Comparison of the surgically assisted orthodontic rehabilitation techniques of patients with transversal maxillary defficiency

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Abstract

The article considers comparison of the outcomes of surgically assisted rapid palatal expansion with the use of tooth-borne and bone-borne expansion appliances in patients with transversal maxillary deficiency. 76 computed tomography scans of 38 patients (24 with bone-borne anchorage, 14 with tooth-borne ones) were studied. Examination of the expansion was performed before the treatment onset and after the activation of the screw of the distraction apparatus. Expansion was evaluated in the areas of canines, premolars and first molars. The maximal amount of the vestibular tooth crown inclination was revealed in premolars with tooth-borne appliances. The use of bone-borne appliances allows to achieve the greatest effect of tooth body shift in a vestibular direction.

About the authors

Andrey V. Nikolaev

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: nikolaev23@gmail.com

Assistant Professor, Department of Orthodontics

Russian Federation, Saint Petersburg

Sergey A. Popov

North-Western State Medical University named after I.I. Mechnikov

Email: sergey.popov@szgmu.ru

Doctor of Medical Sciences, Head of the Orthodontic Department

Russian Federation, Saint Petersburg

Elena A. Satygo

North-Western State Medical University named after I.I. Mechnikov

Email: elena.satygo@szgmu.ru

Doctor of Medical Sciences, Head of Department of Pediatric Dentistry

Russian Federation, Saint Petersburg

Mikhail A. Postnikov

Samara State Medical University

Email: postnikovortho@yandex.ru

Doctor of Medical Sciences, Associate Professor, Department of Dentistry of IPE

Russian Federation, Samara

References

  1. Николаев А.В., Андреищев А.Р., Кутукова С.И. Сравнение биомеханики хирургически ассоциированного расширения неба при использовании дистракционных аппаратов с назубным и накостным типами фиксации // Стоматология. – 2017. – Т. 96. – № 5. – С. 48–55. [Nikolaev AV, Andreishchev AR, Kutukova SI. Comparative biomechanical study of surgically assisted rapid palatal expansion with tooth-borne and bone-borne expanders. Stomatologiia (Mosk). 2017;96(5):48-55. (In Russ.)]. https://doi.org/10.17116/stomat201796548-55.
  2. Постников М.А. Оптимизация ортодонтического лечения детей с мезиальной окклюзией в период смены и после смены зубов: Автореф. дис… докт. мед. наук. – Самара, 2016. – 46 с. [Postnikov MA. Optimizatsiya ortodonticheskogo lecheniya detey s mezial’noy okklyuziyey v period smeny i posle smeny zubov. [dissertation abstract] Samara; 2016. 46 р. (In Russ).] Доступно по: https://search.rsl.ru/ru/record/01006647024. Ссылка активна на 14.09.2019.
  3. Betts NJ, Vanarsdall RL, Barber HD, et al. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg. 1995;10(2):75-96.
  4. Gauthier C1, Voyer R, Paquette M, et al. Periodontal effects of surgically assisted rapid palatal expansion evaluated clinically and with cone-beam computerized tomography: 6-month preliminary results. Am J Orthod Dentofacial Orthop. 2011;139(4 Suppl):S117-128. https://doi.org/10.1016/j.ajodo.2010.06.022.

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2. Fig. 1. Interapical and intercoronal measurements before the treatment onset (a) and after the end of the expansion (b): X1 — intercoronal distance before treatment; X2 — intercoronal distance after maxillary expansion; Y1 — interapical distance before treatment; Y2 — interapical distance аfter maxillary expansion

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3. Fig. 2. Expansion of the apices of the teeth with the application of tooth-borne and bone borne appliances

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4. Fig. 3. Expansion of the crowns of the teeth with the application of tooth-borne and bone borne appliances

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5. Fig. 4. Apparatus with the tooth-borne anchorage. First molars are moved by stainless steel band. Premolars are moved under the pressure of the metal framework

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6. Fig. 5. Patient E., 26 y.o., mesial occlusion, transversal maxillary deficiency

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7. Fig. 6. Digital diagnostic models of patient before the onset of the treatment

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8. Fig. 7. Significant contraction of the maxilla

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9. Fig. 8. Cephalometric evaluation. III skeletal class, upper incisors protrusion is 5°, lower incisors retrusion is 4°

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10. Fig. 9. Imposition of the digital model of the maxilla on the computed tomography scans

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11. Fig. 10. Interapical and intercrown measurements

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12. Fig. 11. Standard appliance with a bone-borne anchorage

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13. Fig. 12. Diastema as a result of the use of distraction apparatus: a — before the onset of thetreatment; b — 5 days after the surgical procedure; c — 15 days after the expansion

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14. Fig. 13. Imposition of the computed tomography scans before (white colour) and after (blue colour) surgically assisted rapid palatal expansion

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Copyright (c) 2020 Nikolaev A.V., Popov S.A., Satygo E.A., Postnikov M.A.

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