC until the desired width was reached. CBCT scans were taken pre and post-expansion. Inclusion criteria for both groups were successful outcomes without surgical assistance. Results The maxilla opened transversally in both groups mildly V-shaped, with a pyramidal shape in the coronal plane, impacting the zygomatic bone. Width measurements at T2 indicated superior mechanical response in FCPC-MASPE-G. Response of zygomaticomaxillary sutures was similar in both groups (p < 0.001 to 0.025). Pterygoid process deformations were notably less in FCPC-MASPE-G (0.87-1.35 mm, p < 0.001) compared to MARPE-G (2.70-3.04 mm, p < 0.001 to 0.009). Dental measurements were similar (p < 0.001 to 0.023), but the ratio "Mid-palatal suture Opening Related to Expander opening" (M.O.R.E.-factor) was better with 84% in FCPC-MASPE-G than with 50% in MARPE-G. Conclusion Slow expansion with FCPC protocol effectively widens the maxilla in adults, with significant impact on bones and sutures and less pterygoid process deformation compared to rapid expansion. Cranial complications were absent in both groups.
Filiaciones:
Walter, A:
Univ Int Catalunya, Dept Oral Surg, Carrer Josep Trueta, Sant Cugat Del Valles, Barcelona, Spain
Winsauer, H:
Hosp Manuel Gea Gonzalez, Mexico City, Mexico
Crespo, E:
Hosp Manuel Gea Gonzalez, Mexico City, Mexico
Walter, D:
Univ Int Catalunya UIC, Barcelona, Spain
Winsauer, C:
Hosp Sant Pau, Barcelona, Spain
Schwärzler, A:
Med Univ Vienna, Univ Clin Dent, Dept Orthodont, Vienna, Austria
Mojal, S:
Hosp Sant Pau, Barcelona, Spain
Arcos, I:
Univ Int Catalunya UIC, Dept Orthodont, Barcelona, Spain
Puigdollers, A:
Univ Int Catalunya UIC, Dept Orthodont, Carrer Josep Trueta, Sant Cugat Del Valles 08195, Barcelona, Spain
gold
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