The impact of rapid maxillary expansion on maxillary first molar root morphology of cleft subjects

Abstract

The aim of this prospective cohort study was to determine the effects of rapid maxillary expansion (RME) on the first molar roots of cleft lip and palate subjects along different root development stages. Thirty participants with unilateral cleft lip and palate were divided into three groups (n=10), according to the type of expander used: Hyrax, iMini and Fan-type. A cone beam CT scan was performed before (T1) and 3months after stabilization of the appliance (T2). Measurements of root lengths of the first permanent maxillary molars were taken to evaluate root development and external apical root resorption (EARR). Roots presenting open apexes before treatment exhibited a statistically significant increase in root length after treatment (P<.001). Conversely, there were no significant changes in the root length of roots that had closed apexes at the beginning of treatment (P>.05). Furthermore, there were no differences among groups, or correlation between cleft side and gender was found vis-à-vis to changes in the root length (p>.05). Orthopaedic forces of RME were neither able to interrupt the root development process nor to cause EARR in cleft subjects. As the RME is the most common orthodontic procedure in patients with cleft lip and palate, understanding its impact on dental structures is of fundamental importance.