Dataset Information

Mini Hyrax vs Hyrax expanders in the rapid palatal expansion in adolescents with posterior crossbite: a randomized controlled clinical trial.

ABSTRACT:

Purpose

The aim of this study was to compare the dental effects, impact on quality of life, and pain perception of adolescents wearing Mini Hyrax and Hyrax expanders in rapid palatal expansion.

Methods

Thirty-four adolescents aged 11 to 16 years, with maxillary transverse deficiency (unilateral or bilateral posterior crossbite), were randomly allocated into two groups, Mini Hyrax group and Hyrax group (1:1 ratio). Dental effects were evaluated by digitally superimposed pretreatment and postretention three-dimensional intraoral scans on the palatal rugaes using the software 3DSlicer. Impact on quality of life was assessed with the OHIP-14 questionnaire applied in the pretreatment, posttreatment and postretention. Visual analog scale was applied 24, 48, and 72 h and 7 days after the first activation of the expander.

Results

Thirty of the 34 adolescents recruited completed the study. There were no statistically significant differences in dentoalveolar effects between groups. OHIP-14 scores across time among Mini Hyrax wearers were similar to those of the Hyrax wearers. The inter-group comparisons showed no difference between groups with respect to the OHIP-14 scores in posttreatment and postretention (p > 0.05). There were no differences in pain perception between groups. Considering intra-group comparison, the reduction in pain perception among adolescents in the Mini Hyrax group was gradual. Among adolescents in the Hyrax group, a statistically significant reduction between 48 and 72 h was observed.

Conclusion

There were no significant differences in dental effects, impact on quality of life and pain perception between adolescents wearing Mini Hyrax and Hyrax expanders in rapid palatal expansion.

SUBMITTER: Silveira GS

PROVIDER: S-EPMC8408292 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundMiniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its efficacy.ObjectivesThis systematic review aims to evaluate the efficacy of MARPE in late adolescents and adults by assessing success rate and skeletal and dental transverse maxillary expansion, as well as treatment duration, dental and periodontal side effects and soft tissue effects.Search methodsSeven electronic databases were searched (MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, ProQuest and ClinicalTrials.gov) without limitations in November 2020.Selection criteriaRandomized and non-randomized clinical trials and observational studies on patients from the age of 16 onwards with transverse maxillary deficiency who were treated with MARPE and which included any of the predefined outcomes.Data collection and analysisInclusion eligibility screening, data extraction and risk of bias assessment were performed independently in duplicate. When possible, exploratory meta-analyses of mean differences (MDs) with their 95% confidence intervals (CIs) were conducted, followed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis of the evidence quality.ResultsEight articles were included: two prospective and six retrospective observational studies. One study had a moderate risk of bias, whereas seven studies had a serious risk of bias. GRADE quality of evidence was very low. MARPE showed a high success rate (mean: 92.5%; 95%CI: 88.7%-96.3%), resulting in a significant skeletal width increase (MD: 2.33 mm; 95%CI: 1.63 mm-3.03 mm) and dental intermolar width increase (MD: 6.55 mm; 95%CI: 5.50 mm-7.59 mm). A significant increase in dental tipping, a decrease in mean buccal bone thickness and buccal alveolar height, as well as nasal soft tissue change was present (P < 0.05). The mean duration of expansion ranged from 20 to 126 days.LimitationsOne of the main drawbacks was the lack of high-quality prospective studies in the literature.Conclusions and implicationsMARPE is a treatment modality that is associated with a high success rate in skeletal and dental maxillary expansion. MARPE can induce dental and periodontal side effects and affect peri-oral soft tissues. Given the serious risk of bias of the included studies, careful data interpretation is necessary and future research of higher quality is strongly recommended.RegistrationPROSPERO (CRD42020176618).FundingNo grants or any other support funding were received.

Project description:BACKGROUND:Correcting posterior crossbite in adult patients using nonsurgical methods may involve buccolingual tooth movement. Knowing the extent of the pretreatment alveolar bony dehiscences and fenestrations in the posterior area will aid orthodontists in planning posterior crossbite patients accordingly to minimize posttreatment bony defects. Before the advent of cone beam computed tomography (CBCT), observing buccal and lingual bony defects was not possible unless other treatment needs allowed for an open-flap procedure. With CBCT technology, we can now detect posterior defects with some accuracy. The aim of the present study was to determine the prevalence of posterior alveolar bony dehiscence and fenestration in adults with posterior crossbite compared with noncrossbite adults. METHODS:The study group consisted of pretreatment CBCTs of 28 samples with at least one or more teeth in posterior crossbite or edgebite. The comparison group consisted of pretreatment CBCTs of 28 samples with no posterior crossbite or edgebite. All buccal and lingual sides of the upper and lower posterior segments were measured for the presence of dehiscence, fenestration, and combined total bony defects. RESULTS:The prevalence of total bony defects was higher in the study group (61.6%) than in the comparison group (52.1%) (p < 0.05). While there was no difference in prevalence between crossbite teeth in the study group and noncrossbite teeth in the comparison group, the noncrossbite teeth in the study group showed a higher prevalence of total bony defects, dehiscence, and fenestration than the noncrossbite teeth in the comparison group (p < 0.05). The prevalence of dehiscence was higher in the study group (41.2%) than in the comparison group (33.3%) (p < 0.05). Neither the prevalence of fenestration nor the mean bony defect size showed statistical significance between the two groups. First premolars showed a higher prevalence of dehiscence than other posterior teeth, and maxillary posterior teeth had a higher prevalence of fenestration than mandibular posterior teeth. Among the maxillary posterior teeth, second premolars had the least amount of fenestration. CONCLUSIONS:Adult subjects with posterior crossbite had a higher prevalence of total bony defects and dehiscence, especially buccal dehiscence, in the posterior region than subjects with no posterior crossbite. This was due to the high prevalence observed in the noncrossbite teeth in posterior crossbite subjects.