Journal articles: 'Orthopedic effects, midpalatal suture'

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Suzuki, Selly Sayuri, Laila Fernanda Souza Braga, Denise Nami Fujii, Won Moon, and Hideo Suzuki. "Corticopuncture Facilitated Microimplant-Assisted Rapid Palatal Expansion." Case Reports in Dentistry 2018 (December 6, 2018): 1–12. http://dx.doi.org/10.1155/2018/1392895.

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Introduction. Microimplant-assisted rapid palatal expansion (MARPE) has been considered an alternative to avoid extensive surgical procedures. In order to obtain skeletal results of MARPE, force should be enough to overcome areas of resistance and the first one that is required to be disrupted is the midpalatal suture, which becomes increasingly interdigitated after adolescence. Objective. The present study aimed at providing a novel approach using a minimally invasive method called corticopuncture (CP) in association with MARPE illustrated by a case report of a 35-year-old Brazilian female Caucasian patient presenting maxillary transverse deficiency. Method. Treatment plan started with an orthopedic correction of the transverse problem using a MARPE device. After many unsuccessful attempts to activate MARPE, corticopunctures were performed along the midpalatal suture. CP procedure at the midpalatal suture included 8 perforations (2 mm apart), performed after previous predrilling followed by miniscrew insertion (5 mm thread length and 1.8 mm diameter). Results. After CP and new activation protocol, the opening of the midpalatal suture was observed by CBCT images, showing skeletal results, suture split of 3.14 mm (premolar area) and 2.06 (molar area), an increase of 4.3 mm (premolar) and 3.03 mm (molar) in basal bone width, 4.43 mm (premolar) and 3.1 mm (molar) in cortical bone width, and minimal dental effects (mean of 1.2° of tooth tipping). Conclusion. The combination of MARPE and corticopuncture method was proved to be a nonsurgical treatment option to correct maxillary transverse deficiency in an adult patient. CP was able to weaken suture interdigitation thus facilitating the split.

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Quintela, Marcelo de Melo, Sabrina Buchmann Rossi, Katty Lalangui Vera, Jaime Cordova Peralta, Isaias Donizeti Silva, Letícia Alecrim de Souza, Caio Vinicius Gonçalves Roman-Torres, Heloísa Fonseca Marao, Wilson Roberto Sendyk, and Angélica Castro Pimentel. "Miniscrew-assisted rapid palatal expansion (MARPE) protocols applied in different ages and stages of maturation of the midpalatal suture: cases report." Research, Society and Development 10, no. 11 (September 7, 2021): e503101119480. http://dx.doi.org/10.33448/rsd-v10i11.19480.

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Objective: To evaluate the Microimplant-assisted Rapid Palatal Expansion (MARPE), considered an alternative to surgical interventions for disjunction of the midpalatal suture in adolescent patients and young adults with maxillary transverse deficiency. The stage of ossification of the midpalatal suture, bone quality and adequate activation protocols are factors that can influence the quantity and quality of the orthopedic separation. Methodology: This paper demonstrates the application of MARPE in an unfavorable case report, of an adult patient with total crossbite, in an advanced stage of fusion of the palatine and maxillary processes, with poverty in the posterior bone volume, in comparison with the same therapy in an adolescent at an earlier stage of sutural maturation. In both cases, after tomographic examinations and oral scanning, the installations and recommended activation protocol were performed. These were not sufficient in the case of the adult patient, and generated side effects that, to be overcome, required changes in activations and additional maneuvers. Results: The application of MARPE may require clinical versatility to adopt differentiated protocols in relation to chronological age, bone thickness and sutural ossification stage. Conclusion: In the end, new computer tomography scans and a clinical examination showed satisfactory results in both patients. In the unfavorable case, the opening of the midpalatal suture occurred at more modest levels, but it was sufficient to correct the posterior crossbite.

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Santana, Lucas Garcia, and Leandro Silva Marques. "Do adjunctive interventions in patients undergoing rapid maxillary expansion increase the treatment effectiveness?" Angle Orthodontist 91, no. 1 (October 12, 2020): 119–28. http://dx.doi.org/10.2319/051320-431.1.

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ABSTRACT Objectives To evaluate the clinical effectiveness of adjunctive interventions in individuals undergoing rapid maxillary expansion (RME). Materials and Methods MEDLINE, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar were searched without restrictions up to June 2020. Trials involving participants undergoing orthopedic or surgical RME, along with adjunctive interventions, were included. Risk-of-bias assessments were performed using the Cochrane tool for randomized trials-2. The certainty level of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool. Results Six randomized clinical trials, with low to high risk of bias, were included. Low certainty of the evidence suggested that low-level laser facilitated opening of the midpalatal suture during the active phase of RME. Likewise, moderate certainty demonstrated that low-level laser accelerated the healing process of the suture during the retention phase. The clinical impact of this outcome, that is, stability and retention time, was not evaluated. Very low evidence indicated that osteoperforations along the midpalatal suture increased maxillary transverse skeletal gains in young adults undergoing RME. Low evidence suggested that platelet-rich plasma therapy did not minimize the vertical and thickness bone loss after RME in the short term. Conclusions Based on currently available information, the use of low-level laser associated with maxillary expansion seems to provide a more efficient suture opening and bone healing. Limited evidence suggests that osteoperforations improve the skeletal effects of RME in non-growing individuals. There are no adjunctive interventions capable of reducing the periodontal side effects of RME.

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Suzuki, Hideo, Won Moon, Luiz Henrique Previdente, Selly Sayuri Suzuki, Aguinaldo Silva Garcez, and Alberto Consolaro. "Miniscrew-assisted rapid palatal expander (MARPE): the quest for pure orthopedic movement." Dental Press Journal of Orthodontics 21, no. 4 (August 2016): 17–23. http://dx.doi.org/10.1590/2177-6709.21.4.017-023.oin.

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ABSTRACT The midpalatal suture has bone margins with thick connective tissue interposed between them, and it does not represent the fusion of maxillary palatal processes only, but also the fusion of palatal processes of the jaws and horizontal osseous laminae of palatal bones. Changing it implies affecting neighboring areas. It has got three segments that should be considered by all clinical analyses, whether therapeutic or experimental: the anterior segment (before the incisive foramen, or intermaxillary segment), the middle segment (from the incisive foramen to the suture transversal to the palatal bone ) and the posterior segment (after the suture transversal to the palatal bone ). Rapid palatal expansion might be recommended for patients at the final pubertal growth stage, in addition to adult patients with maxillary constriction. It represents a treatment solution that can potentially avoid surgical intervention. When performed in association with rapid palatal expanders, it might enhance the skeletal effects of the latter. Of the various designs of expansion appliances, MARPE (miniscrew-assisted rapid palatal expander) has been modified in order to allow its operational advantages and outcomes to become familiar in the clinical practice.

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Yu, Dayeol, and Donghyun Kim. "Assessment of Midpalatal Suture Maturation by Skeletal Maturity on Hand Wrist Radiographs." JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY 48, no. 1 (February 28, 2021): 31–41. http://dx.doi.org/10.5933/jkapd.2021.48.1.31.

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The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman’s correlation coefficient, ϒS = 0.905, p < 0.05) was slightly greater than that of MP3 stages (ϒS = 0.830, p < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒS = 0.868,p < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.

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Vizzotto, Mariana Boessio, Fernando Borba de Araújo, Heloísa Emília Dias da Silveira, Adriano Asmuz Boza, and Luciane Quadrado Closs. "The Quad-Helix Appliance in the Primary Dentition –Orthodontic and Orthopedic Measurements." Journal of Clinical Pediatric Dentistry 32, no. 2 (December 1, 2007): 165–70. http://dx.doi.org/10.17796/jcpd.32.2.5171342317148474.

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Changes in the midpalatal suture and the alterations in intercanine and intermolar widths with the use of the quad-helix appliance were evaluated. Study casts and occlusal radiographs from 10 patients with a mean age of 4 years and 10 months (SD 11 months) were analyzed. A statistically significant palatal suture widening was observed in all cases. The proportion of dental tipping accomplished with the treatment was greater than opening of the suture.

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Lione, Roberta, Lorenzo Franchi, and Paola Cozza. "Does rapid maxillary expansion induce adverse effects in growing subjects?" Angle Orthodontist 83, no. 1 (July 23, 2012): 172–82. http://dx.doi.org/10.2319/041012-300.1.

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Abstract Objective: To assess the scientific evidence that rapid maxillary expansion (RME) causes Adverse Effects on the midpalatal suture, vertical dimension, dental and periodontal structures in growing subjects. Materials and Methods Electronic databases were searched for articles dated through December 2011. The quality of the studies was ranked on a 13-point scale in which 1 was the low end of the scale and 13 was the high end. Results: Thirty relevant articles were identified. The amount of midpalatal suture opening ranged from 1.6 to 4.3 mm in the anterior region and from 1.2 to 4.4 mm in the posterior region. At the end of the active phase, RME resulted in slight inferior movement of the maxilla (SN-PNS +0.9 mm; SN-ANS +1.6 mm), increased tipping of anchored teeth from 3.4° to 9.2° and bending of the alveolar bone from 5.1° to 11.3°. In the long term, RME did not modify the facial growth patterns, and no significant changes on dentoalveolar structures were observed. Of the 30 studies, 2 were medium-high quality, 8 were medium quality, and 20 were low quality. Conclusions: RME always opened the midpalatal suture in growing subjects. The vertical changes were small and transitory. In the long-term evaluation, an uprighting of anchored teeth was observed and periodontal structures were not compromised.

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Woller, Jessica L., Ki Beom Kim, Rolf G. Behrents, and Peter H. Buschang. "An assessment of the maxilla after rapid maxillary expansion using cone beam computed tomography in growing children." Dental Press Journal of Orthodontics 19, no. 1 (January 2014): 26–35. http://dx.doi.org/10.1590/2176-9451.19.1.026-035.oar.

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INTRODUCTION: With the advent of cone beam computed tomography (CBCT), it is now possible to quantitatively evaluate the effects of rapid maxillary expansion (RME) on the entire maxillary complex in growing patients. OBJECTIVE: The purpose of this study is to use three-dimensional images to evaluate the displacement that occurs at the circummaxillary sutures (frontonasal, zygomaticomaxillary, intermaxillary, midpalatal, and transpalatal sutures) following rapid maxillary expansion in growing children. METHODS: The CBCT scans of 25 consecutively treated RME patients (10 male, 15 female) with mean age of 12.3 ± 2.6 years, were examined before expansion and immediately following the last activation of the expansion appliance. RESULTS: Statistically significant (P < 0.05) amounts of separation were found for the displacement of the bones of the frontonasal suture, the intermaxillary suture, the zygomaticomaxillary sutures, and the midpalatal suture. The change in angulation of the maxillary first molars due to RME was also statistically significant. There was no statistically significant displacement of the transpalatal suture. CONCLUSIONS: Rapid maxillary expansion results in significant displacement of the bones of circummaxillary sutures in growing children.

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Bilgiç, Fundagül, İbrahim Damlar, Özgür Sürmelioğlu, Özlem Akıncı Sözer, and Ufuk Tatlı. "Relationship between voice function and skeletal effects of rapid maxillary expansion." Angle Orthodontist 88, no. 2 (November 15, 2017): 202–7. http://dx.doi.org/10.2319/062717-431.1.

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ABSTRACT Objective: To evaluate the effects of rapid maxillary expansion (RME) on the vocal quality, maxillary central incisors, midpalatal suture, and nasal cavity in patients with maxillary crossbite. Materials and Methods: Coronal CT scans of 30 subjects (14 boys, 16 girls; mean age, 12.01 ± 0.75) were taken before RME (T0), and at the end of the expansion phase (T1). Voice samples of all patients were recorded with a high-quality condenser microphone (RODE NT2-A) on a desktop computer at T0 and T1. Statistical analyses were performed using a paired-sample t-test. The degree of association between the changes in the voice parameters and nasal width was assessed with Pearson's correlation. Results: RME treatment produced a significant increase in the transverse dimensions of the midpalatal suture and nasal cavity between T0 and T1 (P < .05). The maximum F0 and jitter (%) results were shown to decrease statistically significantly from T0 to T1 (P < .001 and P = .042, respectively). Between T0 and T1, shimmer (%) and shimmer (dB) exhibited statistically significant increases (P = .037 and P = .019, respectively). Conclusions: After RME therapy, voice quality differences were found to be associated with increases in nasal width.

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Goto, Shota, Yuko Fujita, Maika Hotta, Ayako Sugiyama, and Kenshi Maki. "Influence of differences in the hardness and calcium content of diets on the growth of craniofacial bone in rats." Angle Orthodontist 85, no. 6 (January 28, 2015): 969–79. http://dx.doi.org/10.2319/102214-765.1.

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ABSTRACT Objective: To examine the effects of a soft diet and a low-calcium diet on the craniofacial growth and bone architectures of the maxilla and mandible. Materials and Methods: Male rats (n = 20, 3 weeks old) were divided into four groups. Ten rats were given a normal-calcium diet, and the other rats were given a low-calcium diet. Each group was then divided into two subgroups, which were fed a hard or a soft diet. After 4 weeks, craniofacial growth and architecture in maxillary and mandibular bone were analyzed using cephalometry, micro-computed tomography, and histopathology. Results: The low-calcium diet had no effect on serum calcium levels. The low-calcium diet had the greatest effect on craniofacial bone growth, while the soft diet affected the growth of several bone sites that are attached to the masseter muscle. A low-calcium diet resulted in the deterioration of the connectivity of the trabeculae in the furcation region of the maxillary and mandibular first molar, while a soft diet resulted in the diffuse disappearance of trabeculae in the central part of the furcation regions. In the midpalatal suture, a low-calcium diet resulted in inhibition of cartilaginous ossification, although the midpalatal suture had a normal cartilaginous structure. A soft diet resulted in narrower cartilage cell layers in the midpalatal suture. Conclusions: We demonstrated that a low-calcium diet and a soft diet resulted in a deterioration of bone structures in both the maxilla and in the mandible; however, the mechanisms underlying these effects differed between diets.

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Sarraj, Mohamad, Sercan Akyalcin, Hong He, Jun Xiang, Ghaddy AlSaty, Tugce Celenk-Koca, Christina DeBiase, Chris Martin, Khaled AlSharif, and Peter Ngan. "Comparison of skeletal and dentoalveolar changes between pure bone-borne and hybrid tooth-borne and bone-borne maxillary rapid palatal expanders using cone-beam computed tomography." APOS Trends in Orthodontics 11 (April 10, 2021): 32–40. http://dx.doi.org/10.25259/apos_160_2020.

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Objectives: The objectives of the study were to compare the skeletal, dentoalveolar, and periodontal changes between two types of microimplant-assisted rapid maxillary expansion appliances: The bone-anchored maxillary expanders (BAME) and the tooth-bone-anchored maxillary skeletal expander (MSE). Materials and Methods: Thirty-four patients with a transverse maxillary deficiency were divided into two groups; the first group (16 patients, average age 14.9 years) was treated with the MSE appliance, and the second group (18 patients, average age 13.8 years) was treated with the BAME appliance. Cone-beam computed tomography scans were taken at pre-treatment (T1) and immediately post-expansion (T2) to measure the changes in midpalatal suture opening, total expansion (TE), alveolar bone bending, dental tipping (DT), and buccal bone thickness. Data were analyzed using paired t-test and two-sample t-test. Results: Midpalatal suture separation was found in 100% of the patients in both groups. The TE at the first molar was 5.9 mm in the MSE group and 4.7 mm in the BAME group. The skeletal contributions were 56% and 83% of TE for the MSE and BAME groups, respectively. Significantly less dental buccal tipping and buccal bone loss were found with the BAME group. The midpalatal suture in both groups exhibited a parallel opening pattern in the axial plane. Conclusion: The use of BAME appliance resulted in greater skeletal effects, less dental tipping, and less buccal bone reduction compared to MSE appliance (immediately after maxillary expansion).

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Liu, ShiYao, TianMin Xu, and Wei Zou. "Effects of rapid maxillary expansion on the midpalatal suture: a systematic review." European Journal of Orthodontics 37, no. 6 (February 19, 2015): 651–55. http://dx.doi.org/10.1093/ejo/cju100.

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Młynarek, K., and J. Żmudzki. "Distribution of forces on supporting teeth in the midpalatal expander during “Hyrax” screw pre-load." Journal of Achievements in Materials and Manufacturing Engineering 1-2, no. 93 (March 1, 2019): 26–31. http://dx.doi.org/10.5604/01.3001.0013.4138.

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Purpose: The aim of the study was to determine forces which are transferred to supporting teeth during the treatment with the midpalatal device with Hyrax screw and to evaluate orthodontic and orthopaedic effects based on displacement analysis. Design/methodology/approach: The finite element method (FEM) was used to simulation the midpalatal expansion forces activated by the screw pre-loaded during a turn of 180° which corresponds to daily recommended value. Distribution of expansion forces of Hyrax device was calculated as reaction forces on elastic supports with stiffness corresponding to the teeth working on periodontal ligament in alveolar bone. Findings: On the basis of the displacement analysis was observed the movement of supporting teeth by a value higher than 0.1 mm which corresponds to the recommended daily value. The midpalatal suture splitting forces were determined on the first premolars with a value of 32.8 N and on the first premolars of 44.2 N. Research limitations/implications: The studies did not take into account the shape of palate other craniofacial bones and their stiffness. Practical implications: Adjusting the stiffness of the device to degree of ossification midpalatal suture and teeth mobility. Searching for new solutions which eliminate the negative phenomenon of tilting teeth during the expansion of maxilla and recommending a surgically assisted techniques. Originality/value: The simulation confirmed that treatment with Hyrax screw gives a uniform expansion with values of forces corresponded to stiffness of premolar and molar teeth. The studies have indicated a possibility of tendency to tilting the supporting teeth what is a negative phenomenon.

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Ngan, Peter, Uyen Kelly Nguyen, Tung Nguyen, Timothy Tremont, and Chris Martin. "Skeletal, Dentoalveolar, and Periodontal Changes of Skeletally Matured Patients with Maxillary Deficiency Treated with Microimplant-assisted Rapid Palatal Expansion Appliances: A Pilot Study." APOS Trends in Orthodontics 8 (June 1, 2018): 71–85. http://dx.doi.org/10.4103/apos.apos_27_18.

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Introduction Microimplant-assisted rapid palatal expansion (MARPE) has recently been offered to adult patients for correcting maxillary transverse deficiency. However, there is limited information in the literature on the success of this appliance and its skeletal and dental effects on skeletally matured patients. The purpose of this study was to investigate the immediate skeletal, dentoalveolar, and periodontal response to MARPE appliance using cone-beam computed tomography in a skeletally matured patient as assessed by the cervical vertebral maturation method. Materials and Methods Eight consecutively treated patients (2 females, 6 males; mean age of 21.9 ± 1.5 years) treated with a maxillary skeletal expander were included in the study. Measurements were taken before and after expansion to determine the amount of midpalatal suture opening, upper facial bony expansion, alveolar bone bending, dental tipping, and buccal bone thickness (BBT). Data were analyzed using a one-way ANOVA and matched-pair t-test (α = 0.05). Results Midpalatal suture separation was found in 100% of the patients with no dislodged microimplants. Total maxillary expansion was attributed to 41% skeletal, 12% alveolar bone bending, and 48% dental tipping. Pattern of midpalatal suture opening was found to be parallel in both the coronal and axial planes. On average, the absolute dental tipping ranged from 4.17° to 4.96° and the BBT was reduced by an average of 39% measured at the premolars and molars. Conclusions The MARPE appliance can be a clinically acceptable, nonsurgical treatment option for correcting mild to moderate maxillary transverse discrepancies for skeletally matured adult patients with a healthy periodontium.

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Uysal, Tancan, Ayca Ustdal, Mehmet Fatih Sonmez, and Figen Ozturk. "Stimulation of Bone Formation by Dietary Boron in an Orthopedically Expanded Suture in Rabbits." Angle Orthodontist 79, no. 5 (September 1, 2009): 984–90. http://dx.doi.org/10.2319/112708-604.1.

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Abstract Objective: To evaluate the effects of dietary boron on bone regeneration in rabbits in response to expansion of the midpalatal suture during different retention periods. Materials and Methods: Twenty-eight 12-week-old New Zealand white male rabbits were separated into four equal groups: group 1 (B+10) and group 2 (B−10) had retention periods of 10 days with or without boron intake, respectively. Group 3 (B+20, with boron) and group 4 (B−20, without boron) were retained for 20 days. All groups had a 5-day expansion period. For both B+ groups, boron was prepared in distilled water and given to the rabbits during their (1) nursery phase (40 days), (2) expansion phase, and (3) retention period at a dosage of 3 mg/kg daily by oral gavage. Bone regeneration in the midpalatal suture was evaluated by a bone histomorphometric method, and the mineralized area (Md.Ar), fibrosis area (Fb.Ar), mineralized area/fibrosis area (Md.Ar/Fb.Ar), bone area (B.Ar) and osteoblast number (N.Ob) parameters were evaluated. Results: Statistical analysis showed significant differences between groups for all investigated measurements. Md.Ar (P < .01), Md.Ar/Fb.Ar (P < .001), B.Ar (P < .01), and N.Ob (P < .01) parameters were increased and Fb.Ar (P < .01) was decreased in groups B+10 and B+20. No significant differences were observed during an additional 10-day retention period in all groups (P < .05). Conclusions: Boron has a positive effect on the early phase of bone regeneration of the midpalatal suture in response to expansion and may be beneficial in routine maxillary expansion procedures.

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Takahashi, I., I. Mizoguchi, M. Nakamura, Y. Sasano, S. Saitoh, M. Kagayama, and H. Mitani. "Effects of expansive force on the differentiation of midpalatal suture cartilage in rats." Bone 18, no. 4 (April 1996): 341–48. http://dx.doi.org/10.1016/8756-3282(96)00012-9.

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Bud, Eugen-Silviu, Mariana Păcurar, Alexandru Vlasa, Ana Petra Lazăr, Luminița Lazăr, Petru Vaida, and Anamaria Bud. "Retrospective Case Series Regarding the Advantages of Cortico-Puncture (CP) Therapy in Association with Micro-Implant Assisted Rapid Palatal Expander (MARPE)." Applied Sciences 11, no. 3 (February 1, 2021): 1306. http://dx.doi.org/10.3390/app11031306.

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Transverse maxillary deficiency currently affects 8–23% of adults. One of the most widely used orthodontic treatments today in patients with transverse maxillary defects is the maxillary skeletal expander (MSE). This was a retrospective observational imaging study regarding structural bone changes that may occur during healing after the placement of micro-implant assisted rapid palatal expanders (MARPE) in combination with cortico-puncture (CP) therapy. Regarding the magnitude of the mid-palatal suture opening, the mean split at the anterior nasal spine (ANS) and the posterior nasal spine (PNS) was 3.76 and 3.12 mm, respectively. The amount of split at the PNS was smaller than at the ANS, approximately 85% of the distance, showing that the opening of the midpalatal suture was almost parallel in the sagittal plane. On average, one-half of the anterior nasal spine (ANS) moved more than the contralateral by 0.89 mm. In the present study, we show that MARPE associated with CP therapy had a positive outcome on the midpalatal suture opening. This occurred in safe conditions, without post-surgery bleeding, and showing healing at the corticotomy level, with no signs of swelling or sepsis, which are side effects usually associated with more complex surgical treatments. Our results suggest that non-surgical palatal expansion, assisted by MARPE and CP, is achievable and predictable in young adults.

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Tas Deynek, Gul, and Sabri Ilhan Ramoglu. "Effects of different settings for 940 nm diode laser on expanded suture in rats." Angle Orthodontist 89, no. 3 (January 2, 2019): 446–54. http://dx.doi.org/10.2319/052318-392.1.

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ABSTRACT Objectives: To evaluate the effects of the Indium Gallium Arsenide Phosphoride (InGaAsP) diode laser at different energy levels on orthopedically expanded midpalatal sutures of rats. Materials and Methods: Eighty Wistar rats were randomly divided into four groups: a control group and low-, moderate-, and high-level laser groups with amounts of energy irradiated at 0 J, 18 J, 42 J, and 60 J, respectively. Each group was divided into two subgroups (n = 10) according to the schedule of sacrifice (7 and 21 days). Laser application (940 ± 10 nm, 0.1 W) was completed twice weekly until sacrifice. The number of osteoblasts (OB), osteocytes (OC), and vessels (V); area of connective tissue (CT); inflammation (IN); and newly formed bone (NB); as well as the ratio of newly formed bone to the total bone area (N/T) were evaluated statistically at a significance level of P < .05. Results: For the low-level laser group, OB, NB, and N/T were significantly higher, and CT was lower, on both the 7th and 21st days. The amount of OC was significantly higher in the low-level laser group compared with the control group on the 7th day and the control and high-level laser groups on the 21st day. The IN was significantly higher for the high-level group on the 21st day compared with other groups. Both the moderate-level and high-level laser groups possessed fewer vessels than the low-level laser group on the 21st day. Conclusions: The InGaAsP laser at the low dosage induced a favorable effect on bone formation in the orthopedically expanded midpalatal suture of rats.

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Yi, Jianru, Li Mei, Xue Li, Wei Zheng, Yu Li, and Zhihe Zhao. "Effects of continuous and intermittent parathyroid hormone administration on midpalatal suture expansion in rats." Archives of Oral Biology 99 (March 2019): 161–68. http://dx.doi.org/10.1016/j.archoralbio.2019.01.014.

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Cheng, Ye, Jianfeng Sun, Zeyuan Zhou, Jie Pan, Shujuan Zou, and Jianwei Chen. "Effects of lactoferrin on bone resorption of midpalatal suture during rapid expansion in rats." American Journal of Orthodontics and Dentofacial Orthopedics 154, no. 1 (July 2018): 115–27. http://dx.doi.org/10.1016/j.ajodo.2017.09.020.

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Itou, Rie, Tadahiko Utsunomiya, and Masaru Yamaguchi. "Histopathological Study of Inhibitory Effects for Relapse by Relaxin after Expansion in Rat Midpalatal Suture." International Journal of Oral-Medical Sciences 7, no. 3 (2009): 166–75. http://dx.doi.org/10.5466/ijoms.7.166.

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Loddi, Patricia P., Max D. Pereira, Angela B. Wolosker, Claudia T. Hino, Tessie M. Kreniski, and Lydia M. Ferreira. "Transverse Effects After Surgically Assisted Rapid Maxillary Expansion in the Midpalatal Suture Using Computed Tomography." Journal of Craniofacial Surgery 19, no. 2 (March 2008): 433–38. http://dx.doi.org/10.1097/scs.0b013e318163e2f5.

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Piancino, Maria Grazia, Francesco MacDonald, Ivana Laponte, Rosangela Cannavale, Vito Crincoli, and Paola Dalmasso. "Juvenile/Adolescent Idiopatic Scoliosis and Rapid Palatal Expansion. A Pilot Study." Children 8, no. 5 (April 30, 2021): 362. http://dx.doi.org/10.3390/children8050362.

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The question of whether orthodontic therapy by means of rapid palatal expansion (RPE) affects the spine during development is important in clinical practice. RPE is an expansive, fixed therapy conducted with heavy forces to separate the midpalatal suture at a rate of 0.2–0.5 mm/day. The aim of the study was to evaluate the influence of RPE on the curves of the spine of juvenile/adolescent idiopathic scoliosis patients. Eighteen patients under orthopedic supervision for juvenile/adolescent idiopathic scoliosis and independently treated with RPE for orthodontic reasons were included in the study: Group A, 10 subjects (10.4 ± 1.3 years), first spinal radiograph before the application of the RPE, second one during the orthodontic therapy with RPE; Group B, 8 patients (11.3 ± 1.6 years), first radiograph during the use of RPE second one after the removal. Group A showed a significant worsening of the Cobb angle (p ≤ 0.005) at the second radiograph after RPE. Group B showed a significant improvement of the Cobb angle (p = 0.01) at the second radiograph after removal of RPE. Based on the results, the use of RPE during adolescence might influence the spinal curves of patients with idiopathic scoliosis.

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Shetty, Preeth, Amitha Hegde, and Kavita Rai. "Study of Stress Distribution and Displacement of the Maxillary Complex Following Application of Forces using Jackscrew and Nitanium Palatal Expander 2 – A Finite Element Study." Journal of Clinical Pediatric Dentistry 34, no. 1 (September 1, 2009): 87–93. http://dx.doi.org/10.17796/jcpd.34.1.dv5100j371184087.

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The stress distribution patterns within the maxillary complex during the expansion by slow maxillary expansion plate and Nitanium palate expander 2 was analyzed. Objective: This comparative study was done using a finite element model of a young maxillary bone. The model was generated using the data from computerized tomographic scans of a dried maxillary bone. The model was then strained to a dimensional pattern of displacement and stress distribution for the two appliances. Results: This present study showed the maximum lateral displacement for jack screw by 0.170mm at the region of cusp tips of posteriors indicating a tipping movement.Whereas NPE2, showed maximum displacement of 0.004mm corresponding to maxillary molars. Concentration of stress distribution ranging from 343.42 N/mm2 to 412.60 N/mm2 for 0.5mm of expansion was significantly depicted at the palatal bone beside the central incisors for jack screw, when compared to NPE2 which depicted low magnitude of stress ranging from 7.78 N/mm2 to 9.08 N/mm2 uniformly distributed along the midpalatal suture. Conclusions: The findings of this study suggests that NPE2 appliance basically an orthodontic appliance however is capable of producing mild to moderate orthopedic changes in maxilla.

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Loriato, Lívia, and Carlos Eduardo Ferreira. "Surgically-assisted rapid maxillary expansion (SARME): indications, planning and treatment of severe maxillary deficiency in an adult patient." Dental Press Journal of Orthodontics 25, no. 3 (May 2020): 73–84. http://dx.doi.org/10.1590/2177-6709.25.3.073-084.bbo.

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ABSTRACT Introduction: Maxillary deficiency, also called transverse deficiency of the maxilla, may be associated with posterior crossbite, as well as with other functional changes, particularly respiratory. In adult patients, because of bone maturation and the midpalatal suture fusion, rapid maxillary expansion has to be combined with a previous surgical procedure to release the areas of resistance of the maxilla. This procedure is known as surgically-assisted rapid maxillary expansion (SARME). Objective: This study discusses the indications, characteristics and effects of SARME, and presents a clinical case of transverse and sagittal skeletal maxillary discrepancy treated using SARME and orthodontic camouflage.

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Utreja, Achint, Carol Bain, Brett Turek, Robert Holland, Rawan AlRasheed, Parand Sorkhdini, and W. Eugene Roberts. "Maxillary expansion in an animal model with light, continuous force." Angle Orthodontist 88, no. 3 (January 24, 2018): 306–13. http://dx.doi.org/10.2319/070717-451.1.

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ABSTRACT Objectives: Maxillary constriction is routinely addressed with rapid maxillary expansion (RME). However, the heavy forces delivered by most RME appliances to expand the palate may lead to deleterious effects on the teeth and supporting tissues. The objective of this study was to explore a more physiologic maxillary expansion with light continuous force. Materials and Methods: Twenty 6-week-old Sprague-Dawley rats were equally divided into experimental (EXPT) and control (CTRL) groups. A custom-fabricated archwire expansion appliance made from 0.014-inch copper-nickel-titanium wire was activated 5 mm and bonded to the maxillary molar segments of animals in the EXPT group for 21 days. The force applied to each maxillary segment was 5 cN. Microfocus x-ray computed tomography and histological analyses were used to compare the tooth movement and bone morphology in the midpalatal suture and buccal aspect of the alveolar process between the EXPT and CTRL groups. Descriptive statistics (mean ± standard error of the mean) and nonparametric statistical tests were used to compare the outcomes across groups. Results: Compared to the CTRL group, there was a statistically significant increase in buccal tooth movement and expansion of the midpalatal suture in the EXPT group. There was no difference in the bone morphologic parameters between groups. The mineral apposition rate was increased on the buccal surface of the alveolar process in the EXPT group. Conclusions: Application of light, continuous force resulted in maxillary osseous expansion due to bilateral sutural apposition and buccal drift of the alveolar processes. This animal experiment provides a more physiologic basis for maxillary expansion.

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Bazargani, Farhan, Ingalill Feldmann, and Lars Bondemark. "Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: A systematic review." Angle Orthodontist 83, no. 6 (June 7, 2013): 1074–82. http://dx.doi.org/10.2319/020413-103.1.

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ABSTRACTObjective:To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging.Materials and Methods:The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies.Results:The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%–50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive.Conclusions:CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.

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Ferreira, Fabíola Nogueira Holanda, Juliana Oliveira Gondim, José Jeová Siebra Moreira Neto, Pedro Cesar Fernandes dos Santos, Karina Matthes de Freitas Pontes, Lúcio Mitsuo Kurita, and Maria Walderez Andrade de Araújo. "Effects of low-level laser therapy on bone regeneration of the midpalatal suture after rapid maxillary expansion." Lasers in Medical Science 31, no. 5 (April 7, 2016): 907–13. http://dx.doi.org/10.1007/s10103-016-1933-8.

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Bistaffa, Alisson Gabriel Idelfonso, Luciana Belomo-Yamaguchi, Marcio Rodrigues de Almeida, Ana Claudia de Castro Ferreira Conti, Paula Vanessa Pedron Oltramari, Mariane Casadei Bravo Santana, and Thais Maria Freire Fernandes. "Differential Maxillary Expander as an Alternative Device for Early Treatment of Posterior Crossbite: Case Report." Journal of Health Sciences 24, no. 1 (March 22, 2022): 02–05. http://dx.doi.org/10.17921/2447-8938.2022v24n1p02-05.

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AbstractRapid maxillary expansion (RME) is the protocol of choice for early treatment of transverse malocclusions and it is achieved with fixed expanders that produce heavy forces to achieve midpalatal suture opening. One third of patients with maxillary constriction have a greater transversal deficiency at the intercanine width than at the intermolar. The aim of this article is to present a protocol for early treatment of posterior crossbite with the use of the expander with differential opening (EDO) for RME. It is a new appliance to perform RME and its main advantage would be to allow the expansion individualization. EDO was proposed aiming to promote greater expansion on the anterior rather than on the posterior region. A 9 year-old female sought treatment. The interceptive treatment plan was based on using EDO for RME. The post-expansion orthopedic response showed an opening of 7.5 mm between the maxillary central incisors, at the level of the incisal edge. It was observed an opening of 4.8mm in the midpalatal suture. The opening at a distance of 10 mm and 20 mm from the crest to posterior at the midpalatal suture were 3.9mm and 2.8mm. The upper intercanine distance showed an increase of 9.31 mm. The upper intermolar distance had increased 8.04 mm. The upper arch perimeter showed a difference from 74.02 mm to 80.11 mm . And the upper arch length, from 29.83 mm to 31.56 mm. The posterior crossbite was 2 mm overcorrected. Early diagnosis and treatment of posterior crossbite has a very favorable prognosis. Keywords: Palatal Expansion Technique. Interceptive Orthodontics. Malocclusion. Resumo A expansão rápida da maxila (ERM) é a técnica de escolha para o tratamento precoce das más oclusões transversais e é ativada com expansores fixos que produzem forças pesadas para possibilitar a abertura da sutura palatina mediana. Um terço dos pacientes com atresia maxilar apresenta uma maior deficiência transversal na região intercaninos do que na região intermolares. O objetivo desse artigo é apresentar um protocolo de tratamento precoce para a mordida cruzada posterior utilizando o expansor maxilar Diferencial (EMD) para realizar a ERM. EMD é um novo dispositivo que pode ser empregado para realização da ERM e sua principal vantagem seria permitir a individualização da expansão. EMD foi proposto para proporcionar maior expansão na região anterior do que na região posterior da maxila. Uma menina de 9 anos de idade buscou tratamento. O plano de tratamento interceptativo proposto foi ERM utilizando o dispositivo EMD. A resposta ortopédica pós-expansão mostrou uma abertura de 7,5 mm entre os incisivos centrais superiores, ao nível da borda incisal. Foi observada uma abertura de 4,8 mm na sutura palatina mediana. A abertura a uma distância de 10 mm e 20 mm da crista para posterior na sutura palatina mediana foi de 3,9 mm e 2,8 mm. A distância intercaninos superior apresentou aumento de 9,31 mm. A distância intermolares superiores aumentou 8,04 mm. O perímetro do arco superior apresentou diferença de 74,02 mm para 80,11 mm. E o comprimento do arco superior, de 29,83 mm para 31,56 mm. A mordida cruzada posterior foi sobrecorrigida em 2 mm. O diagnóstico precoce e o tratamento da mordida cruzada posterior tem um prognóstico muito favorável. Palavras-chave: Técnica de Expansão Palatina. Ortodontia Interceptora. Má Oclusão.

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Zhao, Ning, Han Shi, Yun Xu, and Yang Xi Chen. "Orthopedic Effects of Repelling Rare Earth Magnets on Craniofacial Sutures of Rhesus Monkeys." Key Engineering Materials 330-332 (February 2007): 1319–22. http://dx.doi.org/10.4028/www.scientific.net/kem.330-332.1319.

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The objectives of this study are to investigate the influence of class III orthopedic forces generated by repelling rare earth magnets of class III magnetic orthopedic appliance (MOA-III) on the zygmaticomaxillary suture of Rhesus monkeys. Six male Rhesus monkeys in the stage of mixed dentition were used in this study. Fluorescent dyes were injected intravenously in each animal before and during the experimental period. Distinct changes from physiologic growth remodeling were observed in some sutures but not in the control groups. No inflammation was noted in both experimental and control monkeys. The results show that MOA-III is a small intraoral appliance to treat class III malocclusion, and the 300gm per side heavy orthopedic forces are safe and effective for Rhesus monkey.

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Francel, Paul C., T. S. Park, Jeffrey L. Marsh, and Bruce A. Kaufman. "Frontal plagiocephaly secondary to synostosis of the frontosphenoidal suture." Journal of Neurosurgery 83, no. 4 (October 1995): 733–36. http://dx.doi.org/10.3171/jns.1995.83.4.0733.

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✓ Frontal plagiocephaly may arise from either synostotic or deformational forces. Deformational causes of frontal plagiocephaly can be distinguished from synostotic causes by differences seen on physical examination, which can then be confirmed by skull x-ray films and if necessary three-dimensional computerized tomography (CT). Unilateral coronal synostosis is the main synostotic cause of frontal plagiocephaly, although it has also been seen with fusion of the frontozygomatic suture. In several syndromes presenting with bilateral coronal synostosis, fusion of the frontosphenoidal and frontoethmoidal sutures is also present. The authors report, for perhaps the first time, a case showing synostotic frontal plagiocephaly secondary to fusion of the frontosphenoidal suture alone. Although the phenotypic appearance is superficially similar to that seen in unilateral coronal synostosis, analysis of the cranial base shows markedly different effects: angulation of the anterior cranial base with respect to the posterior cranial base away from the synostotic side and angulation of the posterior cranial base with respect to the midpalatal suture also away from the synostotic side. In unilateral coronal synostosis, both angulations are toward the synostotic side. These effects on the cranial base alter its relationship to the cranial vault and the facial skeleton. Most important, frontal plagiocephaly secondary to fusion of the frontosphenoidal suture should not be overlooked as being deformational. Because this fusion is difficult or impossible to visualize by skull x-ray films, three dimensional CT must be obtained in cases that are not clearly identified as deformational plagiocephaly by physical examination.

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Saito, Shiro, and Noriyoshi Shimizu. "Stimulatory effects of low-power laser irradiation on bone regeneration in midpalatal suture during expansion in the rat." American Journal of Orthodontics and Dentofacial Orthopedics 111, no. 5 (May 1997): 525–32. http://dx.doi.org/10.1016/s0889-5406(97)70152-5.

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Kalogirou, Kostas, Johan Ahlgren, and Björn Klinge. "Effects of buccal shields on the maxillary dentoalveolar structures and the midpalatal suture–histologic and biometric studies in rabbits." American Journal of Orthodontics and Dentofacial Orthopedics 109, no. 5 (May 1996): 521–30. http://dx.doi.org/10.1016/s0889-5406(96)70137-3.

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Sermboonsang, Chayapa, Sutiwa Benjakul, Nattapon Chantarapanich, Samroeng Inglam, and Kanlaya Insee. "Effects of miniscrew location on biomechanical performances of bone-borne rapid palatal expander to midpalatal suture: A finite element study." Medical Engineering & Physics 107 (September 2022): 103872. http://dx.doi.org/10.1016/j.medengphy.2022.103872.

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Rasmussen, Chad M., Nadia N. Laack, Thomas J. Salinas, Olivia M. Muller, Sarah K. Y. Lee, and Alan B. Carr. "In Skeletally Immature Children Receiving Radiation for Craniofacial Pathology, Is Success of Subsequent Orthopedic Treatment of Maxillary Transverse Skeletal Deficiency Affected by Inclusion of the Midpalatal Suture in Proton Beam Volume?" Advances in Radiation Oncology 6, no. 4 (July 2021): 100671. http://dx.doi.org/10.1016/j.adro.2021.100671.

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Vadivel, Aarthi, D. Muralidharan, R. Thirunavukkarasu, C. Nirupama, J. Tamizhmani, and C. Prasanth. "Miniscrew-assisted Rapid Palatal Expander – Non-surgical Method for Maxillary Expansion in Young Adults Based on Histological Review." Asian Pacific Journal of Health Sciences 8, no. 4 (October 17, 2021): 121–25. http://dx.doi.org/10.21276/apjhs.2021.8.4.20.

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Expansion is one of the most effectual orthopedic procedures for the treatment of maxillary constriction. Slow and rapid palatal expansion (RPE) are two reliable and commonly used procedures to correct transverse maxillary deficiencies. RPE produces good adaptation at skeletal level in children and adolescents. By late adolescence, the mid-palatal suture allows only limited skeletal expansion and may produce undesirable dental effects. Miniscrew-assisted RPE (MARPE) extended not only skeletal effects with fewer dental changes but also the age limit of nonsurgical maxillary expansion treatment. This review article evaluates the role of MARPE in widening the scope of non-surgical orthodontic treatment from various aspects with a focus on recent studies.

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Bartok, Ruxandra, Bogdan Dimitriu Dimitriu, Constantin Vârlan, Radu Stanciu, Georgiana Moldoveanu, Paul Gagniuc, Ileana Suciu, et al. "Calculations used for assessment of rapid maxillary expansion." ORL.ro 1, no. 1 (March 10, 2016): 24–26. http://dx.doi.org/10.26416/orl.30.1.2016.525.

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Rapid maxillary expansion is defined as the release of medio-palatine suture using an orthopedic forces. The role of this procedure is to expand the upper jaw in order to achieve the broadening of the upper arch. This study was initiated to quantify the effects of disjunction and post- treatment bone changes, after an adequate contention which lasted for three weeks. This study is carried on laboratory animals (common breed rabbit) to determine tensile strength and the elasticity modulus of biological materials used in orthdodontics. The results of the study are consistent with those reported in the literature reference.

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Oda, Sam Golgy Shoyama, Alexandre Navarro Alves Souza, Cesar Augusto Martins Pereira, Andrés Sebastian Aristizabal Escobar, Angélica Cecilia Tartarunas, and Julia Maria Matera. "Biomechanical evaluation of two extracapsular techniques for cranial cruciate ligament reconstruction in cadaver dogs." Semina: Ciências Agrárias 37, no. 3 (June 22, 2016): 1327. http://dx.doi.org/10.5433/1679-0359.2016v37n3p1327.

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Cranial cruciate ligament rupture (CCLR) is one of the most important orthopedic conditions in dogs, leading to joint instability, pain, osteoarthritis and eventually to meniscal injuries. Several surgical techniques have been described to reestablish joint stability following CCLR, including extracapsular procedures. This study compared the biomechanical effects of two extracapsular stabilization techniques (lateral fabello-tibial suture – LFTS, and modified retinacular imbrication technique – MRIT) using nylon leader line following experimental CCLR in cadaver dogs. Twenty canine cadaveric stifles were used. Joint stiffness, cranial and caudal tibial displacement were evaluated in 4 different experimental scenarios: intact stifle, stifle with CCLR, CCLR treated with lateral fabello-tibial suture (LFTS), and CCLR treated with modified retinacular imbrication technique (MRIT). Results: Mean cranial tibial displacement increased progressively from intact to MRIT, LFTS and CCRL stifles. MRIT resulted in less caudal drawer motion than LFTS. Joint stiffness did not differ significantly between LFTS and MRIT treated stifles. Conclusion: LFTS and MRIT increase joint stability but MRIT is more effective; however none of the techniques studied was able to restore original intact stifle stiffness. Clinical implications of the results presented remain to be determined but kinetic gait analysis studies are warranted to determine whether this biomechanical advantage translates into improved hind limb function in dogs.

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Drummond, Nathan, Bradley W. Bruner, Michael H. Heggeness, Bradley Dart, and Shang-You Yang. "Effect of BMP-2 Adherent to Resorbable Sutures on Cartilage Repair: A Rat Model of Xyphoid Process." Materials 13, no. 17 (August 26, 2020): 3764. http://dx.doi.org/10.3390/ma13173764.

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Meniscal tears are often seen in orthopedic practice. The current strategy for meniscal repair has only had limited success with a relatively high incidence of re-operative rate. This study evaluates the therapeutic effects of Bone morphogenetic protein-2 (BMP-2) soaked sutures for cartilage repair, using a rat model of xyphoid healing. Vicryl-resorbable sutures were presoaked in BMP-2 solutions prior to animal experimentation. Rat xyphoid process (an avascular hyaline cartilage structure) was surgically ruptured followed by repair procedures with regular suture or with sutures that were pre-soaked in BMP-2 solutions. In vitro assessment indicated that presoaking the Vicryl-resorbable sutures with 10 µg/mL BMP-2 resulted in a sustained amount of the growth factor release up to 7 days. Histological analysis suggested that application of this BMP-2 soaked suture on the rat xyphoid process model significantly improved the avascular cartilage healing compared to non-soaked control sutures. In conclusion, data here confirm that the rat xyphoid process repair is a reproducible and inexpensive animal model for meniscus and other cartilage repair. More importantly, coating of BMP-2 on sutures appears a potential avenue to improve cartilage repair and regeneration. Further study is warranted to explore the molecular mechanisms of this strategy.

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Oliva, V. N. L. S., V. B. Albuquerque, B. P. Floriano, T. M. Meneghetti, C. J. X. Abimussi, J. Z. Ferreira, J. T. Wagatsuma, G. M. Laranjeira, and P. S. P. Santos. "Different rates of tramadol infusion for peri and postoperative analgesia in dogs undergoing orthopedic surgery." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 71, no. 1 (February 2019): 127–36. http://dx.doi.org/10.1590/1678-4162-10244.

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ABSTRACT The study aimed to determine the continuous rate infusion of tramadol associated with peri- and postoperative analgesia for orthopedic surgeries in dogs, as well as cardiorespiratory and adverse effects. Thirty dogs aged 4.2±1.2 years and weighing 15.1±0.9kg were enrolled in the study, premedicated intramuscularly with acepromazine (0.04mg kg-1) and tramadol (2mg kg-1); anesthesia was induced with propofol and maintained with isoflurane in oxygen. Three infusion rates were compared, comprising three experimental groups: G2: 2.0mg kg-1 h-1; G2.5: 2.5mg kg-1 h-1; and G3: 3.0mg kg-1 h-1. Surgery was initiated 15 minutes following the start of tramadol infusion. During anesthesia, animals were monitored in predefined time points: immediately after tracheal intubation and start of inhalation anesthesia (T0); surgical incision (TSI); final suture (TFS) and end of tramadol infusion (TEI), which was maintained for at least 120 minutes and prolonged according to the duration of surgery. Postoperative analgesia was evaluated through an interval pain scoring scale and the Melbourne pain scale. The mean time of tramadol infusion was greater than 120 minutes in all groups and no differences were found among them (141±27 minutes in G2, 137±27 minutes in G2.5 and 137±30 minutes in G3). Perioperative analgesia was regarded as short and did not correlate with infusion rates. Tramadol infusion provided adequate analgesia with cardiorespiratory stability Analgesia was not dose-dependent, however, and residual postoperative effects were short-lasting, which warrants proper postoperative analgesia following tramadol infusion. Additional studies are required using higher infusion rates and standardized nociceptive stimulation in order to determine how doses influence tramadol analgesia and whe therthereis a limit to its effect in dogs.

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Fernandes, Luciana Quintanilha Pires, Jonas Capelli Junior, and José Augusto Mendes Miguel. "Expansão Maxilar Apoiada em Mini-implantes (MARPE) – guia prático para planejamento e instalação." Orthodontic Science and Practice 13, no. 52 (2020): 10–24. http://dx.doi.org/10.24077/2020;1352-csf1024.

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Rapid maxillary expansion (RME) is an orthodontic treatment alternative that aims to increase the transverse direction of the maxilla by separating the median palatine suture (MPS). miniscrew-assisted rapid palatal expansion (MARPE) aims to enhance the orthopedic effects of RME through skeletal anchorage. Thus, the aim of this article is to provide a guide for MARPE planning in cone beam computed tomography (CBCT) and for installation of the expander device with this technique. In addition, a case report of a Caucasian male patient, 16 years and 3 months old with Class II malocclusion, division 1 right subdivision, posterior crossbite of the right side and atresic upper arch in the post-pubertal growth spurt phase will be presented. The patient was treated with MARPE for a period of 5 weeks, when overcorrection of crossbite, correction of maxillary atresia, opening of MPS and creation of a transient diastema between the upper incisors were achieved, evidencing the success of the MARPE technique in a post-pubertal growth spurt patient.

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de Oliveira Cavassan, Arlete, Marcelo D'Albuquerque de Albuquerque, and Leopoldino Capelozza Filho. "Rapid Maxillary Expansion after Secondary Alveolar Bone Graft in a Patient with Bilateral Cleft Lip and Palate." Cleft Palate-Craniofacial Journal 41, no. 3 (May 2004): 332–39. http://dx.doi.org/10.1597/02-099.1.

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Objective To verify the effects of rapid maxillary expansion performed after secondary alveolar bone graft in one patient. Setting Department of Orthodontics of the Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo. Patient(s) The patient had bilateral cleft lip and palate, had already had a bone graft, and showed a relapsing maxillary constriction in need of correction. Intervention A fixed dental-mucous-bone-supported expander corrected the maxillary constriction. Main Outcome Measure(s) Measurements were obtained from dental casts, including transverse dimensions (intercanine distance [IC], interfirst premolar distance [IP], and interfirst molar distance [IM]) and measurements of the grafted area (interfirst premolar/central incisors [IPI] and interfirst premolar/canine [IPC]) to observe the changes. Clinical and radiographic analyses were done through direct view. Results The occlusal radiograph of the maxilla after expansion showed opening of the intermaxillary suture in the premaxillary area, which was clinically confirmed by the diastema between the maxillary central incisors. No radiographic alteration was observed in the grafted area. The transverse measurements of the dental casts (IC, IP, and IM) showed a significant increase. The measurements of the teeth adjacent to the grafted area, IPI and IPC, increased. Conclusions The orthopedic effect of rapid maxillary expansion after bone graft was verified. Nevertheless, additional studies are necessary to define any side effects in patients submitted to bone graft.

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BISTAFFA, Alisson Gabriel Idelfonso, Luciana BELOMO-YAMAGUCHI, Marcio Rodrigues de ALMEIDA, Ana Claudia de Castro Ferreira CONTI, Paula Vanessa Pedron OLTRAMARI, and Thais Maria Freire FERNANDES. "Immediate skeletal effects of rapid maxillary expansion at midpalatal suture opening with Differential, Hyrax and Haas expanders." Dental Press Journal of Orthodontics 27, no. 6 (2022). http://dx.doi.org/10.1590/2177-6709.27.6.e2220525.oar.

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ABSTRACT Objective: The aim of this study was to test the null hypothesis that there is no difference at the midpalatal suture opening after rapid maxillary expansion (RME) using Expander with Differential Opening (EDO), Hyrax-type and Haas-type expanders. Methods: Occlusal radiographs of 52 patients (19 males and 33 females; average age= 9.46?1.20 years) treated with RME were divided into three groups, according to the expander used: EDO (n=17), Hyrax-type (n=21) and Haas-type (n=14). The evaluated variables were: A) Distance between the maxillary central incisors at the incisal edge; B) Distance between the alveolar ridges at the midpalatal suture; C) Suture opening at 10-mm distance from the crest to posterior, at the midpalatal suture; D) Suture opening at 20-mm distance from the crest to posterior, at the midpalatal suture; and E) Suture opening at 30-mm distance from the crest to posterior, at the midpalatal suture. To assess the normality of variables, the Shapiro-Wilk test was performed. For intergroup comparison, ANOVA with a significance level of 5% was used. Results: At the region A, Hyrax-type (4.66 mm) and EDO (4.87 mm) groups presented larger openings than the Haas-type group (3.43 mm). In regions B and C, EDO showed a statistically significant greater opening than the Haas-type group. In region D, a smaller opening of the midpalatal suture was observed in the Haas-type group, compared to the Hyrax-type and EDO groups. Conclusions: EDO and Hyrax-type produced greater immediate skeletal effects, compared with Haas-type, but these differences were about 1 mm and might not be clinically significant.

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Chun, Joo-Hee, Amanda Cunha Regal de Castro, Sunmee Oh, Kyung-Ho Kim, Sung-Hwan Choi, Lincoln Issamu Nojima, Matilde da Cunha Gonçalves Nojima, and Kee-Joon Lee. "Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT." BMC Oral Health 22, no. 1 (April 8, 2022). http://dx.doi.org/10.1186/s12903-022-02138-w.

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Abstract Background This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) in adolescent and young adult patients. Methods This study followed a two-arm, parallel, randomized clinical trial design that recruited patients with transverse maxillary deficiency in a 1:1 allocation ratio. Forty patients (14 men and 26 women) requiring maxillary expansion were randomly allocated to the RPE (n = 20, age = 14.0 ± 4.5) or MARPE (n = 20, age = 14.1 ± 4.2) groups. The assignment was performed via computer-generated block randomization, with a block size of four. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). The primary outcome of this study comprised the assessment of midpalatal suture separation. Secondary outcomes included, skeletal, dentoalveolar, and periodontal measurements, which were performed at each time point. Results The frequency of midpalatal suture separation was 90% (18/20) and 95% (19/20) for the RPE and MARPE groups, respectively. A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after the expansion (T1-T0) and consolidation periods (T2-T0) in the MARPE group compared to the RPE group (P < 0.05). The MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW). The MARPE group presented greater bilateral first premolar (PM-MW) and molar (M-MW) maxillary width in relation to the RPE group (P < 0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT)( P < 0.05). Conclusions Midpalatal suture separation was observed in 90% and 95% of patients in the RPE and MARPE groups, respectively. Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. Trial registration WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration date 27/12/2021).

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ÇAMILI, Yasin, Sıddık MALKOÇ, Aslı TAŞLIDERE, Zehra İLERI, and Ozge Celik GULER. "Effects of teriparatide on bone formation in rats with experimentally induced premaxillary expansion." Dental Press Journal of Orthodontics 27, no. 3 (2022). http://dx.doi.org/10.1590/2177-6709.27.3.e2220370.oar.

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ABSTRACT Objective: This study aimed to evaluate the effects of systemic teriparatide on sutural bone formation after premaxillary suture expansion in rats. Material and Methods: Twenty Wistar male rats (8-10 weeks old) were randomly divided into two groups, namely, control (C, n=10) and teriparatide (T, n=10). An expansion force was applied to the maxillary incisors using helical spring for a seven-day expansion period, for both groups. On the eighth day, the rats were kept for a seven-day consolidation period, and then 60 µg/kg teriparatide (once a day) was administered to group T subcutaneously for seven days. Then, all the rats were sacrificed, and histological sections were stained with hemotoxylin-eosin for examination. Anti-osteonectin, anti-osteocalcin, anti-Vascular endothelial growth factor (VEGF) and anti-transforming growth factor beta (TGF-β) were evaluated by immunohistochemical analysis in the midpalatal suture area. Results: Histologically, the newly formed bone tissue was observed to be larger in group T than in group C. The number of immunoreactive osteoblasts for osteonectin, osteocalcin and VEGF antibodies was significantly higher in group T than in group C (p = 0.0001). The TGF-β antibody showed a mild reaction in group T, but did not reach significance in comparison with group C (p ˃ 0.05). Conclusion: Systemic teriparatide application following the premaxillary expansion of the suture area may stimulate bone formation and add to the consolidation of the expansion in rats by regulating osteonectin, osteocalcin and VEGF.

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Bazargani, Farhan, Henrik Lund, Anders Magnuson, and Björn Ludwig. "Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances: a randomized controlled trial with 1-year follow-up." European Journal of Orthodontics, August 6, 2020. http://dx.doi.org/10.1093/ejo/cjaa040.

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Summary Objectives To evaluate and compare the skeletal and dentoalveolar effects of tooth-borne (TB) and tooth-bone-borne (TBB) rapid maxillary expansion (RME). Materials and methods Fifty-two consecutive patients who met the eligibility criteria were recruited and allocated to either the TB group, mean age 9.3 years [standard deviation (SD) 1.3], or the TBB group, mean age 9.5 years (SD 1.2). Cone-beam computed tomography (CBCT) records and plaster models were taken before (T0), directly after (T1), and 1 year after expansion (T2). Dentoalveolar and skeletal measurements were made on the CBCT images. The dental expansion was also measured on the plaster models. Randomization Participants were randomly allocated in blocks of different sizes using the concealed allocation principle in a 1:1 ratio. The randomization list was also stratified by sex to ensure homogeneity between groups. Blinding Due to clinical limitations, only the outcomes assessors were blinded to the groups to which the patients were allocated. Results Skeletal expansion in the midpalatal suture and at the level of the nasal cavity was significantly higher in the TBB group. However, the magnitude of the expansion in the midpalatal suture was around 1 mm [95 per cent confidence interval (CI) 0.5–1.7, P = 0.001] more and perhaps not clinically significant. The magnitude of the expansion at the level of the nasal cavity was almost two times higher in the TBB group (95 per cent CI 0.7–2.6, P = 0.001). The dental expansion, alveolar bending, tipping of the molars, and stability 1 year post-expansion did not show any statistically significant differences between the groups. The actual direct cost of the treatment for the TBB group was approximately €300 higher than TB group. Limitations Double blinding was not possible due to the clinical limitations. Conclusions In young preadolescents with constricted maxilla and no signs of upper airway obstruction, it seems that conventional TB RME achieves the same clinical results with good stability 1 year post-expansion at lower cost. Trial registration The trial was not registered.

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Panchal, Hemangi, Alap Shah, Rushvi Mistry, Kinnari Shah, Bharvi Jani, and Aditi Mehta. "The effects of 3-D Screw on the nasomaxillary complex in skeletal class III malocclusion." International journal of health sciences, March 31, 2022, 496–507. http://dx.doi.org/10.53730/ijhs.v6ns3.5317.

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Aim of the study is to evaluate the Stress distribution and displacement of various structures of nasomaxillary complex with 3- D screw in skeletal class III malocclusion. An analytical model was developed from a human skull of a 15-year-old male. CT scan images of the skull were taken in axial direction parallel to the F-H plane, which was processed using Mimics software, required portion of the skull & 3-D screw appliance was converted into geometric model using reverse engineering technique. ANSYS software was used to solve the mathematical equation. Contour plots of the displacement and stresses were obtained from the results of the analysis performed. Maximum transverse displacement was 3.18mm at the permanent first maxillary teeth. Maximum antero-posterior displacement was 1.26mm at the anterior part of zygomatic bone and 1.35mm of displacement frontozygomatic suture. maximum vertical displacement was 2.81 mm representing the inferior and medial portion of the nasal bone and indicating downward displacement. Pyramidal displacement of maxilla was evident. Apex of pyramid faced towards nasal bone and base was located on the oral side. There was downward, forward movement of maxilla with a tendency toward posterior rotation. Maximum von Mises stresses were found along midpalatal, zygomaticomaxillary, nasomaxillary, frontozygomatic sutures.

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Ferracini, Riccardo, Stefano Artiaco, Walter Daghino, Mara Falco, Alessandra Gallo, Riccardo Garibaldi, Emilia Tiraboschi, Claudio Guidotti, and Alessandro Bistolfi. "Microfragmented Adipose Tissue (M-FATS) for Improved Healing of Surgically Repaired Achilles Tendon Tears: A Preliminary Study." Foot & Ankle Specialist, November 26, 2020, 193864002097455. http://dx.doi.org/10.1177/1938640020974557.

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Introduction Tendon healing is a complicated process that results in inferior structural and functional properties when compared with healthy tendon; the purpose of this study was to assess the effects of the adjunct of microfragmented adipose tissue (M-FATS) after the suture of a series of Achilles tendons. Methods After complete Achilles tendon tear, 8 patients underwent open suture repair in conjunction with perilesional application of a preparation of M-FATS rich in mesenchymal stem cells. Results were compared with a similar group of patients treated with conventional open suture. Outcomes were evaluated based on range of motion, functional recovery, and complications according to the American Orthopedic Foot and Ankle Society (AOFAS) score and Foot and Ankle Disability Index (FADI). Achilles tendons were examined by ultrasound (US) at 3 months. Results The AOFAS and FADI scores showed no differences between the 2 groups. US evaluation showed quicker tendon remodeling in the M-FATS group. Adverse events were not documented for both procedures. Conclusions The combined application of derived M-FATS for tendon rupture is safe and presents new possibilities for enhanced healing. Levels of Evidence Level IIIb: Case control study

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SEVILLANO, Manuel Gustavo Chávez, Daniel Takanori KEMMOKU, Pedro Yoshito NORITOMI, Luciana Quintanilha Pires FERNANDES, Jonas CAPELLI JUNIOR, and Cátia QUINTÃO. "New highlights on effects of rapid palatal expansion on the skull base: a finite element analysis study." Dental Press Journal of Orthodontics 26, no. 6 (2021). http://dx.doi.org/10.1590/2177-6709.26.6.e2120162.oar.

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ABSTRACT Objective: The objective of this study was to evaluate the effect of the rapid palatal expansion (RPE) on the pterygoid process (PP), spheno-occipital synchondrosis (SOS) and sella turcica (ST) in the skull of a patient with transversal maxillary collapse, and identify the distribution of mechanical stresses and displacement, by finite element analysis (FEA). Methods: Cone-beam computed tomography (CBCT) was employed to examine the skull of a patient in this study. The patient was a 13-year-old boy, with Class II skeletal relationship due to transverse atresia and maxillary protrusion. The computer-aided design (CAD) geometry of skull was imported into the SimLab v. 13.1 software, to build the finite element mesh. For the simulation, a displacement of 1 mm, 3 mm and 5 mm in a transverse direction was defined at the midpalatal suture, thereby representing the RPE. For the analysis of results, maximum principal stress (MPS) and displacements were evaluated by identifying different nodes, which were represented by the points as per the areas of interest in the study. Results: In MPS, the maximum tensile stress was found at point 2 (366.50 MPa) and point 3 (271.50 Mpa). The maximum compressive stress was found at point 8 (-5.84 Mpa). The higher displacements in the transversal plane and the lateral segment were located at point 1 (2.212 mm), point 2 (0.903 mm) and point 3 (0.238 mm). Conclusions: RPE has a direct effect on PP, SOS and ST in the Class II model skeletal relationship with a transversal maxillary collapse. PP supported a higher tensile stress and displacement.

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Küchler, Erika Calvano, Rafaela Mariana de Lara, Marjorie Ayumi Omori, Guido Marañón-Vásquez, Flares Baratto-Filho, Paulo Nelson-Filho, Maria Bernadete Sasso Stuani, et al. "Effects of estrogen deficiency during puberty on maxillary and mandibular growth and associated gene expression – an μCT study on rats." Head & Face Medicine 17, no. 1 (April 22, 2021). http://dx.doi.org/10.1186/s13005-021-00265-3.

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Abstract Background Estrogen is a well-known and important hormone involved in skeletal homeostasis, which regulates genes involved in bone biology. Some studies support that estrogen is important for craniofacial growth and development. Therefore this in vivo animal study aimed to investigate, whether and in which way low estrogen levels in the prepubertal period affect craniofacial development in the postpubertal stage and to quantify the gene expression of RANK, RANKL and OPG in cranial growth sites in ovariectomized estrogen-deficient rats during puberty. Methods Control (sham-operated, n = 18) and ovariectomy (OVX, n = 18) surgeries were performed on 21-days-old female Wistar rats. Animals euthanized at an age of 45 days (pubertal stage) were used for gene expression analyses (n = 6 per group) and immunohistochemistry of RANK, RANKL and OPG. Animals euthanized at 63 days of age (post-pubertal stage) were used for craniofacial two-dimensional and three-dimensional craniofacial measurements using μCT imaging (n = 12 per group). Results In the μCT analysis of the mandible and maxilla many statistically significant differences between sham-operated and OVX groups were observed, such as increased maxillary and mandibular bone length in OVX animals (p < 0.05). Condylar volume was also significantly different between groups (p < 0.05). The sham-operated group showed a higher level of RANK expression in the midpalatal suture (p = 0.036) and the RANKL:OPG ratio levels were higher in the OVX group (p = 0.015). Conclusions Our results suggest that estrogen deficiency during the prepubertal period is associated with alterations in the maxillary and mandibular bone length and condylar growth.

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Journal articles on the topic 'Orthopedic effects, midpalatal suture'

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