Effects of Asymmetric Rapid Maxillary Expansion on Dentoskeletal Structures in Mixed Dentition

NCT ID: NCT06486324

Last Updated: 2024-07-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-04-30
• Study Completion Date: 2010-01-31

Brief Summary

The aim of this clinical trial was to determine the efficacy of a locked modified bonded acrylic rapid maxillary expansion appliance, also known as an asymmetric rapid maxillary expansion appliance (ARME), in patients with a true unilateral posterior crossbite resulting from transversal maxillary deficiency in the mixed dentition.

Detailed Description

A posterior crossbite (PCB) is defined as an abnormal transverse or inverse relationship between the posterior teeth and dentition of the upper and lower jaws. A full buccal segment PCB involves multiple teeth in the posterior dentition and usually represents a transverse size discrepancy between the maxillary and mandibular relationships. This discrepancy is often caused by narrow or underdeveloped transverse dimensions of the maxillary halves. The underlying etiology of PCBs includes congenital, developmental, traumatic, or iatrogenic causes. Since spontaneous correction of this malocclusion is not possible even if the etiological factors are eliminated, it should be treated with maxillary expansion as early as possible.

The PCBs may be seen a unilateral posterior crossbite (UPCB) or bilateral posterior crossbite during all periods of dentition. A UPCB can be described as a functional UPCB or true UPCB. A functional UPCB is usually associated with a lateral shift of the mandible toward the crossbite side during the transition of the mandible. On the other hand, true UPCB is less common than functional UPCB and is caused by the narrowing of one of the maxillary halves. Increasing the maxillary arch transverse dimension is the main goal in the treatment of PCB. Although bilateral maxillary expansion is usually used to symmetrically widen the maxillary arch and eliminate mandibular shift as a standard treatment model in functional PCB, asymmetrical or unilateral maxillary expansion is recommended to expand narrowed sections of the maxillary halves and prevent overexpansion of the non-crossbite side in the treatment of true UPCB. Therefore, several removable or fixed maxillary expansion appliances that are slowly or rapidly activated were modified to produce differential effects on posterior teeth.

This clinical trial was designed to expand the upper jaw asymmetrically, i.e. to prevent the normal side of the bite from expanding while expanding the narrow part of the upper jaw. For this purpose, a locking mechanism was added to a bonded rapid maxillary expansion (RME) appliance to support the lower posterior teeth on the normal side of the bite.The hypothesis tested in the study was whether the true unilateral posterior cross-bite in the mixed dentition period could be corrected with a locked modified bonded rapid maxillary expansion appliance used for asymmetric expansion.

Children aged between 7 and 10 years old with true unilateral posterior crossbite were enrolled in the study. The efficacy of the appliance was compared between the crossbite and non-crossbite sides in the patients included in the study. The crossbite side of the patients was assigned as the treatment group, while the normal bite or noncrossbite side was assigned as the positive control group. Thus, two groups were formed for the study, and the trial was conducted on these groups.In other words, the study was planned as a self-controlled study. A negative control group could not be formed due to ethical reason. The reason for this is that the transversal problem may negatively affect both the anterioposterior and vertical development of the jaws in patients of this age during the developmental period, and therefore it was deemed necessary to correct the cross-bite problem as soon as possible after it was detected.Therefore, the purpose of this study was to evaluate specific dentoskeletal changes induced by treatment with true UPCB in mixed dentition with asymmetric RME.

Conditions

Maxillary Anomaly; Asymmetric Maxillary Arch (Disorder); Cross Bite

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Treatment Group

Crossbite Side

Group Type: EXPERIMENTAL

A locked modified acrylic bonded rapid maxillary expansion appliance (ARME)

Intervention Type: DEVICE

asymmetric maxillary expansion

Positive Control Group

Non-cossbite Side

Group Type: EXPERIMENTAL

A locked modified acrylic bonded rapid maxillary expansion appliance (ARME)

Intervention Type: DEVICE

asymmetric maxillary expansion

Interventions

A locked modified acrylic bonded rapid maxillary expansion appliance (ARME)

asymmetric maxillary expansion

Intervention Type: DEVICE

A locked modified acrylic bonded rapid maxillary expansion appliance (ARME)

asymmetric maxillary expansion

Intervention Type: DEVICE

Other Intervention Names

Narrow maxillary half intended for expansion or crossbite side; Normal maxillary half or non-crossbite side

Eligibility Criteria

Inclusion Criteria

• mixed dentition
• true unilateral posterior crossbite
• erupted first permanent molars and incisors
• all deciduous canines and molars or no more than one missing deciduous molar
• no history of orthodontic treatment
• no systemic disease
• no pathological periodontal status
• no excessive gagging reflex.

Exclusion Criteria

• poor oral hygiene
• caries

• Minimum Eligible Age: 7 Years
• Maximum Eligible Age: 10 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Selcuk University Scientific Research Projects Unit

UNKNOWN

Sponsor Role: collaborator

Celal Irgin

OTHER

Sponsor Role: lead

Responsible Party

Celal Irgin

Assistant Professor

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Celal Irgın, Asst.Prof.

Role: PRINCIPAL_INVESTIGATOR

Selcuk University

References

Sari Z, Uysal T, Usumez S, Basciftci FA. Rapid maxillary expansion. Is it better in the mixed or in the permanent dentition? Angle Orthod. 2003 Dec;73(6):654-61. doi: 10.1043/0003-3219(2003)0732.0.CO;2.

Reference Type: RESULT

PMID: 14719729 (View on PubMed)

Toroglu MS, Uzel E, Kayalioglu M, Uzel I. Asymmetric maxillary expansion (AMEX) appliance for treatment of true unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 2002 Aug;122(2):164-73. doi: 10.1067/mod.2002.125563.

Reference Type: RESULT

PMID: 12165770 (View on PubMed)

da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofacial Orthop. 1991 Aug;100(2):171-9. doi: 10.1016/s0889-5406(05)81524-0.

Reference Type: RESULT

PMID: 1867168 (View on PubMed)

Other Identifiers

08102026

Identifier Type: -

Identifier Source: org_study_id