Dentoskeletal Effects After Expansion Using Two Different Expanders, Maxillary Expansion in Cleft Lip and Palate Patients
Conditions
Keywords
Maxillary Expansion, Cleft, Anterior constriction, Quadhelix, Mini-hyarx
Brief summary
Regarding expansion in cleft lip and palate patients, very few clinical trials were found after searching literature and fewer randomized trials. This means that no enough evidence in literature is tackling expansion in cleft lip and palate patients. To the best of our knowledge, this study will represent the first RCT to compare the dentoskeletal effects of mini-hyrax vs quadhelix. Since cleft cases usually need greater anterior than posterior expansion, both appliances are capable of anterior expansion. Nevertheless, no other study compared how much anterior expansion could be accomplished by either appliance.
Detailed description
Maxillary expansion is usually performed before the secondary alveolar bone grafting procedure. Expansion improves the maxillary arch morphology and causes the segmental alignment creating appropriate conditions for bone grafting surgery as well as correcting the posterior crossbites. An important treatment objective in cleft cases is to achieve greater anterior than posterior maxillary expansion since there is a greater anterior than posterior maxillary constriction in most of those patients. Variable appliances have been used for maxillary arch expansion in cleft patients. * Hyrax expanders exert parallel forces to the alveolar bones and the maxillary complex, generating similar amounts of anterior as well as posterior expansion and might be indicated for patients with overall maxillary transverse deficiency. While with patients of greater anterior constriction, Hyrax expander must be frequently interrupted before the full correction of the anterior transverse deficiency in order to avoid the occurrence of a posterior buccal crossbite. * Fan-shape expanders and mini-hyrax (supported on the first premolars and associated to a transpalatal arch cemented to the first molars) enhanced expansion in the maxillary anterior region and restricted posterior expansion. * Mini-hyrax (supported on the first permanent molars) can expand anteriorly as well as posteriorly and was found comparable to hyrax. I this study we are comparing the dentoskeletal effects of quadhelix versus mini-hyrax utilizing CBCT and digital models performed before and after expansion.
Interventions
DEVICEQuadhelix Expander
Maxillary Expander
DEVICEMinihyrax Expander
Maxillary Expander
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Complete unilateral cleft lip and palate pts with anterior and/or posterior crossbite at mixed dentition stage prepared for secondary alveolar bone grafting.
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
1. Mixed dentition. 2. Both males and females. 3. Unilateral cleft lip and palate 4. Presence of maxillary constriction that needs maxillary expansion prior to secondary alveolar bone grafting. 5. Erupted first permanent maxillary molars. 6. Good periodontal health. 7. No previous orthodontic treatment
Exclusion criteria
1. Syndromic cleft lip and palate patients. 2. Previous secondary alveolar bone grafting. 3. Taking medications that influence growth. 4. Absence of teeth to support the expansion appliance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anterior transverse dento-skeletal effects measured by linear distance tool between deciduous upper canines on CBCT and digital models (axial view) | 6 months | Digital models and CBCTs are used to compare dentoskeletal effects before and after expansion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maxillary and mandibular anteroposterior measurements measured by linear distance tool and angle measurement tool on CBCT and digital models (sagittal view) | 6 months | Digital models \& CBCT |
| Vertical skeletal measurements measured by angle measurement tool (y-axis angle - SnMp) on CBCT (sagittal view) | 6 months | CBCT |
| Dentoskeletal Effects measured by angle measurement tool on CBCT (Coronal view) | 6 months | Molar inclination |
Countries
Egypt
Outcome results
None listed