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Three-dimensional evaluation of soft tissue changes in the orofacial region after tooth-borne and bone-borne surgically assisted rapid maxillary expansion

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Abstract

Objectives

This study seeks to three-dimensionally assess soft tissue changes in the orofacial region following tooth-borne and bone-borne surgically assisted rapid maxillary expansion (SARME).

Materials and methods

This prospective cohort study included 40 skeletally mature patients with transverse maxillary hypoplasia. A tooth-borne distractor (Hyrax) was used for expansion in 25 patients. In the remaining 15, a bone-borne distractor (transpalatal distractor, TPD) was used. Cone beam computed tomography (CBCT) scans were acquired before treatment (T0) and 22 months later (T1). 3D models were constructed from CBCT data and superimposed using voxel-based matching. Distance maps between the superimposed 3D models were computed to evaluate the degree of skeletal and soft tissue changes in the maxillary region.

Results

Distance maps showed negative distances (mean −1.25 (±1.5) mm) in the middle of the upper lip, indicating posterior repositioning of this area. The cheek region showed positive changes (mean 1.66 (±1.1) mm), reflecting the underlying increase in maxillary width. There was no significant difference between the two groups in all measured distances (p > 0.05). Retro-positioning of the upper lip accompanied skeletal remodeling in the anterior alveolar region at a mean ratio of 88 %, while the cheek region followed 32 % of the alveolar expansion.

Conclusion

Soft tissue changes following SARME include posterior repositioning of the upper lip and increased projection of the cheek area. These changes were comparable between bone-borne and tooth-borne appliances.

Clinical relevance

This study provides clinicians with more information over the expected orofacial soft tissue changes following SARME

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Acknowledgments

The authors would like to acknowledge Dr. Martien de Koning, who surgically treated all patients in this study.

Funding

This work was supported by a grant from the Dutch Technology Foundation (STW 10315). R. Nada was funded by the Netherlands Fellowship Program PhD studies, Netherlands Ministry of Foreign Affairs, and Netherlands Organization for International Cooperation in Higher Education (Nuffic), grant number: NFP-PhD: CF 2916/2006. The sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre 309 Dentistry, PO Box 9101, 6500, HB, Nijmegen, The Netherlands

    Rania M. Nada, Anne Marie Kuijpers-Jagtman & Jan GJH Schols

  2. Department of Orthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt

    Rania M. Nada & Yehya A. Mostafa

  3. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Bram van Loon, Thomas J.J. Maal & Stefaan J. Bergé

Authors
  1. Rania M. Nada
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  2. Bram van Loon
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  3. Thomas J.J. Maal
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  4. Stefaan J. Bergé
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  5. Yehya A. Mostafa
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  6. Anne Marie Kuijpers-Jagtman
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  7. Jan GJH Schols
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Corresponding author

Correspondence to Anne Marie Kuijpers-Jagtman.

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Nada, R.M., van Loon, B., Maal, T.J. et al. Three-dimensional evaluation of soft tissue changes in the orofacial region after tooth-borne and bone-borne surgically assisted rapid maxillary expansion. Clin Oral Invest 17, 2017–2024 (2013). https://doi.org/10.1007/s00784-013-0927-1

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  • DOI: https://doi.org/10.1007/s00784-013-0927-1

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