Assessment of Patient-Centered Outcomes When Treating Maxillary Constriction Using a Slow Removable Versus a Rapid Fixed Expansion Appliance in the Adolescence Period: A Randomized Controlled Trial.

Nancy Rabah,Mohammad Y Hajeer,Ghiath Mahmoud,Mowaffak A Ajaj,Heba M Al-Ibrahim

doi:10.7759/cureus.22793

Abstract

ObjectiveThis study aimed to evaluate and compare the levels of pain, discomfort, and functional impairments between slow and rapid maxillary expansion (RME) in treating skeletal maxillary constriction in the adolescence period (i.e., between 12 and 16 years).Materials and methodsThe study sample consisted of 52 patients (21 males and 31 females) with maxillary skeletal constriction in the posterior region. The patients were randomly distributed into either RME (26 patients, with a mean age of 13.87 (± 1.31) years) or slow maxillary expansion group (SME, 26 patients, with a mean age of 14.31 (± 1.19) years). The levels of pain, discomfort, and functional difficulties were assessed after 24 hours (T1), 7 days (T2), 15 days (T3), one month (T4), and four months (T5) following the onset of the expansion procedure.ResultsPatients in the RME group encountered significantly greater levels of pain and discomfort than those in the SME group at T1, T2, and T3 (p>0.001). Chewing and swallowing difficulties were significantly greater in the RME group at T1, T2, T3, and T4 (P≤0.001). The pressure on soft tissue was greater in the RME group at T2 and T3 (p>0.001). After four months (T5), the levels of pain and discomfort decreased to their lowest levels, as well as the difficulties of chewing and swallowing, and the pressure on soft tissue were almost non-existent in both groups.ConclusionPatients treated with the removable slow maxillary expander reported lower levels of pain and discomfort, fewer chewing and swallowing difficulties, and less pressure on soft tissues than those treated with the bonded rapid maxillary expander. These difficulties gradually decreased over time in both groups. The lower levels of pain and discomfort may make the SME an effective and comfortable treatment alternative for adolescents with skeletal maxillary constriction.

Highlights

Skeletal maxillary constriction is a prevalent orthodontic malocclusion that can be seen at any age [1]
Chewing and swallowing difficulties were significantly greater in the rapid maxillary expansion (RME) group at T1, T2, T3, and T4 (P≤0.001)
After four months (T5), the levels of pain and discomfort decreased to their lowest levels, as well as the difficulties of chewing and swallowing, and the pressure on soft tissue were almost nonexistent in both groups

Summary

Introduction

Skeletal maxillary constriction is a prevalent orthodontic malocclusion that can be seen at any age [1]. The maxillary expansion is the most significant treatment choice for this skeletal problem in the upper jaw [2]. It depends on the ability to open the palatal suture at young ages [1,3]. There are numerous types of maxillary expansion in the mixed dentition and permanent dentition in terms of the applied force and the frequency of expansion activations: slow maxillary expansion (SME), rapid maxillary expansion (RME), and semi-rapid maxillary expansion (SRME) [1,2,4]. In adult patients when the ability to expand the maxilla through suture opening is almost absent, surgically assisted rapid maxillary expansion is used as an alternative option [5]. The latest studies have shown that the SME has been similar to the RME in its dentoalveolar effects and its effects on the midpalatal

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Discussion

Conclusion