Abstract
BackgroundAnchorage onto permanent dentition is a common procedure in rapid maxillary expansion. However, replacing first permanent molars with the second deciduous molars seems to be an option to reduce some negative side effects during orthodontic treatment. The purpose of this study was to evaluate the dental effect of rapid maxillary expansion with anchorage exclusively onto deciduous teeth performed in the first period of transition.MethodsTwenty patients with a lateral cross-bite treated exclusively by a Haas expander in early mixed dentition were retrospectively analyzed before treatment, at appliance removal, and at 21 months out of retention. The sagittal and transverse dimensions, together with the inter-canine arch and irregularity index, were digitally measured on scanned images of dental casts. The patients were compared with three balanced control groups (in total, 60 individuals) matched for gender. Two control groups had the same canine dental class as the treated group at T1, were in the inter-transitional period, and either had or lacked a lateral cross-bite. The last control group was comprised of adolescents in permanent dentition with a dental class I. The statistical analysis was performed by means of repeated-measures ANOVA for paired data and one-way ANOVA, the Kruskal-Wallis test, and the Mann-Whitney test for independent measures (α-level p < 0.05).ResultsAt the end of follow-up (inter-transitional period of dentition), the dental arch dimensions of treated patients were similar to those of adolescents with a dental class I and significantly wider than those of patients with a lateral cross-bite. Also, the anterior irregularity index was lower among patients who had undergone expansion treatments than in all untreated study participants.ConclusionsThe Haas expander anchored to the deciduous teeth is effective in increasing the dental arch width in patients with a lateral cross-bite. The dimensions of the dental arch were modified earlier toward the values of the permanent dentition.
Highlights
Anchorage onto permanent dentition is a common procedure in rapid maxillary expansion
Some authors [8,9,10,11] have demonstrated the effectiveness of a modified Haas device, anchored onto the deciduous teeth, in producing expansion of the transverse diameters of the upper arch
The Haas appliance was anchored to the second deciduous molars and deciduous canines (Fig. 1) and was activated once or twice per day; each activation was 0.2 mm, with a maximum allowable total expansion of 10 mm
Summary
Anchorage onto permanent dentition is a common procedure in rapid maxillary expansion. The purpose of this study was to evaluate the dental effect of rapid maxillary expansion with anchorage exclusively onto deciduous teeth performed in the first period of transition. Some authors [8,9,10,11] have demonstrated the effectiveness of a modified Haas device, anchored onto the deciduous teeth (canines and second deciduous molars), in producing expansion of the transverse diameters of the upper arch. The purpose of the present study was to investigate the clinical relevance of changes in dental arch dimensions and irregularity produced by a Haas appliance anchored onto the deciduous dentition and to compare young treated patients with homogeneous untreated individuals The anchorage onto deciduous teeth could be a viable option for preventing root resorption [2, 13,14,15], bone loss [16, 17], gingival recession [18], and white-spot lesions [19] on permanent dentition.
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