Predictors of long-term stability of maxillary dental arch dimensions in patients treated with a transpalatal arch followed by fixed appliances.

Gaetana Raucci,Fabrizia D’Apuzzo,Carlos Flores-Mir,Letizia Perillo,Camila Pachêco-Pereira,Vincenzo Grassia,Maryam Elyasi

doi:10.1186/s40510-015-0094-9

Gaetana Raucci, Fabrizia D’Apuzzo + Show 5 more

Open Access

https://doi.org/10.1186/s40510-015-0094-9

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Abstract

BackgroundThe aim of this retrospective study was to identify which dental and/or cephalometric variables were predictors of long-term maxillary dental arch stability in patients treated with a transpalatal arch (TPA) during the mixed dentition phase followed by full fixed appliances in the permanent dentition.MethodsThirty-six patients, treated with TPA followed up by full fixed appliances, were divided into stable and relapse groups based on the long-term presence or not of relapse. Intercuspid, interpremolar and intermolar widths, arch length and perimeter, crowding, and upper incisor proclination were evaluated before treatment (T0), post-TPA treatment (T1), post-fixed appliance treatment (T2), and a minimum of 3 years after full fixed appliances’ removal (T3). A binary logistic regression was performed thereafter to evaluate the impact of the dental arch and cephalometric measurements at T1 and the changes between T0 and T1 as predictive variables for relapse at T3.ResultsThe proposed model explained 42.7 % of the variance in treatment stability and correctly classified 72.2 % of the sample. Of the seven predictive variables, only upper anterior crowding (p = 0.029) was statistically significant. For every millimeter of decreased crowding at T1 (after TPA treatment/before starting the fixed orthodontic treatment), there was an increase of 3.57 times in the odds of having stability.ConclusionsThe best predictor of relapse was maxillary crowding before treatment. The odds of relapse increase by 3.6 times for every millimeter of crowding at baseline.

Highlights

The aim of this retrospective study was to identify which dental and/or cephalometric variables were predictors of long-term maxillary dental arch stability in patients treated with a transpalatal arch (TPA) during the mixed dentition phase followed by full fixed appliances in the permanent dentition
A treatment option in class I and class II malocclusions with mild to moderate crowding and concomitant molar rotations is the use of a transpalatal arch (TPA)
Differences for the measurements between groups at T0, T1, T2, and T3 can be found in the previous publication [10]

Summary

Introduction

The aim of this retrospective study was to identify which dental and/or cephalometric variables were predictors of long-term maxillary dental arch stability in patients treated with a transpalatal arch (TPA) during the mixed dentition phase followed by full fixed appliances in the permanent dentition. A few studies evaluated the long-term changes in upper arch after non-extraction treatment without a concomitant rapid palatal expansion process. Ciger et al [9] evaluated changes in dental arches in class II division 1 malocclusion patients after non-extraction treatment with cervical headgear and full fixed orthodontic appliances. They reported that the maxillary crowding decreased during treatment by 5.5 mm but increased (relapse) after the retention stage by 3 mm. Raucci et al [10] evaluated maxillary dental arch changes in classes I and II malocclusion patients treated with a TPA during the mixed dentition followed by full fixed appliances in the permanent dentition.

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