Abstract
Purpose The literature regarding the treatment of posterior crossbites using a transpalatal arch (TPA) is scarce. Moreover, there is only one clinical study on the correction of unilateral crossbites using torque activation. This is an important clinical issue; therefore, this study was conducted to show the effects of an active Goshgarian TPA in correcting nonfunctional single-tooth unilateral crossbite. Methods The present single-blind, randomized clinical trial examined 60 observations on 30 individuals with nonfunctional single-tooth unilateral crossbites in the first permanent molar area. Patients were randomly divided into two groups of “symmetric expansion” [control] and “expansion + torque activation” using Goshgarian TPAs [experimental]. The palatal arch was expanded at a rate of 2 mm/month, for 2–8 months. The average treatment durations were 157.9 and 117.1 days, respectively, for the control and experimental groups. Dentoskeletal alterations were assessed on dental records, posteroanterior frontal cephalographs, and occlusal radiographs taken before and after treatment. Changes induced by treatments in each group and differences between changes in both groups were analyzed statistically (α = 0.05). Results The treatment duration was significantly shorter in the experimental group (P < 0.05). The extent of dental displacement on the crossbite side was significant no matter what treatment was applied (P < 0.001); no between-group difference was detected (P > 0.05). Both treatments tilted the teeth in crossbite (P < 0.001) without any between-group difference (P > 0.05). The noncrossbite molar was displaced in the control group, whereas this did not occur in the experimental group (between-group P < 0.001). Conclusions The Goshgarian TPA can be used with torque activation in order to deliver a more effective and faster correction of nonfunctional single-tooth unilateral crossbites with more favorable clinical results.
Highlights
A transpalatal arch (TPA) is a common orthodontic space management appliance used during the mixed or permanent dentitions [1,2,3]
TPAs are clinically favorable because they distribute the force over most of the teeth and reduce the force exerted on a single tooth. is prevents tooth luxation and patient pain or discomfort compared with the process of rapid palatal expansion [22]. ere are differences in the treatment of unilateral functional and nonfunctional crossbites
E findings of the present study indicated that treatment using Goshgarian TPAs, which exerted buccal root torque on the normal side, led to faster and more effective corrections compared with symmetrical palatal expansion
Summary
A transpalatal arch (TPA) is a common orthodontic space management appliance used during the mixed or permanent dentitions [1,2,3]. Asymmetrical activation would lead to moments of different magnitude, causing different extents of tooth movement [2, 14] Because they can move the maxillary molars, TPAs may be used for the treatment of dental crossbites [9, 10]. E part of the double-ended wire on the crossbite side was cut off, so that the arm could rotate in the sheath [21] Afterward, this torque was optimized by measuring the vertical distance between the occlusal surface of the first molar in the other side of the dental arch and TPA and confirming this distance to be around 10 mm.
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