Korean J Orthod.  2022 Mar;52(2):131-141. 10.4041/kjod.2022.52.2.131.

Differences in dentoskeletal and soft tissue changes due to rapid maxillary expansion using a tooth-borne expander between adolescents and adults: A retrospective observational study

• An JS
• Seo BY
• Ahn SJ

• KMID: 2527457
• DOI: http://doi.org/10.4041/kjod.2022.52.2.131

Abstract

Objective
The purpose of this study was to compare the differences in dentoskeletal and soft tissue changes following conventional tooth-borne rapid maxillary expansion (RME) between adolescents and adults.
Methods
Dentoskeletal and soft tissue variables of 17 adolescents and 17 adults were analyzed on posteroanterior and lateral cephalograms and frontal photographs at pretreatment (T1) and after conventional RME using tooth-borne expanders (T2). Changes in variables within each group between T1 and T2 were analyzed using Wilcoxon signed-rank test. Mann–Whitney U test was used to determine the differences in the pretreatment age, expansion and post-expansion durations, and dentoskeletal and soft tissue changes after RME between the groups. Spearman’s correlation between pretreatment age and transverse dentoskeletal changes in the adolescent group was calculated.
Results
Despite similar amounts of expansion at the crown level in both groups, the adult group underwent less skeletal expansion with less intermolar root expansion after RME than the adolescent group. The skeletal vertical dimension increased significantly in both groups without significant intergroup difference. The anteroposterior position of the maxilla was maintained in both groups, while a greater backward displacement of the mandible was evident in the adult group than that in the adolescent group after RME. The soft tissue alar width increased in both groups without a significant intergroup difference. In the adolescent group, pretreatment age was not significantly correlated with transverse dentoskeletal changes.
Conclusions
Conventional RME may induce similar soft tissue changes but different dentoskeletal changes between adolescents and adults.

Keyword

Aging; Posteroanterior cephalometrics; Rapid maxillary expansion; Tooth-borne expander

Figure

• 

  Figure 1 Transverse dentoskeletal variables assessed on posteroanterior cephalogram. 1, nasal width: the longest distance between the left and right lateral bony walls of the nasal cavity; 2, maxillary width: the distance between the left and right jugal points (intersection of the maxillary tuberosity and outline of the zygomatic buttress); 3, intermolar root width: the distance between the left and right buccal root tips of the maxillary first molars; 4, intermolar crown width: the distance between the most lateral points on the buccal surfaces of the maxillary first molar crowns; and 5, intermolar angle: the angle between the lines connecting the most lateral point of the crown to the buccal root tip of both maxillary first molars.

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  Figure 2 Sagittal landmarks and the vertical reference plane assessed on lateral cephalogram. 1, nasion; 2, sella; 3, orbitale; 4, porion; 5, anterior nasal spine; 6, A point; 7, B point; 8, pogonion; 9, menton; 10, gonion; and 11, nasion perpendicular plane: a line perpendicular to the Frankfort horizontal plane and passing through the nasion.

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  Figure 3 Sagittal skeletal variables assessed on lateral cephalogram. 1, Frankfort-mandibular plane angle (FMA); 2, sella-nasion to mandibular plane angle (SN-MP); 3, lower anterior facial height (LAFH, distance between the anterior nasal spine and the menton parallel to the nasion perpendicular); 4, sella-nasion-A point (SNA); 5, sella-nasion-B point (SNB); 6, A point-nasion-B point (ANB); 7, A point to nasion perpendicular (A to N perp); and 8, pogonion to nasion perpendicular (Pog to N perp). A to N perp, Pog to N perp, and LAFH are linear measurements, while the remaining variables are angular measurements.

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  Figure 4 Soft tissue variables assessed on frontal photograph. 1, interpupillary distance: the distance between the left and right pupils; 2, alar width: the distance between the left and right alars; 3, nose length: the distance between the midpoint of the pupils and subnasale; 4, upper lip length: the distance between the subnasale and stomion; and 5, lip chin length: the distance between stomion and menton. Vertical measurements including the nose length, upper lip length, and lip chin length were measured as the distances parallel to the vertical bisector of the pupils.

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  Figure 5 Differences in the transverse dentoskeletal variable changes between the groups after rapid maxillary expansion. *Statistically significant difference (p < 0.05).

Reference

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