• Title/Summary/Keyword: Slow maxillary expansion

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CLINICAL CASES OF NON-SURGICAL PALATAL EXPANSION ON ADULT PATIENTS

  • Kim, Kyung-Ho;Hong, Hee-Sook;Park, Jun-Ho
    • The korean journal of orthodontics
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    • v.25 no.6 s.53
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    • pp.733-746
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    • 1995
  • In narrow maxillary arch, midpalatal suture can be readily opened in growing children with maxillary palatal expansion. In adult patients, narrow maxilla is generally treated surgically because their growth are deemed completed due to their age. However, in patients under 25, midpalatal suture may not be closed. In addition, maxillary expansion may depend upon the closure of other maxillary sutures, which generally remain open at this stage. The present study attempted suture openings with palatal expansion on 5 female patients in their early 20's. The opening was successful in 4 patients, while only one patient showed no suture opening. In all 4 subjects, no discomfort or pain was present during s\expansion, and the successful suture opening was confirmed on occlusal x-rays. Therefore, for those patients with narrow maxilla in their early 20's, rapid palatal expansion or slow palatal expansion may offer a simple and less complicated option which, if successful, may preclude the need for surgery and thereby circumvent the psychological and financial burdens for the patients.

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Three Dimensional Skeletal, Dentoalveolar and Airway Space Changes after Slow Maxillary Expansion in Children (어린이에서 저속 상악 확장에 따른 골격성, 치아치조성, 기도 변화에 대한 3차원적 평가)

  • Nawoon Kim;Daewoo Lee;Jae-Gon Kim;Yeonmi Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.155-167
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    • 2023
  • The aim of this study was to investigate the effects of slow maxillary expansion (SME) on the dentoalveolar, skeletal, upper airway, and maxillary sinus using cone-beam computed tomography (CBCT). Twenty-three orthodontic patients (mean age 8.93 ± 1.61 years) who were treated with maxillary expansion using banded hyrax in the Department of Pediatric Dentistry at Jeonbuk National University Dental Hospital were included. According to the expansion speed applied, they were divided into two groups: SME (12 subjects, mean age 8.92 ± 1.45 years) and rapid maxillary expansion (RME, 11 subjects, mean age 8.94 ± 1.84 years). CBCT were obtained before (T0) and after (T1) the treatment and were analyzed with InVivo5 software (Anatomage, San Jose, CA, USA). Descriptive statistics showed no significant differences between the two groups in age, sex, or skeletal maturity. There were significant increases in maxillary width at the dentoalveolar and skeletal levels for both groups. Upper airway volume revealed a significant increase of 38.59% in the SME group and 28.72% in the RME group. However, there was no significant difference between SME group and RME group in all measurements. This study suggested the efficacy of SME in growing patients. SME was effective in increasing not only dentoalveolar and skeletal measurements but also airway volume. Therefore, pediatric dentists should select an appropriate expansion method considering the physiological aspects of periodontal tissues and discomfort in growing children.

A meta analysis of maxillary expansion : comparisons of intercanine/intermolar expansion and rapid/slow expansion (상악확장술 치료효과의 메타분석 : 견치간 폭경과 대구치간 폭경 확장의 비교 및 급속과 완속 확장의 비교)

  • Ko, Chang-Hee;Lim, Sung-Hoon;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.23-31
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    • 2004
  • As a research method that weighs and combines evidence, meta analysis produces evidence that is more powerful than the original studies. The purpose of this study was to compare the jntercanine/intermolar expansion and rapid/slow expansion in the maxillary expansion treatment using meta analysis. Medline was searched from 1979 to 2000 for all studies examining the stability of transverse expansion of the human maxilla, and 388 articles were found. Then these articles were reduced to 7 based on the defined inclusion and exclusion criteria, and a cumulative Meta evaluation score was computed for each study. The results were as follows; 1. The mean expansion in intermolar width was 6.0mm. of the 6.0mm, 4.8mm was retained and $20.0\%(1.2mm)$ was relapsed while wearing retainers. 2. In intercanines width, the mean expansion was 3.7mm. of the 3.7mm, 2.6mm was retained and $29.7\%(1.1mm)$ was relapsed while wearing retainers. 3. The differences In the amount of expansion and relapse between rapid expansion group and slow expansion group were less than $6\%(0.1-0.3mm)$. But, there might be differences in the skeletal/dental exapnsion ratios according to the expansion method.

Maxillary expansion with the memory screw: a preliminary investigation

  • Halicioglu, Koray;Kiki, Ali;Yavuz, Ibrahim
    • The korean journal of orthodontics
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    • v.42 no.2
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    • pp.73-79
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    • 2012
  • Objective: The purpose of this study was to investigate the effects of a newly developed rapid maxillary expansion screw-the memory screw-over 6 months. Methods: Five subjects, aged between 11.7 and 13.75 years, were enrolled in this study. All subjects underwent placement of a maxillary expansion appliance containing superelastic nickel-titanium open-coil springs in its screw bed. The parents of the patients and/or the patients themselves were instructed to activate the expansion screw by 2 quarter-turns 3 times a day (morning, midday, and evening; 6 quarter-turns a day). The mean expansion period was $7.52{\pm}1.04$ days. Dentoskeletal effects of the procedure, including dentoalveolar inclination, were evaluated. Measurements of all the parameters were repeated after 6 months of retention in order to check for relapse. Results: Sella-Nasion-A point (SNA) and Sella-Nasion/Gonion-Menton angles increased, and Sella-Nasion-B point (SNB) angle decreased in all the subjects during the expansion phase. However, they approximated to the initial values at the end of 6 months. On the other hand, the increments in maxillary apical base (Mxr-Mxl) and intermolar widths was quite stable. As expected, some amount of dentoalveolar tipping was observed. Conclusions: The newly developed memory expansion screw offers advantages of both rapid and slow expansion procedures. It widens the midpalatal suture and expands the maxilla with relatively lighter forces and within a short time. In addition, the resultant increments in the maxillary apical base and intermolar width remained quite stable even aft er 6 months of retention.

Correction of Transverse Discrepancy with Slowly Maxillary Expansion by Hyrax type expander in Adult Patient (성인에서 Hyrax 장치로 완속상악확장하여 폭경부조화를 개선한 증례)

  • Kwak, Kyoung Ho;Kim, Seong Sik;Kim, Yong-Il;Park, Soo-Byung;Son, Woo-Sung
    • The Journal of the Korean dental association
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    • v.55 no.6
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    • pp.400-410
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    • 2017
  • Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

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Mucocele in the maxillary sinus involving the orbit: A report of 2 cases

  • Yeom, Han-Gyeol;Lee, Wan;Han, Su-Il;Lee, Jae-Hoon;Lee, Byung-Do
    • Imaging Science in Dentistry
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    • v.52 no.3
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    • pp.327-332
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    • 2022
  • Mucocele of the paranasal sinuses is a benign, slow-growing, expansile lesion. Maxillary sinus mucoceles are usually associated with painless bulging of the cheek; however, orbital expansion is rarely observed. Maxillary sinus mucoceles can be classified as primary or secondary according to their etiology. An impediment to sinus ostium ventilation is thought to be the cause of primary mucocele, while sequestering of residual mucosa after surgery in the wound and long-term retention of tissue fluid have been suggested to lead to the formation of secondary mucocele. This report presents 2 cases of primary and secondary mucoceles, with a focus on radiographic features. As primary and superiorly positioned secondary maxillary sinus mucoceles are uncommon and their close proximity to the orbit predisposes the patient to significant morbidity, the authors expect that this report will contribute to a better understanding and diagnosis of maxillary sinus mucocele involving the orbit.

Organized Hematoma in the Maxillary Sinus (상악동에 발생한 organized hematoma)

  • Kim, Jae-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.473-477
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    • 2010
  • Organized hematoma of the maxillary sinus is a rare, nonneoplastic benign lesion with locally destructive behavior that may mimic a malignancy. Clinically, symptoms do not usually occur while the lesion remains localized to the maxillary sinus. Because there is gradual enlargement of the lesion causing erosion and displacement of the adjacent bony structures, symptoms such as epistaxis, cheek swelling, nasal obstruc-tion, headache, and exophthalmos become manifest. Radiologically, unilateral cases are much more fre-quent than bilateral, and Waters' view shows complete opacity of the expanded maxillary sinus and some masses. CT scan shows a large heterogeneous enhancing mass causing considerable expansion of the max-illary sinus with bony erosion. On MR imaging, the mass usually has a variable signal intensity on T1- and T2- weighted images, ranging from low to high. After contrast administration, discrete areas of enhance-ment are present within the mass. Although the disease is essentially benign and nonneoplastic, differen-tial diagnosis from neoplastic disease including malignancy both clinically and radiologically has been always problematic. Accurate preoperative diagnosis of organized hematoma of the maxillary sinus is important to avoid unnecessary extensive surgery, because this condition is curative with a simple, conservative surgical approach and rarely recur. Organized hematoma of the maxillary sinus should be included in the differential diagnosis when patients have recurrent epistaxis, slow-growing mass of the cheek, nasal obstruction, and expansile mass in the maxillary sinus. A 33-year-old man was referred to the department of oral and maxillofacial surgery with a three-month history of slowly growing painful swelling of the left cheek. The mass of the maxillary sinus was resected by a Caldwell-Luc approach. Histopahtoly showed only a fibous encapsulated organized hematoma. To our knowledge, organized hematoma of the maxillary sinus has not been previously described in the Korean literature of the oral and maxillofacial surgery. We report a case of organized hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass.

Effects of Horseshoe Expander (Horseshoe Expander의 확장 효과에 관한 연구)

  • Chung, Kyu-Rhim;Park, Young-Guk;Lee, Young-Jun;Kim, Hong-Suk
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.553-563
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    • 2000
  • Horseshoe Expander is one of Slow Maxillary Expansion(SME) which aims to accommodate the contra- lateral expansion and midpalatal suture expansion or the palate. The appliance consists of skeleton type strew embedded in split Horseshoe appliance. It is the objectives of the presentation to manifest the changes in dental & craniofacial components subsequent to the application of Horseshoe Expander. The subjects for this study consisted of 32 patients (mean age : 12.7). frontal, lateral cephalometric headfilm were taken and study casts were fabricated before and after expansion. 24 items were measured, compared preexpansion with postexpansion. Especially, palatal volume was measured by means of 'Hydro-measurement method'. Tooth axis measurement on the dental casts were made with Universal bevel protractor, and Horseshoe Expander group were compared with RME group. This study of changes to maxillary expansion with Horseshoe Expander revealed the following significant results. 1. Triangular-shaped expansion pattern appeared in frontal cephalometric headfilm. 2. Palatal plane, occlusal plane, mandibular plane and upper incisor to FH increased in lateral cephalometrir headfilm. 3. Palatal volume increased significantly. A slight bite opening, reduction of occlusal contact points showed in dental casts. 4. A 2.2:1 ratio of the amount of intermolar width in maxilla(orthodontic movement) to maxillary width (orthopedic movement) was determined. 5. Horseshoe Expander group has less buccal tipping tendency than RME group, by taking high correlation coefficients in the upper second premolar and first molar. It was suggested that Horseshoe Expander showed less orthodontic changes, less buccal tipping tendency. In addition, it was effective in maxillary expansion.

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Odontogenic myxoma: a case report with recent image modalities

  • Kim Jae-Duk;Kim Kwang-Won;Lim Sung-Hoon
    • Imaging Science in Dentistry
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    • v.34 no.4
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    • pp.199-202
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    • 2004
  • The odontogenic myxoma is an benign, slow growing neoplasm which is of ectomesenchymal origin. This neoplasm occurs almost exclusively in the jaw bones and comprises 0.2% to 17.7% of odontogenic tumors. The odontogenic myxoma may show a wide spectrum of radiographic appearances, unilocular, multilocular radiolucency and a distinct or diffuse border, making the differential diagnosis difficult. We present a case of the odontogenic myxoma in the maxilla with conventional and recent image modalities. Occlusal film revealed a medially extended multilocular lesion with intralesional fine and straight trabeculations from the scalloped margin and buccal expansion and thinning of cortical bone. Computed tomogram revealed lesion showed equivalent density to the muscles in the left maxillary sinus with partial cortical discontinuity of medial wall and the tennis-racket pattern with internal straight trabeculations. MRI revealed intermediate signal intensity on Tl weighted image and high signal intensity on T2 weighted image. In Gd enhanced MR image, the peripheral portions of the lesion were enhanced.

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EARLY TREATMENT OF THE POSTERIOR CROSS-BITE: A CASE REPORT (구치부 반대교합의 조기치료에 대한 치험례)

  • Lee, Eun-Mi;Kang, Dong-Kyun;Kim, Tae-Wan;Kim, Young-Jin;Nam, Sun-Hyun;Kim, Hyun-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.357-366
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    • 2008
  • Posterior cross-bite is a relatively frequent malocclusion in primary and early mixed dentition and the reported prevalence of posterior cross-bite varies from 7% to 23%. It has been defined as a transverse discrepancy in arch relationship which the palatal cusp of the upper posterior teeth do not occlude in the central fossa of the opposing lower teeth, and can be manifested in a single tooth or in a group of teeth. Posterior cross-bite does not often self-correct and therefore immediate treatment is recommended. Occlusal adjustment to eliminate premature contact that causes mandibular deviation, expansion of narrow maxillary arch, arrangement of the individual teeth to treat asymmetry within the dental arch are the methods of treating cross-bite. In the present case, functional posterior cross-bite was observed in the primary and the early mixed dentition children. The children were treated by the slow maxillary expansion and occlusal adjustment. The outcome of periodic examinations after the correction of cross-bite was favorable.

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