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Relationship between the position of maxilla and rapid maxillary expansion failure

Fatih Celebi
Sibel Akbulut

Puni tekst: engleski pdf 420 Kb

str. 49-54

preuzimanja: 225



Introduction: The palatal expansion may be a challenging treatment in late adolescents who has passed the peak of skeletal growth. The success rate of palatal expansion in these patients decreases due to decreased growth potential. Aim: The aim of this study was to determine whether there is a predictor that can be used in the failure of rapid maxillary expansion (RME) among investigated five cephalometric variables (related to maxillary position) and three other variables. Materials and methods: The records of the patients who had undergone RME therapy between 2013-2019 were evaluated. The patients were allocated into two groups according to expansion success: successful (S-RME) and failed (F-RME) RME groups. Fifty systemically healthy patients in the cervical vertebral maturation stage 5/6 were enrolled (35 females, 15 males). Eleven patients were (10 females, one male) in the F-RME group, and 39 patients were (25 females, 14 males) in the S-RME group. Five cephalometric variables (related to maxillary position) and three other variables (age, gender, and CVMS) were evaluated. Variables were subjected to multiple logistic regression analysis for setting a prediction model and detecting predictors. Results: Patients with CVMS-6 had a 16.8-fold higher risk of palatal expansion failure than CVMS-5. 1 mm anterior position of PNS increased the risk of failure 2.9 times. 1 mm reduction in the distance between the PNS and cranial base in the vertical direction increased 60% the risk of RME failure. Conclusion: The CVM stage of the patient, along with the vertical and sagittal position of the PNS, were found to be the possible predictors of RME success in late adolescence. Corresponding Author:Fatih Celebi Department of Orthodontics, Faculty of Dentistry, Tokat Gaziosmanpasa University, 60100 Tokat, TurkeyE-mail: fatihcelebi5860@gmail.comRelationship between the skeletal position ofmaxilla and rapid maxillary expansion failure INTRODUCTIONTransverse maxillary deficiency is one of the common skeletal disorders. The treatment includes nonsurgical and surgical treatment modalities. Rapid maxillary expansion (RME) is a method for correcting the transverse skeletal deficiency, which involves heavy force application to the maxilla transversally. The response to this force usually results in the separation of the maxillary halves by rupturing the mid-palatine suture.RME can be successfully achieved in pre-adolescent and adolescent periods without any surgical intervention due to the immature structure of the sutures. In adulthood, the maturation of the mid-palatal suture, along with the circummaxillary sutures, causes resistance to the expansion.1,2 The surgical assistance in the RME procedure (SARME) is the valid treatment option for these patients until sufficient evidence occurs that nonsurgical or bone-anchored RME treatments are feasible. However, the surgical approach requirement is a critical decision since the failure of RME without surgery causes further tissue destruction and complications such as mucosal ulceration or necrosis, accentuated buccal tooth tipping, gingival recession and severe pain around the posterior teeth.3-5 On the other hand, surgery preference in a case that could be treated without surgical assistance would make the patient suffer from an unnecessary operation, which is invasive, costly, and includes surgical risks.

Ključne riječi

Failure, Forecasting, Maxillary expansion

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