Molar inclination and surrounding alveolar bone change relative to the design of bone-borne maxillary expanders: A CBCT study

Angle Orthod. 2020 Jan;90(1):13-22. doi: 10.2319/050619-316.1. Epub 2019 Aug 28.

Abstract

Objective: To evaluate the molar inclination and skeletal and alveolar bone changes when comparing tooth bone-borne (MSE) and tissue bone-borne type maxillary expanders (C-expander) using cone-beam computed tomography (CBCT) in late adolescence.

Materials and methods: A sample of 48 late-adolescent patients were divided into two groups according to the type of expander: MSE group (n = 24, age = 19.2 ± 5.9 years) and C-expander group (n = 24, age = 18.1 ± 4.5 years). CBCT scans were taken before treatment and 3 months after expansion. Transverse skeletal and dental expansion, alveolar inclination, tooth axis, buccal alveolar bone height, thickness, dehiscence, and fenestration were evaluated on the maxillary first molar. Paired t-test, independent t-test, Pearson's chi-square test, and Spearman correlation analysis were performed.

Results: The MSE group produced greater dental expansion (P < .05), whereas skeletal expansion was similar in both groups (P = .859). The C expander group had more alveolar bone inclination change (P < .01), and the MSE group had more buccal tipping of the anchorage teeth (P < .01 or .001). Buccal alveolar bone height loss and thickness changes were greater in the MSE group (P < .01 or <.001). Formation of dehiscences was more frequent in the MSE group (P < .001), whereas for fenestrations, there were no significant differences between the two groups. Buccal bone height loss in the MSE group had a negative correlation with initial buccal bone thickness.

Conclusions: The incorporation of teeth into bone-borne expanders resulted in an increase in the severity of side effects. For patients in late adolescence, tissue bone-borne expanders offer comparable skeletal effects to tooth bone-borne expanders, with fewer dentoalveolar side effects.

Keywords: C-Expander; C-implant; CBCT; Maxillary skeletal expander; Nasomaxillary complex; Rapid maxillary expansion.

MeSH terms

  • Adolescent
  • Cone-Beam Computed Tomography
  • Humans
  • Maxilla
  • Molar* / diagnostic imaging
  • Palatal Expansion Technique*
  • Spiral Cone-Beam Computed Tomography*
  • Young Adult