Periodontal evaluation after maxillary expansion with atooth-bone-borne expander in growing patients : Arandomized clinical trial.

Abstract

This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). Forty-two eligible patients (aged 11-14years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). Twenty-one patients (12girls and 9boys; mean initial age, 13.3years) were included in the TBB group and 21 (5girls and 16boys; mean initial age, 13.2years) were included in the TB group. The TB group exhibited adecrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed asignificant width reduction (0.7 mm; p < 0.001), accompanied by anotable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.