Maxillary dental and skeletal effects after treatment with self-ligating appliance and miniscrew-assisted rapid maxillary expansion

• Published in: American journal of orthodontics and dentofacial orthopedics 2021-02, Vol.159 (2), p.e93-e101
• Main Authors: Calil, Roberta Caetano, Marin Ramirez, Cecilia Maria, Otazu, Aldo, Torres, Dino Marcelo, Gurgel, Júlio de Araújo, Oliveira, Renata Cristina, de Oliveira, Ricardo Cesar Gobbi, Valarelli, Fabricio Pinelli, Freitas, Karina Maria Salvatore
• Format: Article
• Language: English
• Subjects: Adult; Bicuspid; Cone-Beam Computed Tomography; Dental Arch; Humans; Malocclusion, Angle Class I; Maxilla - diagnostic imaging; Orthodontic Appliance Design; Palatal Expansion Technique; Young Adult
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2020.09.011

The objective of the present study was to compare the maxillary dental and skeletal effects after treatment with self-ligating appliance and miniscrew-assisted rapid maxillary expansion (MARPE). The sample comprised 37 patients with Class I malocclusion treated without tooth extraction, divided into 2 groups: group 1 comprises 21 patients with a mean age of 19.55 years (standard deviation = 1.31), submitted to orthodontic treatment with Damon self-ligating appliance, and evaluated until the end of the alignment and leveling stage. Group 2 comprises 16 patients with a mean age of 24.92 years (standard deviation = 7.60), with maxillary atresia, who underwent MARPE, and were evaluated after the removal of the expander. Buccal bone thickness; dental inclinations; and transverse distances of the maxillary arch, nasal base, and jugula widths were measured on cone-beam computed tomography scans before and after treatment. The intergroup comparison was performed with the independent t test. With treatment, there was a significantly greater decrease in buccal bone thickness of canines and premolars in the self-ligating group, the premolars presented a greater buccal inclination in the self-ligating group, and the intercanine and intermolar distances and nasal base and jugula widths showed significantly greater increases in the MARPE group than in the self-ligating group. MARPE treated more severe skeletal transverse maxillary discrepancies and obtained better results than self-ligating appliances in terms of buccal bone loss, tooth inclination, and transverse skeletal increase of the maxilla. MARPE presented more skeletal effects and self-ligating appliances, more dental effects. •Miniscrew assisted rapid palatal expansion (MARPE) and self-ligating appliances were compared.•MARPE produced more skeletal effects; self-ligating appliances more dental effects.•Both treatments resulted in some bone loss and buccal inclination of posterior teeth.•MARPE should be considered for patients with severe skeletal maxillary atresia and posterior crossbite.•Self-ligating appliances are indicated when transverse increase would be beneficial.