Skeletal and Dentoalveolar Changes With Mandibular Expansion in Growing Children

Vaibhav Gandhi; Farheen Malek; Shivam Mehta; Aditya Tadinada; Robert Goldman; Sumit Yadav

doi:10.7759/cureus.47723

Skeletal and Dentoalveolar Changes With Mandibular Expansion in Growing Children

Cureus. 2023 Oct 26;15(10):e47723. doi: 10.7759/cureus.47723. eCollection 2023 Oct.

Authors

Vaibhav Gandhi¹, Farheen Malek², Shivam Mehta³, Aditya Tadinada⁴, Robert Goldman⁵, Sumit Yadav⁶

Affiliations

¹ Orthodontics and Dentofacial Orthopaedics, University of Louisville, Louisville, USA.
² Prosthodontics, Louisiana State University (LSU) School of Dentistry, New Orleans, USA.
³ Orthodontics, Marquette University School of Dentistry, Milwaukee, USA.
⁴ Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA.
⁵ Orthodontics, University of Connecticut, Farmington, USA.
⁶ Growth and Development, University of Nebraska Medical Center, Lincoln, USA.

Abstract

Introduction The primary objective of this study was to quantitatively analyze the skeletal and dentoalveolar parameters following the mandibular expansion with a banded appliance. It was also part of the study to evaluate the amount of dental expansion and assess the change in the intermolar and individual first molar angulation. The basal bone parameters were compared to assess the skeletal effect of removable mandibular expansion appliance therapy. Methods In this retrospective cone beam computed tomography (CBCT) study, a total of 80 subjects with mandibular expansion therapy were screened. After imposing inclusion/exclusion criteria, 70 patients (40 females and 30 males) with a mean age of 8.8±1.24 years and 4.79±3.59 months were included. The mean expansion period was 3.04±1.61 months. Skeletal parameters such as buccal cortical thickness, buccal bone width, and cortical density were measured at 2mm from the alveolar crest, mid-root, and apex region in the coronal slice at the level of the mesiobuccal root of the first molar. Expansion parameters such as intermolar width, intermolar angulation, and individual molar angulation were also measured in the same slice. Finally, basal bone parameters such as inter-mental foramina distance and anterior arch perimeter were recorded. Results No significant difference (p>0.05) was found for most skeletal parameters following the expansion, except for the mid-root buccal bone width (p<0.05). On average, 4.54±2.53 mm of dental expansion (p<0.05) was achieved at the first molar region. Individual molar angulation showed a statistically significant difference (right = 7.46±7.91°, left = 7.53±7.18°, p=<0.05). The basal bone parameters showed no significant difference (p>0.05). Conclusions The mandibular expansion device leads to an increase in intermolar distance. The amount of expansion achieved with such devices is due to the buccal tipping of the molars. Skeletal effects such as cortical thickness, buccal bone width, or changes in the basal bone dimensions should not be expected with mandibular expansion therapy.

Keywords: cone-beam computed tomography; cone-beam computed tomography (cbct); mandible; mandibular expansion; mixed dentition; phase 1 orthodontic treatment.