Posterior Crossbite
Conditions
Brief summary
The aim of this study is to evaluate and compare the effect of rapid maxillary expansion with and without microosteoperforation in patients with skeletal maxillary constriction.Theoretically, the force generated by the activation of the Hyrax expander leads initially to the compression of the periodontal ligament, bending of the alveolar bone, and tipping of the anchor teeth. This in turn contributes to the unfavorable changes in the supporting tissues; such as root resorption, buccal crown tipping, reduction of buccal bone thickness, marginal bone loss and alveolar bone fenestration and dehiscence. In this trial, it is assumed that by reducing the cortical bone resistance, using micro-osteoperforation (MOP), the alveolar bone bending and buccal tipping that usually occur during expansion will be reduced and thus facilitating the bone expansion.
Detailed description
The study consists of 2 groups that are divided divided equally and randomly.The first group will receive a tooth borne Hyrax expander supported on first premolar and first permanent molar , whereas the second group will receive the same appliance associated with microosteoperforation(MOP). The MOP will be performed on the buccal segment bilaterally along the maxilla starting from the distal of the canine till the distal of the first permanent molar. The assessment will be done using CBCT scans immediately after expansion and 6 months postretention.
Interventions
DEVICEtooth borne hyrax expander
ready made four stainless steel bands will be supported on the first premolars and first permanent molars and to which the palatal expander will be soldered to form the Hyrax,.The appliance will be activated one quarter turn per day untill reaching maximum amount of lateral expansion of the jack screw. the patients will be recalled twice per week to evaluate the progress of treatment.
PROCEDUREmicroosteoperforation
ready made four stainless steel bands supported on the first premolars and first permanent molars and to which the palatal expander will be soldered to form the Hyrax.No activation will be provided to the hyrax expander before the micro-osteoperforation is performed. Microosteoperforation will applied bilaterally on the buccal surface between the roots of teeth at the level of mucoginival junction, starting from the distal of canine till the distal of the first permanent molar using a small sized surgical bur mounted on a hand piece .
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
11 Years to 14 Years
Healthy volunteers
Yes
Inclusion criteria
* Female adolescent patients with an age range 11- 14 years. * Having apical constricted maxillary arch reflected by posterior cross-bite and verified through Howe's analysis on the dental study models. * Normal vertical growth pattern. * Fully erupted maxillary first premolars and first permanent molars.
Exclusion criteria
* Previous orthodontic treatment. * Any congenital anomalies, systemic disease, or asymmetries that might have an influence on tooth movement. * Active periodontal affection or severe gingival inflammation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dental tipping. | an average1 year | it will be measured in degree on Cone beam computed tomography image using a software |
| Alveolar bending | an average1 year | it will be measured in degree on Cone beam computed tomography image using a software |
| Dental changes(transverse). | an average1 year | it will be measured in mm on Cone beam computed tomography image using a software |
| Skeletal changes(transverse, anteroposterior and vertical) | an average1 year | it will be measured in mm on Cone beam computed tomography image using a software |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pattern of expansion | an average1 year | it will be assessed on Cone beam computed tomography image and in mm clinically with boley gauge. |
Outcome results
None listed