Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol.

Winsauer, Heinz; Walter, Andre; Katsaros, Christos; Ploder, Oliver (2021). Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol. Head & face medicine, 17(1), p. 50. BioMed Central 10.1186/s13005-021-00301-2

[img]
Preview
Text
Winsauer_et_al_2021.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview

INTRODUCTION

Bone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC).

METHODS

This consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others.

RESULTS

Successful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects' complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019).

CONCLUSIONS

1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%. 2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed. 3. Complications were significantly associated with age. 4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients.

TRIAL REGISTRATION

Consecutive cohort study, Review Board No. EK-2-2014/0016.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics

UniBE Contributor:

Katsaros, Christos

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1746-160X

Publisher:

BioMed Central

Language:

English

Submitter:

Renate Imhof-Etter

Date Deposited:

04 Jan 2022 07:45

Last Modified:

05 Dec 2022 15:57

Publisher DOI:

10.1186/s13005-021-00301-2

PubMed ID:

34895287

Uncontrolled Keywords:

Adult patients Bone-borne Complication MAPE MARPE Maxillary expansion Miniscrew Non-surgical Success

BORIS DOI:

10.48350/162581

URI:

https://boris.unibe.ch/id/eprint/162581

Actions (login required)

Edit item Edit item
Provide Feedback