Predictors of long-term stability of maxillary dental arch dimensions in patients treated with a transpalatal arch followed by fixed appliances

Prog Orthod. 2015:16:24. doi: 10.1186/s40510-015-0094-9. Epub 2015 Jul 28.

Abstract

Background: The aim of this retrospective study was to identify which dental and/or cephalometric variables were predictors of long-term maxillary dental arch stability in patients treated with a transpalatal arch (TPA) during the mixed dentition phase followed by full fixed appliances in the permanent dentition.

Methods: Thirty-six patients, treated with TPA followed up by full fixed appliances, were divided into stable and relapse groups based on the long-term presence or not of relapse. Intercuspid, interpremolar and intermolar widths, arch length and perimeter, crowding, and upper incisor proclination were evaluated before treatment (T 0), post-TPA treatment (T 1), post-fixed appliance treatment (T 2), and a minimum of 3 years after full fixed appliances' removal (T 3). A binary logistic regression was performed thereafter to evaluate the impact of the dental arch and cephalometric measurements at T 1 and the changes between T 0 and T 1 as predictive variables for relapse at T 3.

Results: The proposed model explained 42.7 % of the variance in treatment stability and correctly classified 72.2 % of the sample. Of the seven predictive variables, only upper anterior crowding (p = 0.029) was statistically significant. For every millimeter of decreased crowding at T 1 (after TPA treatment/before starting the fixed orthodontic treatment), there was an increase of 3.57 times in the odds of having stability.

Conclusions: The best predictor of relapse was maxillary crowding before treatment. The odds of relapse increase by 3.6 times for every millimeter of crowding at baseline.

MeSH terms

  • Bicuspid / pathology
  • Cephalometry / methods
  • Child
  • Cuspid / pathology
  • Dental Arch / pathology*
  • Dentition, Mixed
  • Female
  • Follow-Up Studies
  • Forecasting
  • Humans
  • Incisor / pathology
  • Male
  • Malocclusion / pathology
  • Malocclusion / therapy
  • Malocclusion, Angle Class I / therapy
  • Malocclusion, Angle Class II / therapy
  • Maxilla / pathology*
  • Molar / pathology
  • Orthodontic Brackets*
  • Palatal Expansion Technique / instrumentation*
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome