Abstract
BackgroundThe aim of this randomised clinical trial was to assess the effect of early orthodontic treatment in contrast to normal growth effects for functional unilateral posterior crossbite in the late deciduous and early mixed dentition by means of three-dimensional digital model analysis.MethodsThis randomised clinical trial was assessed to analyse the orthodontic treatment effects for patients with functional unilateral posterior crossbite in the late deciduous and early mixed dentition using a two-step procedure: initial maxillary expansion followed by a U-bow activator therapy. In the treatment group 31 patients and in the control group 35 patients with a mean age of 7.3 years (SD 2.1) were monitored. The time between the initial assessment (T1) and the follow-up (T2) was one year. The orthodontic analysis was done by a three-dimensional digital model analysis. Using the ‘Digimodel’ software, the orthodontic measurements in the maxilla and mandible and for the midline deviation, the overjet and overbite were recorded.ResultsSignificant differences between the control and the therapy group at T2 were detected for the anterior, median and posterior transversal dimensions of the maxilla, the palatal depth, the palatal base arch length, the maxillary arch length and inclination, the midline deviation, the overjet and the overbite.ConclusionsOrthodontic treatment of a functional unilateral posterior crossbite with a bonded maxillary expansion device followed by U-bow activator therapy in the late deciduous and early mixed dentition is an effective therapeutic method, as evidenced by the results of this RCT. It leads to three-dimensional therapeutically induced maxillary growth effects. Dental occlusion is significantly improved, and the prognosis for normal craniofacial growth is enhanced.Trial registrationRegistration trial DRKS00003497 on DRKS
Highlights
The aim of this randomised clinical trial was to assess the effect of early orthodontic treatment in contrast to normal growth effects for functional unilateral posterior crossbite in the late deciduous and early mixed dentition by means of three-dimensional digital model analysis
The study protocol, the patient number, the examiner number and calibration for this randomised clinical trial was assessed prior to patient recruiting in close cooperation with the Center for Clinical Trials Münster (the Centre for Clinical Trials Münster is a joint institution of Unilateral posterior crossbite in the late deciduous or early mixed dentition Assessed for eligibility (n=82)
A very significant growth effect was detected for the intercanine distance and the anterior transversal width between T1 and T2
Summary
The aim of this randomised clinical trial was to assess the effect of early orthodontic treatment in contrast to normal growth effects for functional unilateral posterior crossbite in the late deciduous and early mixed dentition by means of three-dimensional digital model analysis. In children presenting with a functional unilateral posterior crossbite, the maxillary complex is often constricted [1,2,3] This abnormal morphological situation is aetiologically based on a multicausal genetic system [4] and influenced in craniofacial growth by different aetiological factors, such as impaired nasal breathing and muscular dysfunction [5,6,7], as well as prolonged sucking habits after the second year of life [8,9]. Young children with deciduous or early mixed dentition do not necessarily show signs and symptoms of craniomandibular dysfunction, as this can develop later in growth [22,23,24]. The evidence for treatment effects is in homogeneous due to variations in patient sample size, study protocols and the often-missing control group with the same initial diagnosis [25,26,27,28,29]
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